Inspection on 19/09/07 for Kingsley House

This inspection was carried out on 19th September 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingsley House 17/01/07

Kingsley House 13/02/06

Kingsley House 10/11/05

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 MIXED CATEGORY MAJORITY ADULTS 18-65 Kingsley House 16 Dudley Road New Brighton Wallasey Wirral CH45 9JP Lead Inspector Debbie Corcoran Key Unannounced Inspection 19th September 2007 11:00 Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 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.V346197.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 and 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.V346197.R01.S.doc Version 5.2 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) kingsleyr@btconnect.com 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.V346197.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Only twelve (12) adults (aged 18 - 64 years) may be accommodated. Only four (4) named older persons (aged 65 years and over) may be accommodated. 17th January 2007 Date of last inspection Brief Description of the Service: Kingsley House is a three storey, Victorian house, offering care and accommodation to 16 people with mental health needs. 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. Two communal lounges are available on the ground floor. 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 staircase. A passenger lift is not available in this home. The range of fees for living at Kingsley House are between £339.35 and £434.70 per week. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was not announced beforehand. During the visit the majority of the residents were met and a number of residents were spoken with on a one to one basis. The home manager and a member of the staff team were also spoken with. A sample of resident’s records were looked at. Other records looked at included staff files, staff training records and health and safety records. A tour of the home was carried out which included all areas. The manager returned a quality assurance assessment on the service to the Commission prior to the visit and some of the information contained in this has been used to inform the findings of the inspection. What the service does well: The home feels welcoming, homely and relaxed. The residents were positive about all aspects of the home and they confirmed that they are contributing to decision making in the home and are making choices with regard to their daily routines. Residents meetings are reported to take place on a regular basis and residents are also given further opportunities to comment on the home through questionnaires and a suggestions box. Residents are well supported with their health care and staff call upon relevant health professionals to support the residents. Staff have been provided with some good training opportunities and further training is planned for the future. 60 of the care staff team have a relevant qualification. The turnover of staff is low and therefore many of the staff have been supporting the residents for a long period of time and have had the opportunity to build relationships with them and to know their needs well. Staff support the residents with developing their personal and independent living skills and with using the local community. Health and safety procedures are in place so as to ensure the home environment is safe to residents, staff and visitors. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 6 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 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 House DS0000018906.V346197.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home Individual Needs and Choices Lifestyle Personal and Healthcare Support Concerns, Complaints and Protection Environment Staffing Conduct of Management of the Home Scoring of Outcomes Statutory Requirements Identified During the Inspection Adults 18 – 65 (Standards 1–5) (Standards 6-10) (Standards 11–17) (Standards 18-21) (Standards 22–23) (Standards 24–30) (Standards 31–36) (Standards 37-43) Older People (Standards 1–5) (Standards 7, 14, 33 & 37) (Standards 10, 12, 13 & 15) (Standards 8-11) (Standards 16-18 & 35) (Standards 19-26) (Standards 27-30 & 36) (Standards 31-34, 37 & 38) Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 (Adults 18 – 65) and Standards 1 – 5 (Older People) are: 1. 2. 3. Prospective service users have the information they need to make an informed choice about where to live. (OP NMS 1) Prospective users’ individual aspirations and needs are assessed. No service user moves into the home without having been assured that these will be met. (OP NMS 3) Prospective service users’ know that the home that they choose will meet their needs and aspirations. Service Users and their representatives know that the home they enter will meet their needs. (OP NMS 4) Prospective service users’ have an opportunity to visit and “test drive” the home. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. (OP NMS 5) Each service user has an individual written contract or statement of terms and conditions with the home. Each service user has a written contract/statement of terms and conditions with the home. (OP NMS 2) 4. 