Inspection on 09/05/05 for Kingsthorpe Grange

This inspection was carried out on 9th May 2005.

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

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

Other inspections for this house

Kingsthorpe Grange 21/01/10

Kingsthorpe Grange 21/05/07

Kingsthorpe Grange 26/10/05

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Kingsthorpe Grange 296 Harborough Road Kingsthorpe Northampton NN2 8LT Lead Inspector Sarah Smart Unannounced 9 May 2005 10.00 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kingsthorpe Grange Address 296 Harborough Road Kingsthorpe Northampton NN2 8LT 01604 711222 01604 791099 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) St Matthews Limited Vacant Care Home with Nursing 50 Category(ies) of OP Old Age (50) registration, with number of places Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 12th October 2004 Brief Description of the Service: Kingsthorpe Grange is a home situated in Kingsthorpe, a suburb of Northampton. The home is within walking distance of community resources, which include churches, shops, pubs and restaurants.The home has recently changed ownership, and is registered to provide Nursing care for service users with a variety of needs over 65 years of age. Accommodation to the service users is provided across two floors, there are 48 single rooms and 1 double room with 26 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 by passenger lift. The home has a rear garden which is accessible to service users and car parking to the front and rear. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.40am and 13.45pm. The pre-inspection questionnaire had not been sent out at this time, and will be included in the next inspection. No written feedback in the form of questionnaires was received from service users or relatives. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, viewing of the staff rota, activities, viewing of several service users rooms and bathrooms, checking the previous requirements made, and staff and service user interviews. Two service users were case tracked. Two staff members, plus the acting manager, were interviewed at length, and several others briefly, whilst five service users were spoken to in detail. What the service does well: The acting manager has recognised the need to introduce new documentation to improve the ease of use of the information held. The home meets the needs of the service users currently residing there. The provision and range of activities is maintained to a high standard. The choice and presentation of food is acceptable. The environment is currently undergoing a large programme of refurbishment which the service users are involved in. The acting manager is considering the impact that work will have upon the service users currently residing in the home. Staff communication with service users was pleasant and appropriate at all times. Staffing levels were acceptable to meet the needs of the service users. Risk assessments were carried out appropriately, to maintain the service users safety. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 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. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 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 standard(s) 3,4 The service users needs were being met, although the assessment document could contain more detail. EVIDENCE: The service users files viewed contained assessments documents. These were thoroughly completed, however they did not cover all of the information outlined in standard 3. The acting manager, and deputy, showed the inspector a sample document of new paperwork to be introduced into the home over the coming months, in which the assessment did cover the areas required. For this reason a requirement has not been made. Service users spoken to by the inspector stated that the staff meet their needs. Staff spoken to were able to give clear information about the needs of the service users in their care. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 partially. Service users health and personal care needs are met, although documentation requires a small amount of attention. EVIDENCE: The majority of care plans were written to a high standard, giving very thorough information to the reader, and were reviewed. The eating and drinking care plan for one service user did not mention that he was diabetic. None of the care plans viewed contained evidence that the service user was involved in their writing. In two instances the daily summary indicated that the instruction given in the care plan was not being carried out. For example, a care plan instructed staff to hoist the service user, however, the daily summary indicated that this was not always necessary, or done. The acting manager explained that a service user had an unusual eating plan in place, which met her individual needs, however, this well structured information was not included in her care plan. This service user was not noted to be sitting in an ideal position to promote eating. Otherwise all areas of needs were Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 10 thoroughly covered by the service users care plans. Staff spoken to stated that they read the care plans, and demonstrated a good knowledge of the service users needs. One service users file indicated that his blood sugar must be recorded weekly, however this had not been done for several weeks, and a continence assessment had not been completed despite the service user being incontinent. All other healthcare assessments were completed accurately, and reviewed. Action indicated as required by these assessments had been carried out, i.e. pressure relieving mattresses on service users beds. Medication is stored in several areas of the home. Three of these areas were viewed. The management of medication appeared satisfactory, except that variable doses were not recorded consistently. The acting manager advised that a new medication system is due to be introduced into the home during the following few days. Two tubs of prescribed creams were found in rooms not belonging to the service user for whom it was prescribed. This was removed by the acting manager at the time, and therefore a requirement has not been made. Service users spoken to stated that their privacy and dignity is respected. In one lounge there were signs on the wall referring to a service users care, which were breaching confidentiality. The acting manager advised that these had been placed by the service users family. In one area of the home service users files, containing confidential information were stored on open shelving in the dining room. This area did not always have staff present, meaning that other service users, or relatives would have access to private information. Service users wishes in the event of their death were recorded, or entries were made if the service user did not wish to discuss this part of their care. