Inspection on 25/04/06 for Kingsthorpe View Care Home

This inspection was carried out on 25th April 2006.

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 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 01/08/08

Kingsthorpe View Care Home 12/06/07

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Kingsthorpe View Care Home Kildare Road St Anns Nottingham NG3 3AF Lead Inspector Stephen Benson Key Unannounced Inspection 25th April 2006 09:30 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.V288095.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 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 9507896 0115 Southern Cross Care Homes No 2 Limited Vacant Care Home 50 Category(ies) of Dementia (50) registration, with number of places Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05/10/05 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 present arrangements around accommodation is that the main building is used for people requiring Nursing care, with the small 9 bed unit for people requiring personal/ residential type 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 Annses 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. The acting manager said on 26/04/06 that the fees for the service range from £277 - £343 per week depending on dependency needs. There are additional charges for hairdressing and chiropody. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first visit to the home since 1st April 2006 by The Commission for Social Care Inspection. The inspection lasted for 5 hours and the main method of inspection used was called case tracking which involved selecting 3 residents and tracking the care they receive through the checking of their records and discussing this with them. Other residents were spoken with and additional records were seen. A discussion was had with staff on duty and care practices were observed. A visiting health professional was spoken with. The premises were not inspected in detail but various areas of the home were visited as part of the inspection What the service does well: There are good arrangements to ensure information about the home is made available to any prospective resident and arrangements are made to assess resident before they move into the home to establish if their needs can be met. Residents said they saw someone from the home before moving in. This means that practices are in place to ensure that any new residents have been assessed to ensure that their needs can be met within the home. A monthly report is sent to head office with details of any complaints made. Some staff have attended a course on protecting adults from abuse. Residents can be confident that their complaints will be taken seriously and acted upon. Residents said that the home is kept clean and tidy and in a good state of repair. Residents live in a safe well maintained environment. There is a training programme and regular training opportunities are offered to staff. There is an induction programme for new staff. The correct recruitment procedures are followed. Residents are protected and supported by the home’s recruitment policy. There are suitable arrangements for helping residents manage their personal allowances. Residents are safeguarded by the financial procedures within the home. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Residents should be provided with a contract detailing the services to be provided. Some of the care plans seen were not fully completed and although some were being reviewed on a monthly basis others had not been reviewed for the last 3 months. All parts of the care plan must be completed and they should all be reviewed a minimum of every month. Current practices do not ensure that staff will be aware of residents’ current needs. Staff were seen to use wheelchairs to move residents without using footplates. There were some wheelchairs that did not have footplates fitted. When using wheelchairs to move residents, footplates must be used to reduce the risk of injury. There were some gaps seen in Medicine Administration Records for which no explanation could be offered. These records must be completed after every drug administration so that residents can be sure they have been given their medication. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 7 Although staff were seen promoting residents privacy and dignity when attending to them, and residents said that this is what staff did, one resident was wearing borrowed clothes as he did not have his own and staff were using another residents bedroom to iron the laundry due to lack of space. Resident’s privacy is being compromised and privacy and dignity must be maintained at all times. The home employs an activities co-ordinator and a new one is currently being recruited. The range of activities provided was limited and residents were not receiving activities on a frequent enough basis. Residents are not having their recreational interests and needs satisfied. The acting manager undertook a survey of residents’ views on the running of the home in December 2005 but the results of this have not been acted upon and a report should be prepared following a survey of residents so that the home is run in the best interest of residents. 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 View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 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 Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. New residents are assessed prior to moving into the home to ensure their needs can be met and are provided with information detailing what they can expect, but these are not being formalised when a resident moves into the home. EVIDENCE: Residents are not issued with a contract or terms and conditions of the placement. A new computer system is now being used to record all enquiries for a place at the home and records all activity carried out from the initial contact. A brochure is sent out providing information about Southern Cross and the services that are provided within their homes. The acting manager has also prepared a leaflet about the home inviting anyone to contact her if they want further details. