Inspection on 13/07/05 for Kingston House

This inspection was carried out on 13th July 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

Kingston House 26/06/09

Kingston House 14/06/07

Kingston House 09/11/05

Kingston House 16/11/04

Kingston House 22/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingston House Lansdowne Crescent Derry Hill Calne Wiltshire SN11 9NT Lead Inspector Malcolm Kippax Unannounced 13th July 2005 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. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingston House Address Lansdowne Crescent Derry Hill Calne Wiltshire SN11 9NT 01249 815555 01249 818928 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) Greensleeves Homes Trust Mrs Carol Mather Care Home 34 Category(ies) of OP Old Age registration, with number of places Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2004 Brief Description of the Service: Kingston House is one of a number of care homes in England that are run by the Greensleeves Homes Trust. Kingston House was purpose built as a convalescent home and became a care home for older people in 1978. The accommodation is on two floors and each service user has their own single room. All rooms have an en-suite toilet and wash hand basin and some rooms also have a bath. A passenger lift is available between floors. There are communal rooms on the ground floor that include a choice of lounges, a dining room and an art/activities room. The home stands in its own grounds and has gardens that are accessible to the service users. Kingston House is the service users’ permanent home, however one room in the home is reserved for people who wish to have a temporary/respite care stay. Service users receive 24-hour personal care and support from a management and staff team. A keyworker system is in operation. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 9.40 am and took place over 4.5 hours. Service users were met with in the lounges and in their own rooms. The inspection focussed on the outcome for three service users, each of whom had a different experience of the home. One of these service users was receiving respite care in the home, another had recently moved in and a third person had lived in the home for several years. Three staff members who were in the role of keyworker to service users, were spoken with. This included a senior carer who was in charge of the home, as the home’s manager and deputy manager were not working at the time. Some of the home’s records were examined, including examples of the service users’ care plans and assessments. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure that the needs of a new service user are always accurately reflected in their assessment records. For the protection of service users and staff, more information must be recorded when a staff member is asked to buy things on behalf of a service user. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 6 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. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 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 Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 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) 1, 2 and 3 Service users receive good information about the home before and after they move in. The needs of prospective and new service users are well assessed, however care is needed to ensure that the correct terminology is used. EVIDENCE: Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 9 Service users said that they and their relatives had been given the information they need about the home. Greensleeves Homes Trust has produced a Statement of Purpose and a separate information pack for service users. Shortly before this inspection, the Commission had received an updated copy of the home’s Statement of Purpose. A copy of the home’s last inspection report was available to service users in one of the lounges. Other information of interest to service users was well displayed in the home. A new service user had received a terms & conditions statement and a copy of this was seen on the service user’s personal file. An initial assessment had been undertaken prior to admission and this had followed by a more comprehensive assessment and care plan after the service user had moved into the home. Different terms were being used to describe the service user’s mental state and cognition, although the use of a particular term was not supported by a confirmed diagnosis. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8 Service users benefit from the information staff members have about their individual needs. Good systems are in place for the monitoring of the service users’ health and personal care. EVIDENCE: The home uses the Greensleeves Homes Trust’s system of care planning. Examples of three service users’ personal files were looked at. Each contained a set of completed care and assessment forms. The care plans had been reviewed on a monthly basis. Service users said that they are not offered a copy of their individual plan but did spend time talking with staff about their care. Staff members confirmed that it was part of their role as keyworker to complete the care plans with service users although the system did not include service users receiving their own copy. Details of appointments with a range of healthcare professionals were recorded in the service users’ records. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 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 and 15 Service users have individual lifestyles. Activities are available but it is recognised that service users may also wish to be independent in their interests and routines. Service users generally enjoy the food and are well consulted about the meals. EVIDENCE: Some service users were spending time in their own rooms and others were using the lounges. Service users said that there was no pressure to be in a particular place and they could choose what communal activities they wished to take part in. Information about the home’s activities programme for the week was on display. The service users’ records included completed ‘Daily Routine’ forms, which give staff information about the service users’ preferred routines and activities. Staff members were aware of where service users were likely to be and morning coffee was served to people in the lounges and in their own rooms. The menu showed that a choice of courses are available for most meals. Service users said that they like the meals and are asked each day about what they would like for lunch and tea. Records are kept of the service users’ choice of courses. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 12 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) 16 Service users have the information they need about complaints. Service users are encouraged to make suggestions and to raise matters of concern. EVIDENCE: A complaints procedure is included in the information pack that is given to service users. Service users said that they would know who to contact if they had a complaint. The comment was made that they had no reason to complain. The date of a forthcoming ‘satellite’ meeting was displayed on a notice board. These meetings are regularly held and service users have the opportunity to comment on matters that affect them in the home. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 13 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 and 24 Service users appreciate the home environment and like their own rooms. Service users benefit from the approach being taken to refurbishment and improvement EVIDENCE: The accommodation looked well decorated and maintained. A maintenance person was attending to various jobs in the home. Service users were coming and going during the day. There is level access to the home, with a good drive and parking space at the front of the building. This meant that service users could easily reach the vehicles parked outside the home. Service users said that they liked their own rooms. The rooms seen looked well personalised with the occupants’ own furniture and pictures. Since the last inspection, the maintenance person has tried to make some of the sliding windows in the service users’ rooms easier to use. This has had limited success. There are now plans to replace the windows with a more suitable Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 14 type. Several service users said that they enjoyed the view from their rooms, which overlooked the home’s gardens. The home continues to provide service users with a good range and variety of communal areas. In addition to the two lounges, there is a separate dining room and smaller rooms for specific activities. The latter include an art and activities room and a small kitchen and utility area for service users. A piano is available. The layout of the lounges enables service users to meet in small groups in relative privacy without disturbance from other activities. There are well maintained and attractive gardens. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 15 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 Service users are supported by a friendly and helpful staff team. Service users benefit from care and ancillary staff who are appropriately deployed and have clearly defined roles. EVIDENCE: A staff rota is maintained which shows the deployment of staff throughout the day. The rota reflected the staff who were actually working at the time. Agency staff were not being used. There were four carers working during the morning, in addition to a senior carer. A new senior carer was shadowing the senior carer as part of her first week of induction. Other staff had catering, domestic and maintenance roles in the home, which meant that the carers could focus on supporting the service users. Staff members spoke about their role in being keyworker to particular service users. This included support with bathing although staff and services users confirmed that other staff would step in at times when the keyworker was not working. A common view of the service users was that the staff were helpful and friendly. This was evident in the contact that was seen between the carers and service users. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 16 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) 35 More needs to be done to safeguard the service users’ financial interests EVIDENCE: It was reported at the last inspection that on occasions staff members are given money by service users and asked if they can purchase items on their behalf. This is usually part of the keyworker’s role. Records were not being kept of this expenditure and a requirement was identified. Since the last inspection a form has been produced for the recording of these transactions. An example was looked at and this did not show the purpose for which the money was received and there was no receipt to confirm the amount of money that was spent on behalf of the service user. The senior carer was not aware of a procedure for staff to follow in connection with this. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 17 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 3 3 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 4 x x x 3 x x 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 3 x x x x x x 2 x x x Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 18 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. 2. Standard 2 35 Regulation 14 20 Requirement That the needs of a new service user are accurately reflected in their assessment records That a record is kept of any money received from a service user or on a service users behalf. The record must state the date on which the money was received and the date on which the money was returned to the service user, or used and, where applicable the pupose for which the money was used (requirement outstanding in part from the last inspection) That a policy and procedure is produced about the involvement that staff members may have with the service users finances Timescale for action FROM 14/07/05 FROM 14/07/05 3. 35 20 BY 31/08/05 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. Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 19 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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 Kingston House D51_D01_S28549_KINGSTONHOUSE_V206999_130705_Stage4.doc Version 1.40 Page 20 - 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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