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,15 Service users needs are met socially, recreationally, and nutritionally. EVIDENCE: Service users spoken to stated that they choose whether to join in with the activities in the home or not. Each service user described the activities they partake in, for example, bowls, card games, manicure, church services, and visiting choirs. Records were viewed of service users hobbies and previous employment, and service users were enabled to pursue pastimes, for example, one service user was taken to the horse races. Service users were reading the daily newspapers whilst eating their breakfast. Staff appeared to focus upon ensuring that service users activities of high importance within the home. An activities board indicated that on average there are two different activities planned each day. Service users stated that their families are welcomed into the home and that they can visit local shops, and churches regularly. Of the five service users spoken to by the inspector two stated that they did not like the food. The other three gave positive feedback. The two were unable to pinpoint exactly what they disliked. The inspector ascertained that service users are offered a full choice at breakfast time, a choice of two hot meals, omelette or salad at lunchtime, and soup or sandwiches for tea. The cook stated that waste food returning to the kitchen is monitored, usually with little waste. She stated that if waste increases, feedback is sought from the service Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 12 users, and staff on duty. The kitchen was clean and tidy, and well organised. Records in this area were satisfactory. The cook advised that the kitchen is due to be refurbished later this year. Lunch was viewed. This looked and smelt appetising. One service user stated that she prepares her breakfast herself in her room. Staff stated that she is safe to do so. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 17 The home did not ensure that all the service users were enabled to vote. EVIDENCE: One service user spoken to stated that she had used a postal vote in the recent elections, however two further service users said that they would liked to have voted, but were unable. The acting manager stated that voting information had been distributed around the home. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,21,22,23,24,25,26 The environment was satisfactory, and the planned refurbishment will make ideal improvements to some areas. EVIDENCE: Service users stated that they were happy with their bedrooms. The home is currently undergoing a programme of refurbishment under the new ownership. Service users have been involved in the choice of décor. Plans for the future of the home are to increase the size of some service user bedrooms and the number of bedrooms with ensuite facilities. The acting manager stated that service users safety, choice and comfort will be considered during the changes planned for the home. All areas of the home are accessible to the service users. Several service users had electric wheelchairs, or those which they could self propel, increasing their independence. Bathroom equipment had been repaired since the requirement at the last inspection. The bathrooms viewed appeared satisfactory. All of the equipment identified in the service users care plans was in place. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 15 Service users bedrooms were individualised by the personal possessions furnishing the rooms. The home was clean and tidy. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 Staffing is appropriate to meet the needs of the service users. EVIDENCE: The staff rota demonstrated that the home has three nurses on duty during the day time shifts. In the morning there are 11 care staff on duty, and 10 during the afternoon. The night shift is covered by two trained nurses, and three carers. The needs of the service users were met by these current staffing levels. The acting manager has recruited numerous staff over the past six months, reducing the level of agency usage considerably. Staff were deployed in various areas of the home, however they were seen to move into other areas during the shift to assist colleagues. At all times during the inspection staff communication with service users was friendly, caring and appropriate. The acting manager stated that service users dependency scores calculated are not used directly to influence the number of staff needed. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 (partially) Service users safety could be more efficiently and effectively protected. EVIDENCE: Several bathrooms, both communal and ensuites contained bottles of cleaning chemicals. The removal of these, other than in the staff area, was arranged promptly by the acting manager. Risk assessments in relation to individual service users were written and maintained to a high standard, and covered all the identified areas. In two service users bedrooms catheter bags did not have covers over them, posing and infection control risk. Call bell cords were tied up in some instances, and did not reach the floor in all cases viewed. If a service user was to fall on the floor they would not be able to alert staff using the call bell. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x 2 x x x x x x x x 2 Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 19 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 7 Regulation 12(1)(a) Requirement All service users care plans must be reviewed and updated on a holistic basis; all identified assessed needs must have an associated care plan. The care plan must include all the information needed to make clear the action to be taken by staff, to ensure that service users assessed needs are met. service users must be inovlved in the writing of the care plans. This is an outstanding requirement from the inspections held on 21/01/04 and 25/05/04, and 12.10.04. Confidential information must be stored appropriately. This requirement was not checked on this inspection. All required checks in accordance with current guidance must be undertaken prior to the employment (commencement) of staff. Measures must be taken to prevent cross infection. Ref: catheter bags This requirement was not checked on this inspection. The homes policies on adult Timescale for action 15.6.05 2. 3. 10 OP29 37 19(1) schedule 2 15.6.05 13/10/04 4. 5. 38 OP18 13(3) 12 & 13 15.6.05 15/12/04 Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 20 protection must reflect the guidance from the Northants Protection of Vulnerable Adults and staff must be aware/trained in this. 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. 4. 5. Refer to Standard 3 9 17 27 38 Good Practice Recommendations A new general assessment should be introduced. Varibale doses should be recorded when administering medication. Service users should be enabled to vote. Dependency score results should be used to determine staffing levels. Call bells should reach the floor in all instances. Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 1st Floor, Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingsthorpe Grange C51 S64133 Kingsthorpe Grange V226125 090505 Stage 4.doc Version 1.30 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!