Inspection on 01/05/07 for Kingsmead Lodge

This inspection was carried out on 1st May 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingsmead Lodge 02/02/09

Kingsmead Lodge 17/01/08

Kingsmead Lodge 18/05/06

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingsmead Lodge West Town Road Shirehampton Bristol BS11 9NJ Lead Inspector Wendy Kirby Key Unannounced Inspection 09:30 1st & 2nd May 2007 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 Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsmead Lodge Address West Town Road Shirehampton Bristol BS11 9NJ 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) 0117 982 3299 0117 982 4515 kingsmead@mimosahealthcare.com None Mimosa Healthcare (No4) Limited Fran Haskins Care Home 81 Category(ies) of Dementia - over 65 years of age (37), Old age, registration, with number not falling within any other category (44) of places Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. May accommodate up to 44 persons requiring nursing care on the first floor (Nightingale Unit) May accommodate up to 37 persons with Dementia, requiring nursing care, on the ground floor (Kingfisher Unit) One named resident under 65 years at the time of registration may remain in the home while their needs continue to be met. Registration will revert to persons over 65 years when that person ceases to be accommodated The person responsible to the registered manager, in charge of the Kingfisher Unit, must have qualifications and experience relevant to the service user group The Registered Manager must be a RN1 or RNA on the NMC register May accommodate up to 5 persons aged between 50 to 65 years of age with a physical disability requiring nursing care, in the Nightingale Unit. May accommodate one named person aged 49 years who requires nursing care in the Nightingale Unit. 18th May 2006 4. 5. 6. 7. Date of last inspection Brief Description of the Service: Kingsmead Lodge is a purpose built home that is currently registered to provide general nursing care for older people, and personal care to people with dementia. The home has 81 places, of which 67 are in single rooms. These rooms all have en suite facilities. The home also has seven shared rooms, of which two have en suite facilities. The home is a two-storey building with lift access to the upper floor. The home has 44 beds on the first floor (Nightingale Unit) for persons requiring nursing care and 37 beds for persons with dementia on the ground floor (Kingfisher Unit). To the rear of the property there are private gardens and a patio area. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 5 The home is located a short distance from Shirehampton village, where there is a range of local shops and amenities. The bus route into Bristol passes through Shirehampton, making the home accessible from the city centre. The M5 and M4 motorways are within easy reach. The cost per week to reside at Kingsmead is between £336.00 and £578.00. Fees are reviewed annually and if care needs increase. This weekly fee does not include provision for items such as hairdressing, chiropody, dental, ophthalmic, or audiology services. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit as part of a key inspection carried out over two days. The inspector sent surveys “Have your say” to residents, visitors and health/social care professionals prior to the inspection and thirty were completed and returned. Information received from the surveys is detailed throughout the report. Results from the homes annual quality assurance surveys were also looked at and details of the survey are detailed throughout the report. The inspector spent time throughout the visit talking to residents, the manager and staff; a number of records and files were looked at, including care records, staff training records, the complaints log and medication records. The inspector toured the premises accompanied by the manager. Feedback was given on the outcome of the inspection. What the service does well: What has improved since the last inspection? Care plans have improved since the last inspection, particularly on the Kingfisher Unit. Each resident had a comprehensive portfolio and person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 7 Following previous requirements residents are now protected by the home’s safe systems of practice in receiving, storing, administering, and disposing of drugs. People who use the service are able to express their concerns. Complaints or concerns are documented, dealt with effectively and outcomes are recorded. Since the last inspection new carpets have been provided on the ground floor dementia care unit (Kingfisher unit) throughout the corridors and lounges. Several lounges and bedrooms in the home have been redecorated. Improvements in the induction of new staff, and the availability of purposeful training, will ensure that staff are skilled and competent to care for the residents. 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. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 8 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 Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents receive information from the home so that they can decide if this is the home they wish to live in. Residents are provided with a statement of terms and conditions/contract giving basic information on what people who live in the home can expect to receive. Prospective residents needs are assessed prior to admission to determine the suitability of placement. They can be confident that staff will have the resources and skills to meet their assessed needs. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 10 EVIDENCE: The homes Statement of Purpose contains all the information necessary for a prospective resident and/or their representative to make an informed decision about moving to the home. Each resident is given a ‘Welcome Pack’ or service users guide. This gives details of the services and facilities they can expect to receive in the home and clearly sets out the objectives and philosophy of the home. Fourteen residents surveys stated that they had not received a contract. On inspection it was evident that there were various reasons for this response. Some residents had been at the home for a long time and had forgotten that they had been given a contract on admission, other residents had had such affairs dealt with by family members and so were unaware that a contract had been issued. The manager also stated that there was a large majority of residents who were funded by social services and that a financial contract agreement was drawn up by social services with the providers. It was discussed that residents who are funded by social services should also receive the contract/terms and conditions of the home and the inspector has received evidence since the inspection that these are now in place. During the last year the manager and staff have been developing the quality and detail obtained in the pre-admission assessments in order to further ensure that the home can meet the needs of prospective residents. The assessments were comprehensive covering activities of daily living, a full health screen and personal history background. The information gathered preadmission should provide a sound benchmark of the resident’s ability and state of health prior to admission. The prospective resident, family and carers are involved in the pre-admission assessment and all information is used to determine the suitability of the placement. Where possible the manager also obtains comprehensive assessments and care plans from other professionals involved for example, social workers and hospital staff. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Because they are consulted about their health and personal care needs residents can be sure their views and expectations will be considered. The health and personal care that residents receive is based on individual needs. Safe systems of practice in receiving, storing, administering, and disposing of drugs protect residents. Residents can be confident that staff have a good awareness of their needs and that they will be treated with dignity and respect. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 12 EVIDENCE: From the pre admission assessments the staff start to develop a set of care plans based on identified needs. During the first months trial period the residents’ plans are reviewed weekly and developed accordingly. Residents’ care files were examined on both Kingfisher and Nightingale, which included care plans, risk assessments, daily record accounts and visits and outcomes from community professionals such as General Practitioners. Care plans have improved since the last inspection, particularly on the Kingfisher Unit. Each resident had a comprehensive portfolio and person centred assessments, which means that staff put the views, wishes, likes and dislikes of each resident at the centre of all care provided. The care plans on the Kingfisher unit contained detailed instructions to staff on how to meet the needs of the residents and were person centred. They also gave clear guidelines to staff on how certain needs may present themselves and how these are best managed. A good example of this was where one residents plan gave a clear detailed account on how they react when having a panic attack, what can cause the attack and what works best for the resident to manage the attack and relieve the residents anxiety. On the Nightingale unit some of the care plans were quite good, however details were sparse and were not so person centred. Care plans written terminology tended to be the same for each resident and when a need had been identified such as depression there were no clear guidelines on how staff would recognise that the resident was depressed or indeed what symptoms to look for leading up to a possible bout of depression. The care plan did not give clear care instructions on what best works for the resident to care for the depression. The manager and unit managers are concentrating their efforts on the residents care files on Nightingale to ensure that they are of the same standard of those on Kingfisher Unit. They have also commenced random monthly audits on the care files. Following each audit written feedback is given to the staff member responsible for those care files and any action required is requested. The staff member must provide proof that the actions have been completed and these are signed of by the management team. The manager is also giving staff support in care plan writing through training sessions. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 13 Relatives were asked in their surveys “Are you kept up to date with important issues?” and “Does the home give the care/support that is agreed and expected?” The feedback was positive and comments included, “Kingsmead always ring and tell us if our relative has been unwell of if the doctor has been asked to visit”, “The care home more than meets our expectations” and “They pay attention to detail for example glasses and hearing aids are always clean and in place”. Health Care needs were well evidenced in the care files and included, wound care charts and photographs, nutritional, and pressure area risk assessments. All information had been regularly reviewed. Records of the General Practitioner visits/contact with residents and the outcomes are also available. Specialist referrals and visits from other professionals were evidenced in care files including Community Chiropodists, Opticians and Dentists. Residents and relatives’ surveys stated that they always felt that they received the medical support they needed. Comments included, “They are prompt to call out the GP” and “Medical needs are always spotted and seen to”. Five health/social care professional surveys were returned, in general comments were positive and helpful and overall they stated that the service provided had improved greatly over the last 2-4 years. Some felt that communication between staff was not always effective and that sometimes there was “a need to check that instructions had been carried out”. On occasions it was felt that there were inappropriate referrals to the GP form Nightingale Unit and at other times important things may have been missed. The home has had good support from the Community Matron to address these issues and it was thought that this had made things much better. Other comments received included, “They have engaged with training from one of the GP’S and should continue to with relevant training”, “They treat visitors and clients with respect” and “Caring staff provide good physical care to the clients”. In June 2006 the Pharmacist inspector conducted an unannounced visit and requirements were made about excess stock levels of medication, disposing of out of date medication, and areas around administration records. Policies and procedures for receiving, storing, administering and disposing of medications were examined and discussed with the manager and the previous requirements made were looked at; all systems in place are effective and well managed. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 14 Revised procedures are now in place to monitor stock levels on a monthly basis and return any unwanted items to pharmacy. Pharmacy Plus who supply medication to the home have supported the staff in putting new systems in place and also conduct regular audits. The manager performs a daily random audit of the administration charts and staff practice has improved. The administration charts were legible and continuity of administration was shown with a signature from the person dispensing. The home promotes privacy and dignity to all people who use the service. Staff receive training on “Promoting Privacy and Dignity” on induction, which covers issues like closing doors and pulling curtains when delivering personal care and knocking on residents doors and waiting for an invitation to enter before going into their rooms. Staff were seen knocking on residents doors before entering confirming respect for the residents individual privacy and dignity at all times. Members of staff spoke respectfully about residents needs and referred to them in the term of address that they preferred, this information was evidenced in the residents care files. Comments from all surveys received stated, “The staff are always attentive and pay attention to detail and individual needs”, “You have treated my relative with dignity and love, well beyond the call of duty” and “The atmosphere is calm and relaxed and residents are treated with respect”. The homes annual quality assurance survey for 2007, asks residents, “Do staff treat you kindly and with respect?” 92 of the residents said yes they did. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a varied activities programme, which is both enjoyable, stimulating and meets individual preferences and expectations. Encouragement and support from staff enables residents to maintain good contact with family and friends. The home actively promotes residents to exercise choice and control over the lives they choose to live by developing comprehensive daily routines and personal preferences. Residents receive a varied and wholesome diet that they are able to influence. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 16 EVIDENCE: There does not appear to be any unnecessary rules in the home and it was evident that the homes philosophy centralises on empowering residents and encourages residents to maintain independence, autonomy and choice. Relatives’ surveys agreed that the service supports people to live the life they choose and one relative said, “Staff seem well appointed with my relative as a person”. Residents’ daily routines are flexible within the home, residents can get up and go to bed when they like, having their meals in their bedrooms, they can go out when they wish and participate in activities they have a particular interest in. This was confirmed through documentation in residents care files and in discussion and through observation during the inspection. Time was spent talking to the activities coordinator who has worked in the home a long time. Each day she divides her day between the two units to provide daily activities, including singing, games, quizzes, exercise classes, sweet making and arts and crafts. Special events are organised throughout the year and are well attended and supported by residents, visitors to the home and staff. Photographic displays were seen around the home of this years Easter party which raised £600 for the residents fund. The photographic display of memorable days and events is regularly updated and provides memories and topics of conversation for residents where they are able to reminisce. Short trips to local parks and shops are organised regularly and day trips to places such as Clevedon, Potishead, Bristol Zoo and Slimbridge are planned annually. Some residents choose not to participate in all the activities provided and the activities coordinator makes sure that she visits all residents daily to say hello. One to one sessions are also arranged for residents who do not leave their rooms. Lounges in the home provide good entertainment systems, including televisions, video and DVD players, and musical systems. A new computer has been purchased for the residents where they can access the Internet; training is currently being accessed for residents so that they can enjoy the benefits of this provision. Residents agreed in their surveys that there was a range of activities that they could take part in. Comments included, “There is a very good activities lady who organises games, poetry sessions and crafts” and “Residents appear happy and contended, with lots of social activity and events organised”. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 17 The home operates an open door policy for visitors. Residents are able to see visitors in the privacy of their rooms and there are several semi-private seating areas around the home and in the gardens. All relatives/visitors agreed that they are always welcomed by the staff when visiting. One relative stated, “Staff are always friendly and welcoming to visitors what ever time it is”. The home has recently appointed a receptionist to greet visitors on arrival to the home and assist with general enquiries. This is positive move and the first point of contact for visitors to the home. The inspector saw the receptionist greet visitors in a warm, friendly, professional manner throughout her two-day visit. The menu rota displays traditional meals and choice is available at each sitting. The menus are reviewed to reflect seasonal trends and availability of produce. Extras are ordered on request for birthdays and special occasions. Fresh fruit and vegetables are delivered daily and bowls of fruit are on offer throughout the day. Surveys confirmed that residents were satisfied with the meals provided and comments included, “The food is excellent with a good choice and home made cakes everyday” and “The food is excellent and I look forward to particular dishes on the menu”. Residents are able to influence the choices on the menus, which is often discussed at residents meetings. The size and layout of the dining rooms enable residents to enjoy the social advantages of dining together. The dining rooms were light, spacious and the tables are attractively laid with tablecloths and napkins. Each dining room had a kitchen area and residents were seen making themselves tea and coffee and helping themselves to fresh fruit. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are policies in place to ensure that complaints by residents or their families are taken seriously and acted upon. There are good arrangements in place for staff training and awareness of protection of vulnerable adults so that residents are protected from abuse. EVIDENCE: A copy of the complaints procedure is on display in a well-frequented part of the home, which means people will know how to obtain the required information if they want to make a complaint. The complaints policy and procedure is detailed and contains all the required information, which can be found in the service user guide and individual contracts, terms and conditions. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 19 Residents stated in the surveys that they knew who to talk if they were not happy, comments included, “The manager is very understanding” and “I am always able to speak to staff”. Many residents said they did not know how to make a complaint; this surprised the manager, as it did not reflect the policies and procedures followed in the home. The complaints procedure is discussed on admission and is included in the service user guide and it was suggested that it could be possible that long-standing residents in the home may have forgotten the information they had received on admission. The complaints policy and procedure will be the focus at the next residents meeting to refresh people’s memory. Relatives/visitors surveys said that they new how to complain. Comments were positive and stated, “We have never had to make a complaint” and “ I would always approach the manager direct”. There are policies and procedures as well as a range of guidance information on the topic of protection of vulnerable adults from abuse. The availability of this information should increase staff awareness and understanding of their role in protecting vulnerable adults who live at the home. The inspector was informed that the home actively promotes staff training and education in the protection of vulnerable adults on induction and on an annual basis the staff receive an update. A number of staff are also undertaking the National Vocational Qualification in care award, and a component of the award addresses issues around the topic of the protection of vulnerable adults from abuse. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, comfortable, well decorated and furnished. It provides a safe, peaceful and well-maintained environment for the residents. The bedrooms, communal rooms and facilities are suitable and well presented for their purpose and meet the residents’ needs. EVIDENCE: The home is a purpose built care home, with facilities arranged over two floors. There are two lifts in between the two floors, making the home fully accessible for disabled people. The home has car parking to the front of the building and gardens to one side and to the rear. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 21 Since the last inspection new carpets have been provided on the ground floor dementia care unit (Kingfisher unit) throughout the corridors and lounges. Several lounges and bedrooms in the home have been redecorated and the manager stated that an ongoing programme of further redecoration and replacement of carpets had been arranged for the remainder of this year. Relatives’ surveys stated, “The environment could be improved if they would redecorate and lay new carpets” and “Bedroom carpets need replacing”. The home is on two floors, with level access via a passenger lift. The inspector walked around the inside of the home and viewed, some of the bedrooms, and the communal living areas including the dining room and lounges. Room sizes are adequate for their stated purposes, particularly the lounges and bedrooms. Rooms have en suite facilities provided and communal bathing areas; showers and toilet facilities are located throughout the home. All areas of the home were tastefully decorated, clean and well maintained. Attention has been given to ensure that all areas are homely. Residents had been supported to personalise their bedrooms with pictures and ornaments and residents are able to bring items of furniture should they wish. The gardens have well-stocked flowerbeds, established trees and shrubs, and a patio area. There are various semi-private seating areas with plenty of sun screening. Residents were making full use of these areas and their bedrooms on the day of the inspection. Residents and relatives stated in their surveys and in discussion with the inspector that the home was always clean and smelled fresh and pleasant throughout. Comments included, “My relatives room is always clean and the room is how they want it to be with personal pictures on the wall”, “The laundry facilities are excellent, clothes are well looked after and never go missing”, “I’ve seen night staff spend time cleaning the wheelchairs” and “They try hard to make it as homely as possible”. The home employs domestic staff on a daily basis. The inspector spoke with the head of housekeeping who was able to demonstrate a sound knowledge of the policies and procedures within the home and the residents who lived there. It was evident that she was confident and knowledgeable in ensuring that the team fulfilled their roles and responsibilities. As the head of housekeeping she explained that she was responsible and involved in recruitment, induction, training, and supervision. In conjunction with the manager they have good systems in place to ensure that things run smoothly and that all requirements are met and maintained to help ensure that the highest standards are achieved. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Adequate staffing levels help to ensure that resident’s needs are met. Residents are supported and protected by the homes recruitment policy. Improvements in the induction of new staff, and the availability of purposeful training, will ensure that staff are skilled and competent to care for the residents. EVIDENCE: The manager ensures that staffing levels are indicative of the needs and levels of care required by the residents twenty-four hours a day and confirmed that levels of staff would rise should dependency levels increase. All residents’ and relatives’ surveys agreed that staff were generally available when they needed them and listened and acted upon what the residents say. One resident said, “Staff could be a bit quicker when answering bells”. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 23 Several residents’ expressed very positive views about staff and the care they receive providing comments, “The trained staff are excellent”, “Staff certainly interact well with residents and remember individual preferences” and “There is good staff retention”. Residents, relatives and visiting health/social care professionals had concerns that some staff members whose first language is not English had limited communication skills. Comments received included, “Communication can be difficult when trying to discuss certain points, although the standard of care is good” and “Communication is difficult when staff do not speak very good English”. Evidence was seen to support that the home was doing much to support all people who use the service in various ways in order to alleviate any anxieties/frustrations. English classes are advertised in the home and in house training is being developed to improve knowledge, understanding and communication. Staff are receiving regular formal supervision with the unit managers and are shadowed on shifts by a senior member of staff until both parties feel confident in their competencies, skills and knowledge. A sample of staff recruitment records was examined and evidenced that the home follows a good recruitment procedure. This will ensure that the right people are employed to work at the home, and residents will be safeguarded. At the last inspection it was evident that the induction training programmes for new staff members was inadequate and a requirement was made for the home to ensure that staff are properly inducted into their role ensuring they have the necessary skills to care for the residents. The home has now accessed a new training provider and training for the “Skills for Care” induction has been implemented to commence in June this year. The new training providers offer an extensive programme of training and evidence was seen of future dates booked over the next six months for all staff. Various mandatory training is now up to date and other training has been booked which is relevant to the needs of the residents in the home. These include “Dementia Awareness”, “Wound Care Management” and “Symptom Control in Palliative Care”. The effectiveness of this training will be the focus of the next inspection. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 24 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and best interests are central to the management approach in the home. Good accounting methods are adopted and policies and procedures are followed correctly when handling residents’ personal money. Records in the home indicate that the health and safety of residents, staff, and visitors is protected. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 25 EVIDENCE: Mr Williams has made an application with the Commission to become the Registered Manager. He is a Registered Nurse and has had previous management experience in other homes. As the acting manager he has worked hard over the last year with the support of the registered provider and staff group and continues to develop new initiatives demonstrating confidence within his role. It was evident from discussions and observation that the management and staff are becoming a stable team that supports a commitment to providing quality care for the benefit of the residents. Comments received from relatives’ surveys included, “Cheerful, pleasant manager and staff”, “Our expectations have been exceeded” and “I am very happy and content within the home”. As mentioned throughout the report the home has completes an annual audit to assess the satisfaction of residents with regards to the service that the home provides by asking residents to complete surveys. The results and comments from the surveys were generally very positive. Information from the surveys is collated and documented effectively. The results have enabled the home to identify strengths and weaknesses within the service they provide and are acted upon in their development plan for the coming year. Progress of any outcomes are discussed with the residents at their meetings. The home has been developing various initiatives towards quality assurance, including monthly audits of the premises, catering, domestic and a monthly care audit. This will be looked at in more detail at the next inspection. Residents meetings are organised and details are found on the homes notice boards. The manger develops a small agenda and then allocates time during the meeting for residents to have their say, discuss any concerns and share any information with fellow residents and staff. Minutes of the meeting were examined and showed that any concerns/issues raised are transferred into an action plan to determine how they can be resolved. The policy and procedure for holding residents personal money was examined and four individual accounts were looked at. It was evident that good accounting methods are adopted which account for all transactions documented and receipts for sundries were available to see. Residents’ accounts are audited on a weekly basis. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 26 Some of the Health and safety records in the home were examined. Documentation showed that relevant checks were maintained correctly and at the required intervals including all fire alarms and equipment and emergency lighting. The homes records showed all necessary service contracts were up to date including, gas and electrical services, and the passenger lifts. Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 27 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 3 3 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 28 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kingsmead Lodge DS0000066342.V341590.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. 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