Random inspection report
Care homes for older people
Name: Address: Kingsthorpe Grange 296 Harborough Road Kingsthorpe Northampton NN2 8LT three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Rajshree Mistry Date: 2 1 0 1 2 0 1 0 Information about the care home
Name of care home: Address: Kingsthorpe Grange 296 Harborough Road Kingsthorpe Northampton NN2 8LT 01604821000 01604821492 kg_ks_ss@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : St Matthews Limited care home 51 Number of places (if applicable): Under 65 Over 65 0 0 51 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Conditions of registration: 51 51 0 The maximum number of service users who can be accommodated: 51 The registered person may provide the following categories of service only: Care Home with Nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Mental Disorder, excluding learning disability or dementia - Code MD Dementia - Code DE Date of last inspection Brief description of the care home Kingsthorpe Grange is a home situated in Kingsthorpe, a suburb of Northampton. The home is within walking distance of community resources, which include churches,
Care Homes for Older People Page 2 of 13 Brief description of the care home shops, pubs and restaurants. Kingsthorpe Grange is registered to provide nursing care to people with a variety of needs over 65 years of age. Accommodation is provided across two floors, there are 51 single rooms with 24 rooms providing en-suite facilities. The home consists of a large older house, which has been extended to form 4 house groups, each area consisting of bedrooms, and lounge/dining facilities. Access to the first floor of the home is via passenger lift or stairs. The home has a rear garden, which is accessible to people and has car parking to the front and rear. The range of fees for 2010/11 are not known. People who are interested in using Kingsthorpe Grange should contact the home directly. The new e-mail address for the Registered Manager is: Katrina.shaw@smhc.uk.com Further information about Kingsthorpe Grange and any specific requriements can be obtained in the form of the Statement of Purpose and the Service User Guide. The findings of the most recent inspection carried out by the Care Quality Commission (CQC) can be found in their Inspection Report, which is available at the home or accessible via our website: www.cqc.org.uk Care Homes for Older People Page 3 of 13 What we found:
We as it appears throughout this Random Inspection Report refers to the Care Quality Commission (CQC). This Random Inspection of Kingsthorpe Grange took place to review the progress and practice within the service following a number of concerns brought to our attention and the management of the service. We were assisted by the Registered Nurse during the site visit in the absence of the Registered Manager, who is having some agreed time off for personal reasons. The Director of Nursing and Clinical Services, representing the management team also introduced themselves to us and provided us with information. We looked at two care files for people who live at the home, both having different health and personal care needs. We found the care files contained basic information about the person, their individual health and personal care needs. There was also information about their family and other health professionals involved in their care and well-being. We read the care plans in the care files, which sets out the persons health and personal care needs. We found the care plans were generic and only personalised by the persons name and a specific requirement, if known. There was no evidence of the person being involved in developing their care plan, their preferences and wishes. It showed that there was no consideration to supporting people with dementia or mental health illness with regards to their ability or capacity to make decisions about their care and well-being. This also showed the care plans were not person-centered and staff have little guidance to supporting people to maintain their independence, having their rights, choices and preferences respected. We saw there were some assessments of risks carried out. However, the safety measures resulting from the assessments of risk were not reflected in the care plans. There was little information with regards to the persons ability to make any decisions or expressed wishes. Therefore, shows staff have little guidance to follow, which could compromise the persons rights and wishes that impacts on the quality of care they experience. We found records to show reviews of care plans and care needs had been completed by the staff at the home and by the Care Management Team for one person. However, the changes in peoples needs and routines were not reflected in the care plans. For example we found a care plan stating the person sleeps in the bed, reviews indicating there were no changes and the meeting with the family highlighted the arrangements to support the person to sleep in the recliner chair, which they had done so for a number of months. The staff we spoke with also told us the person sleeps in the recliner chair, usually in the lounge not the bedroom. We found that medication had been reviewed for another person as there was concerns about their health. The Registered Nurse told us medication had been changed but was not reflective in the care plan and monitoring. Therefore, based on the information in the care plan, there had been no changes and staff may not be aware of the changes. We found in one care file two incident reports had been completed following incidents: a
Care Homes for Older People Page 4 of 13 fall and an injury, both occurring a few days apart. However, the incident and injury record log had not been completed to monitor the persons well-being. There was no reference in the daily logs with regards to how the person was or any treatment given. There was no evidence of new assessments of risks being completed to ensure the health and safety of the individual. This shows that peoples health, safety and well-being is not adequately monitored and communicated to with staff unless they read the individual care files. We found people were receiving additional health support from specialist teams and professionals. Record of pressure care management was maintained and confirmation of the pressure care equipment being used such as pressure cushions. The care files contained records of visits and treatments given following a visit from the General Practitioner. We found monitoring records completed by the staff showing that checks were made through the night at regular intervals such as 30mins or hourly checks. These records are kept either in the individual bedrooms or in office in the respective units. It was unclear how the monitoring information was incorporated into the review of care needs and the care plans as there was no reference or changes made to the care plans. For example, this relates to the person whose medication had changed following the review of the medication and had a noticeable improvement to their well-being. We spoke with some people who use the service and a visiting relative. They all said they were happy with the quality of care provided by the staff at the home. One lady told us she is able to continue having a cigarette, which her son buys for her and occasionally will take part in the activities. They told us, as they pointed to the Volunteer that they could join in with the game of bowls, that