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 10 The acting manager had an appointment to visit and assess a prospective resident the morning of the inspection. Completed assessments were seen on care plans. Staff said they have access to these and details are passed onto them at handover. One recently admitted resident said he had been unable to visit prior to moving into the home but family members had, another said that she had come to look round the home to see if he would like it. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Care plans must be fully completed and efforts made to involve those residents who are able to contribute. Improvements are being made to the healthcare of residents, but different practices are occurring in the administration of medicines, which means that the policies and procedures for medication administration do not protect SU’s adequately. Resident’s privacy and dignity is not always maintained. EVIDENCE: Care plans are prepared from information gathered during the assessment process, although one recently admitted resident did not yet have the care plan prepared. Care plans seen gave clear details of the care to be provided to residents identified any risks and there were forms to monitor all aspects of health and personal care. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 12 Care plans were updated although not all seen had been done on a monthly basis as required. There was also a care file audit form seen completed by the acting manager which highlighted some areas of plans which had not been completed, but this had not been acted upon. There was no evidence seen of residents being involved in their care plans and sheets seen to record contact with relatives were not being fully completed and did not show any involvement in determining residents care. Residents said they were happy with the care they receive but were not able to make any comments about care plans. There were a number of healthcare professionals, including GP’s, seen visiting the home. Those spoken with said they felt that things had improved and there was a good working relationship with the home. The acting manager said that she had met with local doctors to look how to improve their working relationship. The acting manager also said that their had been a fall in the number of accidents had by residents and she was continuing to monitor these. Residents were seen being moved in wheelchairs without using footplates and these were not fitted to some chairs. Residents said that their health is looked after and if they want to see a doctor they just ask. There is a separate medication room on each floor and suitable arrangements were in place for the storage of medication. Good practices were observed in giving out medication, however there were some gaps seen in the Medicine Administration Records which would not have occurred if the observed practices were followed at all times. There are photographs attached to all MAR sheets to aid identification, however one recently admitted resident had not yet had his photograph taken. Residents said that they are given their medication by staff and they don’t have to worry about it. Staff were observed respecting residents dignity when helping them and residents said that their privacy and dignity is definitely respected apart from one recently admitted resident who said he was not wearing his own clothes as his possession shad not been bought to the home. There was an entry stating that a message had been left on an answer phone for relatives about this, but more urgent action was needed. Staff were seen ironing in a residents bedroom. This was explained because they could not use the laundry due to workmen repairing the tumble dryer. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A wider range of activities is needed and residents should have more opportunities to participate in them. Residents are able to maintain contact with family and friends. Residents are provided with a wholesome appealing and balanced diet. EVIDENCE: Entertainers visit the home every other month and residents said they had enjoyed the organist the previous day. An activities co-ordinator is employed, although the current postholder has requested to return to her previous duties as a carer and she does not feel suitably trained to fulfil this role. The acting manager said that she is in the process of recruiting to this post. Some residents were seen completing some jig saws which had been recently purchased although several comments were made that there was not enough equipment available and a residents survey seen included comments about not having enough activities. A record is made when a resident is offered and activity (as sometimes these are refused) and these showed that there could be long time periods, sometimes over a month, between opportunities for residents to join in an activity. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 14 Visitors are welcome to visit and said that they are made welcome by staff. Staff were seen offering choices to residents about what they wanted to drink and where they wanted to sit. No residents have been assessed as being able manage their own financial affairs. Information about advocacy services is included in the brochure sent to prospective residents. There is a three week menu, which provides a choice at each meal and offers a varied and balanced diet. Some residents were seen eating a late breakfast and receiving appropriate assistance from staff. Residents said that they liked the food and had enough to eat. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any complaint made is acted upon and monitored. Staff are aware of how to use the adult protection procedures. EVIDENCE: There is a complaints book kept in the entrance foyer although there were not any entries in this. The acting manager is required to send a monthly return to head office listing all complaints made during the month. There have been two complaints received by the Commission for Social Care Inspection that have been passed to the home to investigate since the last inspection, both of which were partially substantiated. Details of action taken/to be taken were included in the investigation reports sent to Commission for Social Care inspection. Staff have been provided with training on the protection of vulnerable adults and the adult protection procedures have been correctly followed on a previous occasion. Residents said that they are well treated and have not been concerned at how anyone is treated. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 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 well maintained and kept clean. There has been a temporary disruption to the laundry service. EVIDENCE: The home is suitably laid out and kept in good repair. Residents spoke positively about the fabric of the building. The home was clean and tidy and domestic staff were seen working to maintain this. The home has one tumble dryer, which has been broken for about two weeks and was being repaired during the inspection once a part had arrived. Arrangements had been made to use another home nearby within the same organisation to do the laundry but this was not keeping up with the demand and there were over 20 black bin liners full of damp washing on the laundry floor. The acting manager said that some relatives had raised concerns with her about the lack of a dryer, although residents asked were not aware of the problem. Had the tumble dryer not been repaired by the end of Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 17 the inspection an immediate requirement notice would have been issues to make suitable temporary arrangements to complete residents laundry. Measures are in place to prevent the spread of infection. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are sufficient staff on duty to meet the needs of the residents. Arrangements are in hand to ensure that staff are suitable trained and the correct recruitment procedures are followed. EVIDENCE: There should be 8 care staff and 2 trained nurses on duty each shift. There should be 3 care staff and a trained nurse on each floor and a further 2 care staff on duty in the area where residential residents stay. There was some concerns raised by staff about staffing levels, in particular the role of the trained nurses during busy periods. This was discussed with the acting manager who clarified that the trained nurses should assist with care duties during busy periods and should not be carrying out administrative duties when their assistance is required to provide care to residents. The home also employs ancillary staff for running the kitchen, laundry, maintenance and administrative services. There have been frequent training opportunities provided for staff recently and there are records kept of all training done. There is a training plan detailing what training staff require including updates and arrangements are in hand to bring all staff up to date. All new staff are required to go through the home’s induction programme. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 19 The correct recruitment procedures are followed, although there was a mix up identified with a new member of staff’s references this was corrected during the inspection. A recently appointed deputy manager has just successfully completed the Registered Managers Award. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents are not being acted upon. Resident’s financial interests are safeguarded. Staff are aware of promoting health and safety. EVIDENCE: There is not a registered manager in post, but the acting manager has completed an application form, which is with head office to send to The Commission for Social Care Inspection to be considered for registration. The manager contacted head office who said it would be sent within 2 days. The manager has commenced the Registered Managers Award. A survey of residents’ views on the home was carried out in December 2006 in which a number of points were raised, but there has not been any follow up from these. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 21 There is an electronic system to provide assistance to residents to help manage their personal allowances. Two signatures accompany every transaction and receipts are kept for each expenditure. Cleaning materials are appropriately stored and staff were seen to keep them under supervision when in use. Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 22 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 2 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 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 2 X 3 X X 3 Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 23 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 OP2 Regulation 5 Requirement Residents must be provided with a contract or a statement of terms and conditions of the placement Ensure that care plans are fully completed, regularly reviewed and involve residents where able Ensure that footplates are used when using wheelchairs Ensure that Medicine Administration Records sheets are completed after every drug administration Ensure that resident’s privacy and dignity is maintained at all times. Ensure that residents are provided with a suitable range of activities on a regular basis A report must be prepared stating action to be taken following resident surveys. Timescale for action 01/07/06 2 3 4 OP7 OP8 OP9 15 12 13 01/06/06 25/04/06 25/04/06 5 6 7 OP10 OP12 OP33 12 16 24 25/04/06 01/07/06 01/07/06 Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 24 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 Refer to Standard OP9 Good Practice Recommendations Provide photographs of new residents with MAR sheets promptly after admission Kingsthorpe View Care Home DS0000039367.V288095.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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. 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