Inspection on 14/06/07 for Kingston House

This inspection was carried out on 14th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Kingston House 26/06/09

Kingston House 09/11/05

Kingston House 13/07/05

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 Key Unannounced Inspection 14th June 2007 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 Kingston House DS0000028549.V342891.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. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston House Address Lansdowne Crescent Derry Hill Calne Wiltshire SN11 9NT 01249 815555 01249 818928 kingstonhouse@btinternet.com www.greensleeves.org.uk Greensleeves Homes Trust 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) Mrs Carol Mather Care Home 34 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (34) of places Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only the service user referred to in the application dated 12th April 2006 may be accommodated in the home under the category of Dementia, over 65 years of age. 9th November 2005 Date of last inspection Brief Description of the Service: Kingston House was originally built as a convalescent home and became a care home for older people in 1978. The home has been owned and managed by Greensleeves Homes Trust since 1997. There are large gardens on two sides of the home and a parking area at the front. The accommodation is on two floors with a passenger lift available. There are two lounges and a dining room, as well as a library and an activities room. Each service user has a single room with an en-suite toilet and wash hand basin. Some rooms also have a bath. A regular programme of activities is arranged in the home. There is a pay phone and many service users choose to have a telephone in the own rooms. Service users receive 24-hour personal care and support. There is a management team and a staff team, which includes senior carers, carers, catering staff and domestic staff. A keyworker system is in operation. One room in the home is reserved for people who wish to have a temporary or respite care stay. The range of fees at the time of this inspection was between £410 and £485 per week. Information about Greensleeves Home Trust, including the home’s brochure, can be obtained through the organisation’s web site. Inspection reports can be seen in the home and are also available through the Commission’s website: www.csci.org.uk Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included an unannounced visit to the home, which took place on 14 June 2007 between 9.30 am and 4.50 pm. A second visit was arranged with the home’s manager in order to complete the inspection and to give feedback. This took place on 26 June 2007. Evidence was obtained during the visits through: • • • • Time spent with the service users. Meetings with the home’s manager, Mrs Carol Mather, and with four members of staff. Observation and a tour of the home. An examination of records, including five of the service users’ personal files. Other information has been taken into account as part of this inspection: • • A pre-inspection questionnaire that was completed by the manager about the running of the home. Surveys that were completed by 17 service users, 21 relatives and visitors, and by 7 health and care professionals. The judgements contained in this report have been made from all the evidence gathered during the inspection, including the visits. What the service does well: Good information is available, which helps people to make an informed choice about whether to move into the home. Prospective service users have their needs assessed and contracts are agreed. Each person has an individual care plan. People feel that they are well supported with their personal care, health needs and medication. People like the lifestyle that they experience in the home. Regular activities are arranged and there are different areas for recreation and relaxing. Some people prefer to spend time in their own rooms and they are enabled to do this. Staff treat people with dignity and respect their privacy. People are supported by care staff who undertake training and qualifications, which develops their competence. There is a choice of meals, which are well prepared by experienced catering staff. The meals are served in pleasant surroundings. The home is kept clean and well maintained. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 6 Service users are encouraged to make suggestions about the home and to raise any concerns. People are mostly well protected by the systems in place. Checks are carried out on staff, which helps to ensure that they are suitable to work in the home. Relatives and other visitors are made welcome and they feel that the home generally provides a very good service. People are confident about how the home is run and are mostly very happy with the day to day arrangements. What has improved since the last inspection? The home has joined the National Association of Care Catering. This gives it access to guidance and information about nutrition and healthy eating. This will help ensure that service users receive good support in this area. It was recommended at the last inspection that the arrangements for personal shopping are reviewed in order to ensure that appropriate safeguards are in place. Records are now being kept, which show when a service user has given a staff member money and asked them to buy something on their behalf. This provides greater transparency about the arrangements in place and the individual transactions involved. Work had just started at the time of the visits to replace the home’s original windows. These had become difficult to operate for some people. One service user who was met with said that they were very pleased with their new window. Redecoration has taken place in parts of the accommodation, as part of the ongoing upkeep of the home. The number of care staff with a National Vocational Qualification has increased from 40 to 71 . This means that the staff team as a whole are better qualified and service users can be more confident about the competence of the staff who support them. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 7 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. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 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 Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Prospective service users receive the information that they need about the home. Their needs are assessed before moving in. (Standard 6 does not apply to this home). Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 10 EVIDENCE: An information pack for service users and visitors was available in the home’s entrance hall. There was also a copy of the ‘Statement of Purpose’, which set out the home’s aims and gave details of the service to be provided. The home’s Statement of Purpose was last reviewed and amended in December 2006. A copy of the updated Statement of Purpose was sent to the Commission at the time. Thirteen service users who completed surveys confirmed that they had received enough information about the home before moving in, so that they could decide if it was the right place for them. Four people responded that they had not, but qualified this with comments such as ‘the decision to move was based more on recommendations than the information received’; ‘I had visited friends at Kingston House’ and ‘my own fault as I was in hospital and had to move out almost immediately and go straight into a residential home’. In their surveys, all the service users confirmed that they had received a contract. Several new service users had moved into Kingston House since the home was last inspected. The pre-admission assessment arrangements were discussed with the home’s deputy manager, who usually undertook the assessments. The deputy manager said that the assessments were carried out in the prospective service users’ own homes as far as possible. The assessments were recorded on forms that the Greensleeves Homes Trust had produced for use in their care homes. One of the assessment forms, dated January 2007, had not been completed in full. For example, the sections on oral health and foot care; food preferences; religious observation and occupational and recreational needs, were blank. The deputy manager said that these matters had been discussed, although it was sometimes difficult to get all the pre-admission information about service users in the time that was available before they moved in. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area varies, but is good overall. This judgement has been made using available evidence including the visits to the home. Most of the service users’ health and care needs are well set out in their individual plans, although there are some significant omissions. Service users are protected by the home’s policies and procedures for dealing with medication. Service users are treated with respect and their right to privacy is upheld. EVIDENCE: Greensleeves Homes Trust had produced a documentation system to be used as an on-going record of the service users’ care. Each service user had an individual file, which included the assessment and care plan forms that came with the system. Examples of five service users’ individual files were looked at. Care plans were seen which had been signed by service users and appeared to reflect their Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 12 needs. They included good information about people’s expectations, preferred routines and what they were able to do for themselves. However there were examples of where the care plans lacked detail. For example one service user was described as needing ‘minimal assistance with shower or bath’, although the nature of this assistance was not specified. In some cases a particular concern was identified, such as a service user who was ‘prone to falls’ and had previously attended a falls clinic. It was recorded in the ‘Action’ section of the care plan that staff were to be aware, although this had not been followed up with a risk assessment for falls or more detailed guidance. Assessments had been completed for the service users’ moving and handling needs. It was stated in the ‘Statement of Purpose’ that the home can cater for people with mild confusion. The arrangements being made for meeting the specialist needs of one service user were discussed with Mrs Mather. It was found that the care records did not reflect their level of need and their assessment had not been reviewed in response to some significant incidents. There was a lack of clear guidance for staff about how to support this person appropriately. Mrs Mather confirmed that this would receive attention and sent copies of new documentation to the Commission after the visits. Review forms were being used each month to record changes in the care plans. In their survey, a health professional commented that the care plans agreed with the home had been followed in accordance with their instructions. Details of appointments with a range of healthcare professionals were recorded in the service users’ records. Service users were being supported with making GP appointments at the time of the visits. One service user said that they had been well supported with some hospital visits. There was discussion with Mrs Mather about the recording system being used. The format of particular forms did not include sections where the initials of staff and the outcome of reviews could be clearly recorded. Fifteen service users confirmed in their surveys that they always received the care and the medical support that they needed. Two people responded that this was usually the case. Of the relatives and visitors who completed surveys, seventeen people confirmed that the home always gave the support or care that they expected. Four people stated that this usually happened. Fourteen people felt that the home always met the needs of their relative or friend in the home. Seven people felt that this was usually the case. The health professionals who completed surveys responded positively about how the home acted upon advice and met the service users’ individual care Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 13 needs. They also felt that the services users’ privacy and dignity was respected and that service users were always, or usually, supported to live the life they chose. Staff were observed being attentive to service users during the visits. For example, when meeting with one person in their room, a staff member came to replace their jug of water with a fresh supply. The service user commented that this was usual practice and that it would not be a problem to ask staff to visit them at other times. Medication assessments were included in the service users’ care records. Most service users were fully supported by staff with the safekeeping and administration of their medication. Medication was kept securely in a designated room. Current medication was dispensed from a lockable trolley, with other stocks stored separately in a cabinet. Space in this cabinet was very limited and the way that the contents were kept gave it an unorganised appearance. The records of administration were up to date. Other records were being completed as part of the monitored dosage system that the home used. The administration of medication was usually the responsibility of senior staff. Night staff had some responsibility for a limited supply. Stock checks were being made and recorded. Overall the records were well maintained. One error in recording was noted, where an incorrect amount had been entered on the record. This appeared to be an isolated occurrence, which Mrs Mather followed up when it was brought to her attention. