Inspection on 01/08/08 for Kingsthorpe View Care Home

This inspection was carried out on 1st August 2008.

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

Kingsthorpe View Care Home 12/06/07

Kingsthorpe View Care Home 25/04/06

Kingsthorpe View Care Home 05/10/05

Kingsthorpe View Care Home 27/06/05

Kingsthorpe View Care Home 27/01/05

Kingsthorpe View Care Home 09/09/04

Kingsthorpe View Care Home 22/03/04

Kingsthorpe View Care Home 10/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOMES FOR OLDER PEOPLE Kingsthorpe View Care Home Kildare Road St Anns Nottingham NG3 3AF Lead Inspector Lee West Unannounced Inspection 1st August 2008 12:30p 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 Kingsthorpe View Care Home DS0000039367.V369541.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. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsthorpe View Care Home Address Kildare Road St Anns Nottingham NG3 3AF 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) 0115 950 7896 0115 941 1446 kingsthorpeview@schealthcare.co.uk www.southerncrosshealthcare.co.uk Southern Cross Care Homes No 2 Limited Mrs Sally Fitzsimons Care Home 50 Category(ies) of Dementia (50) registration, with number of places Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th June 2007 Brief Description of the Service: Kingsthorpe View is a purpose built care home of 41 beds in the main unit and a smaller unit of 9 beds. The home is registered to accommodate 50 older people whose primary need is dementia. The main building is used for people requiring nursing or residential care, with the small 9 bed unit for people requiring residential care. The registration category only applies to those people admitted since the change of category, this has resulted in a number of people still receiving care at the home for enduring mental illness as the previous category allowed. The home is owned by Southern Cross and is situated in the St Anns area of Nottingham, close to the city centre and on a main bus route; the area is mainly residential with a few local shops and community facilities. Fees for the service range from £348 to £640 per week depending on dependency needs and the method of funding. There are additional charges for hairdressing and chiropody. Further information about the home is available in the brochure and service user guide or from the website: www.southerncrosshealthcare.co.uk. The manager or provider welcome any telephone enquiries and a copy of the last key inspection report is available in the foyer. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This inspection was unannounced and involved one inspector. The main method of inspection used is “case tracking”, which involves selecting three people and looking at the quality of the care they receive by speaking with them, observation, reading their records, and asking staff about their needs. Three members of staff were also interviewed and their records checked to make sure the service carries out robust recruitment procedures to protect vulnerable people. Due to the complex needs of some of the people, time was spent with them in the lounge and dining areas observing their interactions with staff and each other, as well as communicating directly with them. Documents, including care plans and medication administration records were inspected to help form an opinion about the health, safety and welfare of people at the home. Information supplied to the commission by the manager, including the Annual Quality Assessment, with information received by the Commission about the home, since the last inspection, were also considered, and helped the decision of which areas to focus on. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes What the service does well: Carers support people in a dignified and positive manner. One relative said, “This home is 10 times better than the last one my father was in, I am not worried about him now.” Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 6 Another commented “They tell me everything that’s going on with my relative, I’ve been to carers meetings and feel as though I am still important and involved with my relative’s daily care.” The menus are varied, with choices at each meal, served in pleasant dining areas, which promotes the well-being of people using the service. One relative said, “my relative has gained weight and looks really well.” There is a homely atmosphere with decorations along corridors that encourage people to touch them and stimulate mental interest. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 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 Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 6, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People have a full assessment before moving into the home to make sure their needs can be met. They also have opportunities to visit to help them decide if the home is suitable. Intermediate care is not offered at Kingsthorpe View. EVIDENCE: Records were seen of assessments completed by Adult Services, and also prepared by staff at the home for privately funded people. These were thorough and used to prepare a pre-admission care plan. One relative of a newly admitted resident said, “we were able to visit this home before my relative made the decision to be admitted. We were shown round the place and told about activities and how staff would be able to help my relative.” Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 9 Staff spoken with said they were informed about new residents who were coming into the home and they had basic care plans to work from when they arrived. The home does not provide an intermediate care service. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 10 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, 11, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are assisted in a positive and dignified manner, and in accordance with actions set out in individual care plans, which fully meet their health care needs. EVIDENCE: One relative spoken with said, “my father was admitted recently and for the first time in a long time he is alert and laughing. He can’t get out of bed, but everyone here works very hard to help him and he has also gained some weight.” In the records of people using the service case tracked, pre-admission dementia assessments seen were thorough, used to formulate plans of care and actions needed to carry out that care set out clearly. Records were seen of professional visits, for example, one showed a visit by the chiropodist and another the dates of visits from the Community nursing Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 11 team. Records of communication, including information from relatives, and regular care planning reviews were also in place. During periods of observation, interactions between staff and people using the service were seen to be positive and supportive. Whilst people were eating their lunch staff were observed assisting them in a dignified manner, helping one person at a time, and encouraging them to eat at their own pace. One person was observed not eating and staff used gentle encouragement and kept prompting until the meal was eaten. After lunch people were settled into their preferred places in the lounge areas, or in their own rooms, and staff were again observed interacting positively with them. Three ladies spoken with said they were very satisfied with the care they received and that staff treated them with dignity and ensured their privacy whenever it was needed. A Community nurse was attending to the needs of people within the residential unit, and staff were observed supporting people whilst this was happening. In particular one person became distressed and care staff tried to reassure and encourage them during the nurse’s visit. Medicines were stored and distributed in accordance with policy and people were given their medication on time. Medicines Administration Records were seen to be accurately completed, and those case tracked had no omissions, with appropriate identification of reasons why medication had not been given. Lunchtime administration of medicines was observed and staff carrying out this ensured people had their medicines on time, encouraged them to take it and signed the records after it had been taken. Records were seen of people enrolled in The Golden Charter Funeral Service, which was a plan specifying wishes on death. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 12 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. People’s lifestyle generally matches their expectations and they have choices. The wholesome, balanced diet is served in pleasant surroundings, with people choosing what they like to eat. EVIDENCE: During a period of observation, people were seen to be interacting with each other as well as with staff members. Others were seen walking around the corridors in each unit and everyone was able to choose where they wanted to be and what they wanted to do. An activities co-ordinator has now been recruited and an activities programme was displayed. In the small residential unit people were playing dominos, watching a classic film and just chatting with staff in the unit. People in the other units were engaged in conversations with each other and staff members and after lunch, there was music with some dancing. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 13 People spoken with said they were able to join in activities if they wanted to. Others were observed joining in with the dancing and another group were using a soft ball for a throw and catch game. Staff spoken with demonstrated their knowledge of the people using the service, including their individual backgrounds and what they prefer to do now. One staff member told of a person who uses the service who likes to go out and buy their own clothes, and another she said, “likes to come with me and sit under a tree and watch things going on around us.” Relatives spoken with said they were welcome any time and one said, “I have attended some of the relatives’ meetings and staff always keep me informed of what’s happening with my relative.” A central kitchen is used to prepare the meals for the three units and menus provide choices at every meal and staff were observed offering choices when the meal was being served. People were observed eating a nourishing and wholesome meal, which was served in pleasant dining areas. A number of people were asked about their meals and they said they were very satisfied with the food. One relative said, “my relative had lost a great deal of weight before coming into this home, but now has begun gaining weight and enjoying the food.” Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 14 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. People are aware of how to make complaints and any complaints or allegations are taken seriously and acted upon. EVIDENCE: Complaints procedures were seen and available for everyone and people spoken with said they were happy they would be able to make a complaint. Families also said they were aware of complaints procedures but that the acting manager was very approachable and helpful if there was a problem. There was a copy of the Safeguarding adults procedures seen. The acting manager said there had been a safeguarding allegation which was being investigated, but with no outcome at this time. Staff spoken with said they had received training on safeguarding adults, and records of this were seen in their staff files and they were able to describe their role in the safeguarding procedures, as well as explain the whistleblowing policy. Two relatives spoken with said, “we feel very happy with the home and staff and if we have any concerns the manager listens to us.” Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 15 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 atmosphere in the home is very welcoming and homely and all areas are clean and well-maintained positively enhancing the well-being of people using the service. EVIDENCE: The corridors and communal areas have décor that people can touch and which help stimulate mental interests, as well as being designed to help people with dementia orientate themselves. All areas of the home were clean and hygienic and a member of the cleaning team was observed working in the small residential unit, being assisted by one of the people who uses the service, who wanted to help. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 16 Different coloured doors, street names in corridors and each bedroom with its own letterbox and door knocker, with pictures and newspaper pages from bygone days, and special areas like the garden area also provide areas of interest for people who like to wander in the corridors. The home had a relaxed and homely atmosphere and people’s own rooms were clean and contained personal possessions and photographs. One person spoken with said, “I love the view out of my window and I’ve got all my photos of my family around me and my room suits me fine.” The home was well maintained and information provided in the Annual Quality Assurance Assessment records showed regular health and safety checks, fire safety, electrical inspections, lift inspections and legionnella testing and the dates these were carried out. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 17 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. Generally, people are supported and protected by carers who are recruited following the home’s procedures, and are competent, with sufficient numbers working to help people when needed. EVIDENCE: Staff records were case tracked and one carer had started work with pova first and before the Criminal Records Bureau check had been received and the regional manager for Southern Cross stated this was their usual practice and they used the time to carry out induction of carers. Staff said they were given the company handbook and their job description and had an induction. During observations it was noted sufficient staff were working to support the care needs of people using the service, in all the units, at lunchtime there were 5 carers supporting people to eat their food, some sitting assisting people, others encouraging and prompting them. Relatives spoken with said there were always carers around when they were needed. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 18 One said, “my relative is nursed in bed and the staff take great care. My relative has not been here long, but has improved a great deal. This place is 100 times better than the last place.” Records were seen of training undertaken by staff and this shows what staff have completed and when they are due for updating. The service has an inhouse trainer, working 8 hours a week. Carers are enrolled with NVQ UK for their National Vocational Qualifications. Staff members spoken with confirmed they had received training, one said, “I have done moving and handling training, Mental Capacity Act and safeguarding adults training as well as being enrolled to do National Vocational Qualification at Level 3. People spoken with, who use the service said they were satisfied with the support provided by the staff and that they felt safe and secure. One said, “Everyone looks after me very well, I get a bit anxious about things, but everyone is so kind and I feel protected.” Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 19 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, 36, 38, Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Management is open and people’s financial interests are safeguarded by the home’s procedures. Health and Safety are protected and people using the service are central to the running of the service, with their input being used within the service’s quality monitoring system. EVIDENCE: The Registered Manager, has now been replaced by an acting manager, who has previous experience of many years, has achieved the National Vocational Qualification at Level 4 and the Registered Managers Award and who is preparing the documents for application to become the registered manager of this service. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 20 Staff spoken with said the acting manager had made a big difference since managing the home and people using the service and their relatives also said a big difference had been seen since she became manager. During observations the manager was seen to interact with people using the service, and their relatives, in a very positive and open way. Regular meetings held with the operations manager, include provider inspection reports and audit of the home and facilities and records of these were seen. Meetings for people using the service, their relatives and staff were recorded and one relative said, “I’ve been to a number of meetings and I am kept informed about all aspects of my relatives care, and can make suggestions of things which might improve the care provided, and I feel I am being listened to.” Some people who use the service have an account for their money. A record is kept and they have access to it during office hours, these accounts were found to be accurate. Records were seen of regular staff supervision and staff spoken with confirmed they had regular supervision and any training needs were identified during this. Dates of tests, servicing and maintenance of equipment were recorded in the Annual Quality Assurance Assessment report and records kept in the office supported these to support the health, safety and welfare of staff and people who use the service. Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 21 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 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 3 x 3 Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP29 Regulation 19(1) Requirement Timescale for action 30/09/08 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 Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingsthorpe View Care Home DS0000039367.V369541.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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