CARE HOMES FOR OLDER PEOPLE
Kingsley Nursing Home 4 Trafalgar Road Southport Merseyside PR8 2EA Lead Inspector
Mrs Claire Lee Unannounced Inspection 10:30 28 February 2006
th X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Kingsley Nursing Home Address 4 Trafalgar Road Southport Merseyside PR8 2EA 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) 01704 566386 Kingsley Nursing Homes Ltd Mrs Barbara Evans Care Home 25 Category(ies) of Old age, not falling within any other category registration, with number (25) of places Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social care Inspection. 26th July 2005 Date of last inspection Brief Description of the Service: Kingsley is a privately run home providing 25 places for older people who need nursing care. The registered provider/owner is Kingsley Nursing Homes Ltd. The premises are detached and comprise of 2 buildings over 4 floors. The home has 21 single bedrooms (4 with ensuite) and 2 double bedrooms both ensuite. The accommodation is on the ground, first and second floor and a passenger lift provides access to all areas. Residents have access to a call system with an alarm facility. Recreational space consists of a lounge and dining room overlooking the front. Bathrooms although domestic in style have aids to assist those who are less independent. The home has well established gardens to the front and rear and there is some car parking space. A ramp leads to the front door. Kingsley is situated in a residential area of Southport with easy access to local shops, the town centre and public transport. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was an unannounced inspection undertaken by on inspector over a day. The total duration of the inspection was 3 hours. CSCI inspects “core” standards over 2 inspections. The core standards not covered in this report were covered in the previous report undertaken on 26/06/05. The inspector undertook this inspection by reviewing on-site records such as resident’s finances, daily records, resident’s financial records, tour of the home and staff training and staff recruitment records. Other records reviewed were previous reports and CSCI records such as notifiable incidents and provider visit reports. Discussions were held with 7 residents, 2 relatives and 3 staff. The inspection was undertaken with the support of the manager. Full feedback was given to the manager at the end of the inspection. There were no requirements from the previous report, three requirements were made in this report. What the service does well: What has improved since the last inspection?
The home has continued to improve staff training since the last inspection the staff have had updated training in Health and Safety, moving and handling, fire safety and the Protection of Vulnerable Adults. Checks on staff prior to employment have also improved all staff now receive a Protection of Vulnerable Adults check prior to employment.
Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 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 Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 8 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 the following standard(s): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: It was noted that a care plan contained a good assessment for residents done prior to them moving into the home. Discussions with residents and relatives detailed that an assessments was undertaken and were seen as a positive experience. One resident said, “it was lovely to move in and know a friendly face”. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 9 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 the following standard(s): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Staff observed during the inspection demonstrated a genuinely kind caring and respectful attitude towards residents. All the residents spoken with spoke positively of the care that they received comments such as “really kind”, “busy, happy, caring staff” and “it’s very nice living here, the staff treat me very nicely and the matron is lovely”. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 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 the following standard(s): 14 Residents are encouraged and supported to have a daily routine of their choosing. EVIDENCE: Staff are able to detail residents choices such as what activities they like you do. Several residents like to spend their time in their bedrooms and others spend the day in the lounge. Residents spoken with discussed how staff help them make choices, this included aspects such as explaining the food available, what time to get up and what time to go to bed. One resident said “I pretty much do my own thing, staff know what I like and help me by making sure I can do it”. A relative spoken with said, “I’m welcomed to come all the time. I know when the staff are busy and when it suits mum and come at times to suit us all”. There are a number of routines in the home such as meal-times and drinks, residents spoken with were not aware that drinks and snacks where available at all times. The home should give some consideration to informing residents of all their available choices and the ways to influence the routine. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 11 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 the following standard(s): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Awareness of potential abuse training is available for staff and the home has recently received a copy of Sefton’s Social Services policy on reporting and dealing with any allegations of abuse. Discussion with senior staff detailed that they were not fully aware of how to manage a potential allegation and it was clear that this lack of knowledge may result in placing residents at further risk by inappropriately dealing with an allegation. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 12 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 the following standard(s): None of the standards in this area were fully reviewed at this inspection. EVIDENCE: Kingsley is homely in appearance. The manager is aware of the need to redecorate and redevelop some areas of the home and has plans to further develop the facilities in the home such as new kitchen facilities. Residents spoken with said the home was “lovely and clean”, “always tidy” and “decorated in a really nice way”. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 13 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 Staff have received a variety of training make sure that residents are in safe hands. Further development of National Vocational Qualifications (NVQ) a training course for care assistants and employment checks is needed. EVIDENCE: Staff inductions are available for all new staff. A training schedule is available that details a variety of training courses such as moving and handling, food hygiene, first aid and fire training. 5 staff have achieved an NVQ level 2 or above and further 4 staff have commenced this training. Once the staff currently undergoing NVQ’s have completed Kingsley will have just under half their staff with an NVQ in a care field. A relative spoken with said, “the staff are very good at their jobs, they really know what to do”. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 14 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 The registered manager continues to progress the quality of the service provided. Quality assurance scheme although commenced is in the early stages and in need of further development Resident’s financial interests are safeguarded. EVIDENCE: The manager is developing quality assurance. At present residents receive a questionnaire asking them their opinion of the care and the home. The manager has not received all of the questionnaires back from the residents, there are further plans to expand these to relatives. Once all of the information is received the manager will act on the comments available. The manager is registered with CSCI and is review management courses to further enhance her skills. There continues to be significant improvement in the quality of service since the manager was appointed. Residents, relatives
Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 15 and staff were confident about the manager’s abilities, comments included, “very helpful”, and “really made a difference” and “very approachable”. The home is not the legal appointee of any of the resident’s funds. They will hold funds at the request of the resident or their families and keeps clear accounts of any spending. Generally residents are billed for any money they spend such as hairdressing, papers etc and this is included in the residents bill for their accommodation and care. During the inspection it was noted that fire doors were inappropriately propped open and staff frequently used wheelchairs without lap straps and footrests. Both these areas place residents at potential risk of injury. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 16 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X X Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 17 No 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 OP18 Regulation 13 (6) Requirement Timescale for action 30/04/06 2. OP30 13 (4) (b) The manager must make sure that all senior staff are aware of how to deal with any potential allegations of abuse. Staff must be remained of their 30/04/06 roles and responsibilities regarding health and safety. In particular fire door arrangements and the safe usage of moving and handling equipment such as wheelchairs. 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 OP14 OP15 OP19 Good Practice Recommendations For residents to be made aware of the variety of choices that are available in the home such as drinks, bathing arrangements, meals and meal times To include the choice of meal at lunch time on the menu and to purchase new serving trays for residents meals To continue with a programme of redecoration and refurbishment. To mend the broken dressing table
DS0000044817.V280742.R01.S.doc Version 5.1 Page 18 Kingsley Nursing Home 4. 5. OP27 OP33 Faxed references to be followed up with the original reference Resident’s questionnaires to be utilised in developing the quality of the service and to further expand the quality assurance commenced. Kingsley Nursing Home DS0000044817.V280742.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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