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 14 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 and 15 Quality in this outcome area is excellent. This judgement has been made using available evidence including the visits to the home. The lifestyle in the home generally meets the service users’ expectations and needs very well. Service users can maintain contact with relatives and their visitors are welcomed into the home. Service users have meals that they enjoy. They can exercise choice at mealtimes and in other aspects of their daily life in the home. EVIDENCE: Service users were met with during a tour of the home on the morning of the first visit. One noticeable feature was the different activities that the service users were involved in. Several people were spending time in the lounges, where they were reading, having conversations or just relaxing. The chairs in both lounges were arranged so that service users had different outlooks and could meet in small groups. One of the lounges was relatively busy as it was a throughway to other parts of the home. The other lounge was quieter. A service user said that staff were thoughtful about where people would like to meet with their visitors and helped to find a quiet spot in one of the lounges. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 15 One service user was having a game of patience in the activities room. Large format playing cards were available. There were paintings and drawings on display in the room, which service users had produced when attending the art classes. Service users were also spending time in their own rooms. People said that this was their choice and that they decided when they wanted to join in with an activity in one of the lounges. One service user said that they liked the quiet of their own room and they were not inclined to use the communal areas because of the noise. Of the relatives and visitors who completed surveys, thirteen people confirmed that the home always helped their relative or friend in the home to keep in touch with them. One person stated that this usually happened and two people that it sometimes did. Details of the home’s activities programme were displayed, together with other information that would be of interest to service users and visitors. This was in large print format. Some service users took part in a quiz on the day of the visit. Meetings were being held when service users had the opportunity to comment on the routines and activities in the home. Minutes of the meetings were kept and on display. In their surveys, ten service users confirmed that there were always activities arranged by the home that they could take part in. Three people stated that there usually were and four people stated sometimes. Fifteen relatives and visitors confirmed in their surveys that the home always supported people to live the life that they chose. Three people stated that the home usually did this. A religious service was regularly held in the home. On occasions this was arranged ‘in-house’ and at other times it was a service with communion involving an outside minister. There were photographs on display of some recent events that the home had arranged. Some coach trips had been previously been arranged although Mrs Mather said that there was a move towards shorter outings involving a smaller number of people. There was a requirement at the last inspection that the needs and wishes of individual service users must be taken into account as part of a review of the home’s activities programme. A new system had since been introduced as a development of the home’s activities programme. This resulted in service users receiving one to one support with a specific task or activity, for example being accompanied on a short walk. An ex-member of staff was now also working as a volunteer and available to act as an escort to service users, for example when going shopping. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 16 The service users’ records included completed ‘Daily Routine’ and ‘Personal Profile’ forms, which gave staff information about the service users’ preferred routines and activities. Service users said that they liked the meals. The people who completed surveys also commented favourably. Fifteen service users confirmed that they always liked the meals and two people stated that this was usually the case. One person commented that the cook was thoughtful and good about meeting their individual needs. Service users were joined for lunch during the visit on 14 June 2007. There was a choice of dishes and service users had been asked what they would like before the meal. People’s individual preferences were confirmed with them when seated at the table. The majority of service users required no support with their meal although staff members were aware of a small number of people who needed assistance. There were examples of support being provided in a sensitive and thoughtful way. This included a choice of dishes being brought to a service user to help them decide which one to have. One service user had support with cutting up their meat away from the table, so that it was not something that other people needed to be aware of. The home’s main cook talked about their approach to the preparation of meals and meeting the needs of older people. This was very positive and the home was obtaining guidance from the National Association of Care Catering. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 17 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users are encouraged to make suggestions and raise any concerns. Service users and their relatives can have confidence in how these would be followed up. Service users are protected from abuse. There are further ways in which polices and practice in this area could be developed. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 18 EVIDENCE: Twelve service users and eighteen relatives and visitors responded positively when asked in the surveys if they knew how to make a complaint. Of those that didn’t, one person commented that they hadn’t needed to and another that they could find out if they needed to. Eleven relatives and visitors confirmed that the home always responded appropriately if they or a service user had raised concerns about the care. Four people stated that this usually happened. The home’s complaints procedure was well set out in the written information that was produced for service users. This included information about how a concern or complaint would be followed up and who could be contacted if a complaint remained unresolved. Details were given about the Commission’s involvement. The Commission has received no complaints about the home and Mrs Mather confirmed that none have been made directly to the home. Staff members received guidance and training in the home about abuse awareness and the reporting of allegations. The training did not include any external input, which would give staff a different perspective about the procedures for safeguarding vulnerable adults and how these are implemented. Greensleeves Homes Trust had produced polices and procedures, which were designed to promote good practice and reduce the risk of service users coming to harm. This included guidance for staff about abuse prevention, whistle blowing and their involvement in service users’ financial affairs. It was recommended at the last inspection that the arrangements being made for personal shopping are reviewed in order to ensure that appropriate safeguards are in place. This had received attention with the setting up of a recording system, which shows when a service user has given a staff member money and asked them to buy something on their behalf. This provided greater transparency about the individual transactions involved, although the form used did not refer to the need to obtain receipts. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 19 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 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users live in a well-maintained environment, which is kept clean and tidy. EVIDENCE: Kingston House is in a quiet location in a residential area. There was level access to the home, with a spacious drive and parking area at the front of the building. The grounds were well kept. There were features such as hanging baskets and flowering borders, which made the exterior of the home look attractive and welcoming. There were no unpleasant odours upon arrival at the home and when going around the accommodation. The accommodation looked well decorated and maintained. As previously reported, there were a variety of communal areas that service users were using during the visits. In addition to the two lounges, Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 20 there was a separate dining room and smaller rooms for specific activities. The latter included an art and activities room and a small kitchen and utility area for use by service users. A piano was available. The service users’ rooms looked well personalised with the occupants’ own furniture and pictures. The majority of rooms had outlooks over the gardens, which some people said they particularly enjoyed. Kingston House was purpose built as a convalescent home. Several facilities, including the passenger lift, have been upgraded over the years and improved the overall environment for use by older people. Work had just started to replace the home’s original windows, which had become difficult to operate for some people. One service user who was met with on 26 June 2007 said that they were pleased with their new window. The home looked clean and tidy. Staff, in the role of house assistants, were working at the time of the visits. Service users said that they were satisfied with the support that they received with the cleaning of their own rooms. In their surveys, sixteen service users confirmed that the home was always kept fresh and clean. One person thought that this was usually the case. This is also something that relatives and visitors thought that the home did well. Their comments included: ‘ the care home is always immaculately presented’; ‘it is very clean and makes you feel at home’; ‘the dining room is scrupulously clean and attractive’; ‘spotlessly clean, maintain the building and gardens well’ and ‘the home itself is very clean and well appointed’. One service user suggested that hygiene would be further enhanced by providing visitors with a means of washing their hands when arriving at the home. This was discussed with Mrs Mather, who was aware of the issue. She had given it some thought, but was concerned about the practical arrangements and that impact that a facility would have on the appearance of the front hall. (There may be products available, such as a hand cleansing gel, which would have less impact in this way). Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 21 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. The service users’ needs are being met by competent staff. Service users are protected by the home’s recruitment practices. EVIDENCE: Staff rotas were being kept which showed the deployment of care staff during the day and at night. Care staff were not significantly involved in domestic duties and there were separate rotas for cooks, house assistants and the maintenance person. Staffing levels varied between three and five people, dependant upon the time of day. At least one member of the senior staff team was deployed throughout the day. There had been some use of agency staff during the last few weeks, although this was not excessive. Based on the home’s own calculation of dependency levels, the number of care hours provided were slightly in excess of the number required for this size of home, as recommended in guidance produced by the Residential Forum. The service users met with spoke favourable about how they were supported and the approach from staff. In their surveys, nine service users confirmed that staff were always available when they were needed. Eight service users felt that this was usually the case. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 22 The recruitment and employment files were looked at for two care staff who had started work in recent months. These files were well organised and contained the required references and documentation in respect of Criminal Record Bureau (CRB), Protection of Vulnerable Adults (POVA) list and other checks. Staff training events and courses were arranged in conjunction with the Greensleeves Homes Trust’s Training & Administrative Co-ordinator. Plans were produced showing the range of training activities provided, the dates for attendance and when refresher courses were due. Mrs Mather also maintained individual records for staff, as a means of monitoring progress with meeting their individual training needs. The home had achieved the ‘Investors in People’ award. New staff members took part in a planned induction programme and were expected to follow this with undertaking a National Vocational Qualification (NVQ). 