was taking place that morning. The visiting relative told us they visit 3-4 times a week and help feed her husband at lunchtime. We found Kingsthorpe Grange is a large care home with nursing. The home is divided into four accommodation areas with a communal lounge, dining area and kitchenette. We were shown around the home by the Registered Nurse in charge. We saw the majority of people sitting in the lounges, some slept in the chair whilst others watched television or watched what the staff were doing. We saw staff in three of the four units sitting and talking with people. We saw several bedrooms including the bedrooms of the two people whose care files we looked at. The bedrooms were clean, decorated, bedding and pillows on the bed and the room was personalised with photographs, pictures and ornaments. We found there was missing plaster and paint behind the headboard of a bed in one room. We found people were provided with specialist equipment to such as pressure cushions and mattresses to avoid the risk of skin breakdown and pressure sores developing. The Director of Nursing and Clinical Services representing the management told us that an Acting Manager had been appointed to manage the service whilst the Registered Manager has had a short period of planned absence. Although we had not been notified of this appointment it showed the service was being managed. We found staff have attended regular staff meetings. However, staff said they last had a formal supervision meeting with the Registered Manager in August 2009 and none had
Care Homes for Older People Page 5 of 13 with the Acting Manager. The Director of Nursing and Clinical Services told us that there have been new appointments made. They told us that the Registered Manager will be having a phased returned to work, supported by the management team and the Acting Manager. The Registered Nurse told us there are 2 nurses and 7 care staff on duty for the day and evening shifts to cover the four units. We looked at the staff rota and found there were only 2 registered nurses and 6 staff on duty each shift, corresponding to the staff seen on duty. This contradicted what we were told and highlights the need to review staffing levels to ensure the needs of people who use the service are met safely and staff in charge is aware of the staffing levels, in case of any emergencies. The Registered Nurse in charge told us the formal monthly visits, known are Regulation 26 visits are conducted by the Acting Manager. However, the visit reports were not available or accessible on the day. Therefore, it is not known whether these visits are taking place regularly to demonstrate the internal monitoring of standards of care within the service. What the care home does well:
Kingsthorpe Grange is a large care home with nursing that cares for people with complex personal care and health needs. The home is divided into four areas of accommodation, creating a more homely atmosphere, each with a dedicated team of staff. There are Volunteers that work at the home entertaining and hosting a variety of stimulating activities that people can take part in. Visitors are welcome at any time are are invited to social events arranged by the home. All areas of the home are clean and tidy. People can personalise their bedrooms to reflect their interest and preferences. Specialist equipment is available to promote the health, safety and well-being of people who use the service. We found that all the meals at present are prepared and cooked on the premises. The Cook described to us the range of special meals that are prepared to meet dietary needs including birthday cakes and foods for seasonal celebrations. The people who use the service and their relatives spoke positively about the quality of care provided by the staff. People are able to move around the home freely as some people like to walk. Some of the comments we received from them included: They have activities here - theyre playing bowls over there today I should do more but Im quite happy sitting here watching the television Hes very good and looks after me I come about 3-4 times a week and they always make me feel welcome
Care Homes for Older People Page 6 of 13 The food is really good, hes having lamb casserole today They always do things here, in fact theyve invited me in for Valentines Day and they will do something special The staff are in uniforms, are in areas where they can respond quickly to the call bells and requests of people who use the service. What they could do better: If you want to know what action the person responsible for this care home is taking
Care Homes for Older People Page 7 of 13 following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 8 of 13 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 9 of 13 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 15 The Registered Person must 02/03/2010 develop care plans, which provides information and guidance to staff as to how individual needs are met and how someone with dementia, mental health or at risk of deprivation of liberty, is to be supported. There should be consideration to known triggers and mechanisms for supporting someone should they become anxious or distressed. All care plans to included individual preferred daily routines and personalised to reflect their wishes. To ensure the health and well-being of people who use the service and improve the quality of their lives. 2 7 15 The Registered Person must 02/03/2010 ensure that the reviewing of care plans and risk assessments are combined to ensure consistency of information. Care Homes for Older People Page 10 of 13 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action To ensure that the health and well-being of people who use the service is promoted and maintained. 3 18 23 The Registered Person must 28/02/2010 ensure all areas of the home are in good state of repair and decor. This includes making good of exposed plaster and decoration in bedrooms. To ensure people live in a good, clean and decorated home that promotes their well-being. 4 31 26 The Registered Person must 28/02/2010 ensure monthly regulation 26 visit reports are conducted and reports are available. To ensure internal quality monitoring of the home promotes the health, safety and well-being of those who use the service. 5 36 18 The Registered Person must ensure all staff receive regular support and formal supervision with the manager, which is recorded. To ensure staff are supported to ensure peoples well-being and an improved quality of life. 6 38 37 The Registered Person must 28/02/2010 ensure all incident, accidents and injuries are recorded and reported including maintaining internal
Page 11 of 13 02/03/2010 Care Homes for Older People Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action monitoring records. To ensure the health, safety and well-being of those who use the service. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 8 The Registered Manager, person in charge and the staff should have training in deprivation of liberty and the Mental Capacity Act to ensure they can support people in the home safely, whilst respecting their rights and expressed wishes. The staff rota should accurately reflect the staffing levels required to meet the needs of the people who use the service and known by the person in charge. 2 27 Care Homes for Older People Page 12 of 13 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 13 of 13 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