5. The Commission considers Standard 2 (Adults 18-65) and Standards 3 and 6 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 (Adults 18 –65) 3, 6 (Older People) Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Systems are in place for ensuring the needs of prospective residents are assessed before they move to the home. EVIDENCE: There have been no new residents to the home for almost two years and therefore the current assessment and referrals processes used at the home could not be practically assessed. The manager has reported that she attains information on the needs of a prospective resident from the relevant Social Services department and that she carries out a risk assessment prior to admitting a resident to the home and will only admit a person whose needs can be appropriately met. The home provides long term care only and does not provide intermediate care. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6-10 (Adults 18-65) and Standards 7, 14, 33 & 37 (Older People) are: 6. Service users know their assessed and changing needs and personal goals are reflected in their Individual Plan. The Service Users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users make decisions about their lives with assistance as needed. Service Users are helped to exercise choice and control over their lives. (OP NMS 14) Service users are consulted on, and participate in, all aspects of life at the home. The home is run in the best interests of service users. (OP NMS 33) Service users are supported to take risks as part of an independent lifestyle. The service users health, personal and social care needs are set out in an individual plan of care. (OP NMS 7) Service users know that the information about them is handled appropriately and that their confidences are kept. Service Users rights and best interests are safeguarded by the home’s record keeping, policies and procedures. (OP NMS 37) 7. 8. 9. 10. The Commission considers Standards 6, 7 and 9 (Adults 18-65) and Standards 7, 14 and 33 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 (Adults 18-65) 7, 14, 33 (Older People) Quality in this outcome are is adequate. This judgement has been made using available evidence including a visit to this service. Resident’s care plans do not provide sufficient detail as to the support they need with aspects of their health and psychological needs. Residents are encouraged and supported to make their own decisions and to take risks as part of an independent lifestyle. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 10 EVIDENCE: Care plans for two of the residents were checked. Since the last inspection visit a new system of care planning has been introduced. The new system of care planning includes core care plans covering issues such as the resident’s personal care needs, social and relationships needs, and behavioural needs. The core care plans are very process based and do not describe the needs of the individual residents and are more of a guide for staff practice as opposed to individualised guidelines. Additional information was found to have been added to some of these and where this was the case the information was found to be more relevant to the needs of the individual resident. In addition to the core care plans the manager has introduced care plans based on an essential lifestyle plan. These include information such as what is required to support the person successfully and what is important to the person and the persons’ likes and dislikes. These were found to include some useful and relevant information for some of the residents but were found to be in the development stage for other residents. Even though there are two systems of care planning running together there were examples noted whereby the care plans fail to identify the physical health needs of the residents and the psychological health needs of the residents. For example one resident requires support with a specific health condition but this was not reflected in their care plan. Other residents require specific support with their mental health needs and this information was not included in their care plans. The details of these examples were discussed with the manager during the visit. The manager and a member of staff were able to demonstrate that they are aware of the needs of the residents and how these need to be met but this information is not being documented in the resident’s care plans. The manager must ensure that there is a clear and auditable link between identifying a resident’s needs and ensuring an appropriate care plan is in place which meets the identified needs. Residents, and as appropriate their representatives, should be included in the development of their care plan and should be encouraged to contribute to the plan and to read and sign the plan as confirmation of this and as appropriate to the resident’s individual needs. A number of staff have worked at the home for a significant period of time and as a result staff appear to know the needs of the residents well and they have had the opportunity to build good relationships with the residents and this is very positive. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 11 As at the last inspection residents were very positive about their support and appeared confident that staff were meeting their needs and providing good care and support. Residents who were spoken with said that they are making their own decisions as to their daily support and their routines within the home. Residents are supported to manage their own matters when possible. For example to manage their own post, money or medication. The provider has reported through a quality assurance assessment that quarterly residents meetings take place and these provide residents with the opportunity to discuss the running of the home with staff on a more formal basis. Residents are supported to take risks as part of an independent lifestyle. Risk assessments are carried out where a resident is felt to be at risk. The risk assessments viewed for the resident’s whose care plans were looked at included minimal information and there was no indication that they had been reviewed for a number of years. The manager has started to complete new risk assessments for a number of residents. One of these was viewed and found to include a lot of information. The manager should ensure that risk assessments are completed with regards to the support provided to each resident and that these are up to date, reviewed on a regular basis are readily available to staff to read and be familiar with. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 (Adults 18-65) and Standards 10, 12, 13 & 15 (Older People) are: 11. Service users have opportunities for personal development. 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. (OP NMS 12) Service users are able to take part in age, peer and culturally appropriate activities. 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. (OP NMS 12) Service users are part of the local community. Service users maintain contact with family/ friends/ representatives and the local community as they wish. (OP NMS 13) Service users engage in appropriate leisure activities. 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. (OP NMS 12) Service users have appropriate personal, family and sexual relationships and maintain contact with family/friends/representatives and the local community as they wish. (OP NMS 13) Service users’ rights are respected and responsibilities recognised in their daily lives. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users are offered a (wholesome appealing balanced) healthy diet and enjoy their meals and mealtimes. Service users receive a wholesome appeaing balanced diet in pleasing surroundings at times convenient to them. (OP NMS 15) 12. 13. 14. 15. 16. 17. The Commission considers Standards 12, 13, 15, 16 and 17 (Adults 1865) and Standards 10, 12, 13 and 15 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12,13,14,15,16,17 (Adults 18-65) 10,12, 13, 15 (Older People) Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 13 Residents are supported to develop their independent living skills, to develop and maintain relationships and to be involved in local community activities. Residents are provided with a varied diet of home cooked food. EVIDENCE: Residents gave good feedback on their support with pursuing leisure and social activities. There are some regular routines at the home and on the day of the visit the home owner accompanied a group of residents to a local pub. A number of residents are supported by staff to go swimming and to attend a gym. Residents are going out and using community resources independently when they are able to and with support from staff when needed. A number of residents said that they were looking forward to a forthcoming weekend away. Residents are encouraged to make choices about the running of the home and their care. Residents confirmed that they are making choices and they gave examples such as choosing when to get up, when to go to bed, their meals, their daily routine, how to spend their day and this will include going outside of the home on their own if they have the skills to be able to do this independently. Residents reported that staff respect these choices. Many of the residents are well able to express their needs and preferences and contribute to changes at the home. Residents have the opportunity to attend a residents meeting on a regular basis and are given the opportunity to complete surveys to give feedback on the home. These surveys had recently been distributed and returned and the feedback from residents was good. The surveys included questions such as whether or not people are satisfied with the quality of care provided, are being involved in decision making, and whether or not their privacy, dignity and choice are respected. Residents are encouraged to use and develop their independent living skills and one of the residents described being supported to learn new skills in an aim to move to more independent living in the future. Residents are supported to manage their own affairs when possible. Visitors are welcome in the home at all reasonable times. Resident’s families are welcome to attend parties at the home. In order to assess the meals and food provided the menus were checked, the kitchen was checked and a number of the residents were asked to comment on the food. All feedback on the food and meals was positive and one of the residents said that they have a choice for their meals and particularly enjoy a cooked breakfast on Saturdays and their Sunday lunch. Menus were looked at and appeared varied and appetising. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 – 21 (Adults 18-65) and Standards 8 – 11 (Older People) are: 18. 19. 20. Service users receive personal support in the way they prefer and require. Service users feel they are treated with respect and their right to privacy is upheld. (OP NMS 10) Service users’ physical and emotional health needs are met. Service users’ health care needs are fully met. (OP NMS 8) 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. Service users, where appropriate, are responsible for their own medication and are protected by the home’s policies and procedures for dealing with medicines. (OP NMS 9) The ageing, illness and death of a service user are handled with respect and as the individual would wish. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. (OP NMS 11) 21. The Commission considers Standards 18, 19 and 20 (Adults 18-65) and Standards 8, 9 and 10 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 (Adults 18-65) 8, 9, 10 (Older People) Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents are well supported with their health, physical care needs and emotional care needs although this is not always reflected in their care plans. Medication is well managed on the whole but there are some areas for improvement. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 15 EVIDENCE: Residents gave good feedback on staff and how staff support them. When asked if staff were respectful of their privacy residents said that they were. The manager has introduced a new system for recording when a resident has been supported to attend health appointments and these showed that residents are supported to visit a General Practitioner, District Nurse, Community Nurse or Psychiatrist when required and are supported to visit other health professionals such as a dentist, optician etc on a regular basis. This information is well documented. Resident’s care plans did not include a great level of information on their physical, emotional and health needs. The manager must ensure that each of the residents has a comprehensive care plan which describes the resident needs in sufficient detail and details how these are to be met. This must include the residents needs with their physical health, mental health and emotional well being. Medication storage and administration records were checked for two of the residents. These showed that medication appears to be appropriately managed on the whole but that there are a number of areas of practice which need to be addressed. These are to ensure that medication administration records are accurately maintained at all times and when a medication is discontinued then this must be appropriately recorded on the medication administration records. Information on the administration of ‘as required’ medication should be recorded so as to guide staff appropriately on the use of this medication. Controlled drugs must be entered in the appropriate register when received in to the home. The manager reported that she carries out medication audits. The quality of this audit needs to be reviewed so as to ensure that problems with medication are identified and rectified more effectively. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22-23 (Adults 18-65) and Standards 16-18 & 35 (Older People) are: 22. 23. Service users feel their views are listened to and acted on. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted on. (OP NMS 16) Service users’ are protected from abuse, neglect and self-harm. Service users legal rights are protected. (OP NMS 17) Also Service users are protected from abuse. (OP NMS 18) Also Service users financial interests are safeguarded. (OP NMS 35) The Commission considers Standards 22-23 (Adults 18-65) and Standards 16-18 and 35 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 (Adults 18-65) 16, 18, 35 (Older People) Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Policies, procedures and practices are in place for dealing with complaints and for aiming to protect service users against abuse or neglect and systems are in place for dealing with allegations of abuse. EVIDENCE: The home has a complaints procedure which is time scaled appropriately and includes contact details for the Commission. The manager has reported that residents have been provided with a ‘service user guide’ and these include details for making a complaint. A copy of the complaints procedure is available to residents on the resident’s notice board. Residents spoken with about complaints said that if they weren’t happy about something then they would tell the manager. There have been no complaints made to the home since the last inspection. A suggestions box has been placed in the main hallway so that residents can comment on the service or contribute to improving the service. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 17 The home has an Adult protection procedure. This procedure provides information on adult protection and responsibilities for contacting relevant authorities. Care staff have been provided with training in adult protection. A record of key events is maintained for example accident reports. These were checked and found to be maintained appropriately and there were no areas of concern identified. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 (Adults 18-65) and Standards 19-26 (Older People) are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users live in a safe, well-maintained environment (OP NMS 19) Also Service users live in safe, comfortable surroundings. (OP NMS 25) Service users’ bedrooms suit their needs and lifestyles. Service users own rooms suit their needs. (OP NMS 23) Service users’ bedrooms promote their independence. Service users live in safe, comfortable bedrooms with their own possessions around them. (OP NMS 24) Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Service users have sufficient and suitable lavatories and washing facilities. (OP NMS 21) Shared spaces complement and supplement service users’ individual rooms. Service users have access to safe and comfortable indoor and outdoor communal facilities. (OP NMS 20) Service users have the specialist equipment they require to maximise their independence. Service users have the specialist equipment they require to maximise their independence. (OP NMS 22) The home is clean and hygienic. The home is clean, pleasant and hygienic. (OP NMS 26) The Commission considers Standards 24 and 30 (Adults 18-65) and Standards 19 and 26 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26, 28, 30 (Adults 18-65) 19, 20, 24, 26 (Older People) Quality in this outcome are is adequate. This judgement has been made using available evidence including a visit to this service. The home is safe and generally presented to an appropriate standard although there is room for improvement in a number of areas. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 19 EVIDENCE: A tour of the premises was carried out which included all areas. The home feels welcoming and homely. The accommodation provides 8 single occupancy bedrooms and 4 shared bedrooms. Resident’s bedrooms were personalised with some of their belongings and each room is fitted with a lock so as to ensure resident’s privacy. When asked about their rooms residents said that they were happy with them. There are two communal lounges and the dinning area is in a conservatory extension. The main lounge has been redecorated and refurbished since the last inspection visit. The hallway and stairs have also been redecorated. The environment is generally appropriately maintained, however a tour of the home revealed that a number of areas requiring attention; • • • • • The carpet in the conservatory is dirty and needs to be replaced. Carpeting in some of the communal areas such as hall, stairs and corridors needs to be cleaned. One of the resident’s rooms was malodorous and this needs to be addressed. Both the inside and the exterior of the home should be cleared of unused items / clutter It is recommended that a dish washer is provided The home has health and safety practices and procedures which are aimed at ensuring the home is safe and clean and free from hazards to the health and safety of residents and staff. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 (Adults 18-65) and Standards 27 – 30 & 36 (Older People) are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users are supported by competent and qualified staff. Service users are in safe hands at all times. (OP NMS 28) Service users are supported by an effective staff team. Service users needs are met by the numbers and skill mix of staff. (OP NMS 27) Service users are supported and protected by the home’s recruitment policy and practices. Service users are supported and protected by the home’s recruitment policy and practices. (OP NMS 29) Service users’ individual and joint needs are met by appropriately trained staff. Staff are trained and competent to do their jobs. (OP NMS 30) Service users benefit from well supported and supervised staff. Staff are appropriately supervised. (OP NMS 36) The Commission considers Standards 32, 34 and 35 (Adults 18-65) and Standards 27, 28, 29 and 30 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 34, 35, 36 (Adults 18-65) 27, 28, 29, 30, 36 (Older People) Quality in this outcome are is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by qualified and trained staff. Staff numbers are appropriate to ensure that the resident’s needs are being met effectively. Staff recruitment and selection practices are thorough and aim to protect residents. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 21 EVIDENCE: Staff training records show that staff are trained in topics such as first aid, fire safety, adult protection, food hygiene and infection control. The manager reported that more specialised training on mental health issues has been provided to staff in the past. Overall the level of staff training appears to be quite good. The care staff team consists of 15 staff and of these 8 have a National Vocational Qualification (N.V.Q) level 2 in care. This means that over 60 of the care staff team have attained a relevant qualification and the home has exceeded the target for the workforce to be qualified to this level. In addition to this 3 members of staff are working towards attaining a relevant qualification. Residents gave positive feedback about the staff including “they’re all very good here” and “nothing is too much trouble for them”. During discussion with a member of the staff team they reported feeling well supported by the manager and they referred to good team work. The member of staff was able to give a clear account of the needs of residents when asked specific questions about their care and support. Staff turnover is low and therefore many of the staff have been supporting the residents for a significant period of time and have had the opportunity to get to know the residents well. Three new members of staff have commenced employment since the last inspection. The records relating to the recruitment and selection of these member of staff were checked. These showed that all relevant pre employment checks had been carried out before they started working at the home. These practices are aimed to safeguard the welfare of the residents. It was reported by the manager and a member of staff that staff meetings occur on a regular basis. These aim to provide staff with a regular forum to discuss issues that may effect the service provided to the residents and the implementation of polices, procedures and practices within the home. Since the last inspection there has been no progress in ensuring that staff are provided with one to one supervision meetings. Supervision should provide an opportunity for staff to reflect on their practice, explore new ways of working and discuss their development. This in turn should benefit residents. A repeated requirement has been given to ensure that staff are provided with regular and recorded supervision. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 (Adults 18-65) and Standards 31-34, 37 & 38 (Older People) are: 37. Service users benefit from a well run home. 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. (OP NMS 31) Service users benefit from the ethos, leadership and management approach of the home. Service users benefit from the ethos, leadership and management approach of the home. (OP NMS 32) Service users are confident their views underpin all self-monitoring, review and development by the home. The home is run in the best interests of service users. (OP NMS 33) 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 homes record keeping, policies and procedures. (OP NMS 37) Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. Service users rights and best interests are safeguarded by the homes record keeping policies and procedures. (OP NMS 37) The health, safety and welfare of service users are promoted and protected. The health, safety and welfare of service users and staff are promoted and protected. (OP NMS 38) Service users benefit from competent and accountable management of the service. Service users are safeguarded by the accounting and financial procedures of the home. (OP NMS 34) 38. 39. 40. 41. 42. 43. The Commission considers Standards 37, 39 and 42 (Adults 18-65) and Standards 31, 33, 35 and 38 (Older People) the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 (Adults 18-65) 31, 33, 38 (Older People) 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 in the best interests of the residents. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 23 Procedures, practices and checks are in place which aim to safeguard and protect the health and safety and well being of residents and staff. EVIDENCE: The manager has been managing the home for approximately 5 years. As at the last inspection residents gave good feedback on the manager. The home appears to be well run and there have been some improvements to the home since the last inspection visit. There does however continue to be areas for improvement particularly in relation to care planning and risk assessment. Along with residents contributing to daily decision making in the home residents are also invited to comment on the home through residents meetings and through completing surveys on the home on annual basis. A recent survey had been distributed to residents and returned and the feedback in these was positive in relation to all areas covered in the survey. Residents manage their own money when appropriate. Where a resident needs support with managing their money then a record of all money they give in and take out is kept and receipts are kept for purchases whenever possible. At the previous inspection a random sample of residents monies were checked and found to be well documented. The records for this were not looked at on this occasion. The provider has assessed that there have been no changes to the system. Fire safety and health and safety practices are adopted. Those records of fire and health and safety checks which were looked at were found to be up to date with the exception of water safety checks. The hot water supply is thermostatically controlled. However the manager was advised that water temperatures still need to be checked and recorded on a regular basis. This was made a requirement following the last inspection but has not been met and has therefore been given again. The manager must demonstrate a system for ensuring water safety practices are adopted. The manager should ensure that risk assessments are carried out for all safe working practice topics. Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 24 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. 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 Standard No Score 1 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 2 CONDUCT AND MANAGEMENT Standard No Score 37 3 38 X 39 3 40 X 41 X 42 2 43 x 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingsley House Score 3 3 2 X DS0000018906.V346197.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes 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 YA6 Regulation 15 Requirement Each resident must have a care plan which accurately reflects their needs for all aspects of their personal and health care. Timescale for action 19/11/07 2. YA9 13 (4) (c ) Risk assessments must be appropriately detailed, reviewed and updated so as to demonstrate that the welfare of resident is being safeguarded. 13 (2) Medication administration records must be accurately maintained at all times so as to safeguard the well being of the residents. Redecoration, refurbishment and maintenance work as identified in the report must be completed. 19/11/07 3. YA20 19/10/07 4. YA24 23 19/12/07 5. YA43 13 (4) ( c) Water safety and temperatures checks must be made and recorded on a regular basis. 19/10/07 Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 26 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 YA20 Good Practice Recommendations The way in which medication audits are carried out should be reviewed to ensure the audit is thorough and identifies issues promptly. Staff must be provided with regular and recorded supervision. A risk assessment should be carried out for safe working practices. 2. 3. YA36 YA42 Kingsley House DS0000018906.V346197.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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 © 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.V346197.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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