71 of the care staff had achieved NVQ at level 2 or above. This was an increase of 31 since the home was last inspected in 2005. Statutory training had taken place during the last year, including moving and handling, food hygiene, first aid, fire and infection control. Other training events had included ‘Therapeutic Activities and Dementia’, ‘Care of the Diabetic’ and a course titled ‘Food for Thought’. The home’s main cook had undertaken courses in food hygiene and nutrition in care settings. Further training had been planned in some of these topics, including first aid, which not all staff had received. Courses in ‘Dementia Awareness’, ‘Risk Assessment’ and ‘Nutrition and Oral Care’ had been planned. Three care staff members were met with during the visit on 16 June 2007. They confirmed the induction that they had received and felt that the on-going training was comprehensive. Sixteen relatives and visitors who completed surveys thought that the care staff always had the right skills and experience to look after people properly. Four people thought that they usually did. All seventeen service users who completed surveys confirmed that the staff listened and acted on what they said. Many people made positive comments about the attitude and friendliness of staff. A small number of people made comments about staff appearing to be stretched at times and mentioned that providing more staff would be one way that the home could improve. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 23 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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including the visits to the home. Service users benefit from a manager who is well qualified and experienced to run the home. Service users and their relatives are given opportunities to express their views. Their feedback is not well reflected in the home’s development plans. Service users are generally well protected by the health and safety systems that are in place. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 24 EVIDENCE: Mrs Mather has had several years’ experience of managing Kingston House and other care services. She has achieved a range of relevant qualifications, including the Registered Managers Award and NVQs at level 4 in Care and in Management. Mrs Mather had undertaken training with Greensleeves Home Trust and through other agencies. This included completion of an Open University course in ‘Mental Health Problems in Old Age’. The home’s deputy manager has achieved NVQ at level 4 in Care and in Management. Greensleeves Homes Trust had produced a system for auditing standards in the home. Customer satisfaction surveys were sent out in October 2006 and the results of this were analysed during the following month. The feedback received was generally very positive, although some comments were received about the standard of laundry on occasions. Comments received by the Commission as part of the inspection were generally very favourable. These were discussed with Mrs Mather during the visit on 26 June 2007. A number of people had commented positively about the friendly atmosphere in the home and the efforts of the management and staff team. Residents’ meetings were being held, when people were consulted and could give their views about the day to day arrangements. A requirement was made at the last inspection that a development or improvement type plan is produced as part of the home’s system of quality assurance. Mr Mather had since produced a document titled ‘Annual Business Plan Information for 2007/8’. This set out some objectives for the home, which would develop the service. However it did not highlight the views of service users or other parties and how these had been followed up. Information about health and safety, including the maintenance and servicing of equipment and the checking of the fire precaution systems, was received from the home in a pre-inspection questionnaire. Some records were looked at during the visits. The home was using the services of a care consultancy company to manage health and safety in the home. The completed documentation included risk assessments of the environment, for example in respect of fire and slipping on pathways. A health and safety audit report had been written in December 2006. Mrs Mather said that the issues raised in this report were being addressed. Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 25 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 3 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 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 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 15(2) Requirement The service users’ individual plans, including risk assessments where appropriate, must be kept under review to ensure that they set out all aspects of the service users’ current needs and how these are to be met. Timescale for action 27/06/07 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 OP3 Good Practice Recommendations That the assessment forms are completed in full, in order to ensure that there is good information recorded about a service user’s needs and preferences. That more detail is recorded in the service users’ care plans, in order to give better guidance to staff about the type of support that service users should receive. That the facilities for the storage of medication are changed in order to produce a more organised approach. 2. OP7 3. OP9 Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 27 4. OP18 That there is some external input into the training that staff receive in abuse awareness. This is so that staff receive a different perspective about how the procedures for safeguarding adults are implemented. That a statement on quality assurance is produced, which details the different components and the timescales that apply. (Recommendation made at last inspection) That the home’s development plans are developed in order to show the involvement of service users and others and how their feedback has contributed to the improvements and objectives identified. 5. OP33 6. OP33 Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Kingston House DS0000028549.V342891.R01.S.doc Version 5.2 Page 29 - 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. 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