Inspection on 21/09/05 for Kingston House

This inspection was carried out on 21st September 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingston House 26/06/07

Kingston House 04/07/06

Kingston House 22/02/06

Kingston House 15/03/05

Kingston House 09/11/04

Kingston House 29/10/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Kingston House 43 Woodfield Park Drive Leigh On Sea Essex SS9 1LN Lead Inspector Patricia Stanton Unannounced Inspection 21st September 2005 08:00 Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 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 DS0000036988.V252672.R01.S.doc Version 5.0 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 Adults 18-65. 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 DS0000036988.V252672.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingston House Address 43 Woodfield Park Drive Leigh On Sea Essex SS9 1LN 01702 712022 01702 712544 sarah.axam@achuk.com 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) Aitch Care Homes Limited Manager post vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15/3/2005 Brief Description of the Service: Kingston House is situated in a residential area of Leigh on Sea, Essex in close proximity to the town centre, local amenities, shops, pubs, clubs and sea front. The home provides care to a wide age of residents from both genders. The home can accommodate up to nine residents with a learning disability. The house has good quality sized single bedrooms on the three floors, all with ensuite facilities, plus good sized communal areas and garden. The home is decorated to a fair standard but in need of some interior decoration. The home provides transport for staff to transport residents. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The routine unannounced inspection too place on the 19/9/2005. During the inspection some of the premises were inspected and records and documents were looked at, including the previous requirements and recommendations from the last inspection. Time was spent in the lounge, kitchen, garden and dining room, chatting and taking note of the residents’ daily routine in the home. The inspector spoke to six of the residents, two staff members, the assistant manager and acting manager who were most helpful, and this was greatly appreciated. The inspector would like to thank the residents and staff for their hospitality, time and cooperation during inspection. What the service does well: What has improved since the last inspection? The home has produced a resident’s information magazine for publication for residents, friends and family plus internet facilities to assist residents keep in contact with friends and family and help increase information and contact. Residents have developed a sensory room with the assistance of the homes staff and the acting manager has begun a network support with other homes to share good practice and promote continuity of care, including training and role-play to educate staff. Residents with challenging behaviour have settled and improved with assistance from staff, resulting in a more positive effect on both residents and staff. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 6 The home has sought an appropriate sexual health policy and accessed appropriate videos for individual’s who required sexual health education. The home has produced new policy regarding drug administration and personal issues. The home helps residents complete a scrapbook regarding significant events in their lives to assist reflection on achievements and record memories. The home has replaced some furniture and carpets in the home to make the home homely. More than 50 of all staff working in the home have achieved NVQ level 2 or above. 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. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Prospective residents and their representatives know that the home will assess and meet their individual needs and aspirations. EVIDENCE: From talking to residents and examining records regarding activities and daily lives, it was evident residents feel their needs and aspirations were met whilst living in the home. Residents receive care from key workers and co key workers who ensure residents’ needs are assessed and plans drawn up to help residents achieve their dreams and goals. Some residents had made several big steps in personal achievement since the last inspection and the residents’ needs appeared to be at the centre of the homes ethos. One resident who had a fear of cars, was to get into a car to visit his mother. The resident was assisted by the homes staff to gradually become involved in cars, first by washing cars, then sitting inside one. Eventually the resident was able to go to visit his mother who he had not seen for many years. The resident appeared elated with his achievement. Another resident wanted to go horse riding and staff encouraged her to attend the stables and familiarise herself with horses before taking the next step to ride a horse. Other residents were observed to have progressed in individual personal goals and appeared contented living in the home. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 9 The communication between residents’ relatives and friends had improved with the introduction of the residents three monthly newsletters and email which had resulted in feedback from relatives expressing their gratitude with the homes staff. It was evidenced that relatives feel much more informed and happy knowing the care their loved ones receive, meet their individual needs. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14,33,7,37 Residents make decisions about their lives and are given choice and control assisted by the homes staff. Residents are consulted on and participate in all aspect of their life in the home, which is run in the best interest of residents. Residents are supported to take risks as part of an independent lifestyle with appropriate assessments completed by staff. The homes staff access appropriate care for individuals health, personal and social care needs. EVIDENCE: The home does not hold regular residents meetings but speaks individually to residents on a daily basis to seek their views and opinions regarding their care. Residents plan with key workers every three months, their goal plans and monthly activity plans. Residents decide on where they would like to go each week, which activities they would like to participate in, which education or work placement they would like to attend and are involved in care planning and reviews with staff and their significant others. Risk assessments are completed for residents who wish to participate in physical activities such as horse riding, climbing and outdoors pursuits. Many of the homes residents are very young and enjoy a wide range of activities but one resident who is older prefers not to participate in physical activities and the home respected his wishes. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 11 The home had supported the resident recently with appropriate health care checks. One letter received from a relative thanked staff for taking her son to a consultant’s appointment. Other residents attended health appointments including doctors, dentist, opticians, psychologist, physiatrists, and sexual health clinic. Two residents who had challenging behaviour had benefited from sessions with a behaviour therapist, with the assistance of staff in the home. The outcome had resulted in a marked improvement in the understanding of residents’ behaviour. The home had accessed appropriate sexual health education videos for individual residents to assist them to understand their emotional needs. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,10,15 Residents find their lifestyle experience whilst living in the home matches their expectations and preferences and satisfies their social, cultural religious and recreational interest and needs. Residents maintain contact with family, friends and the local community as they wish and their right’s and privacy respected by the homes staff who treat them with respect and kindness. Residents receive a wholesome appealing balanced diet in a pleasing surrounding, at times convenient to them. EVIDENCE: Daily routines were flexible and there was a strong ethos in the home of promoting resident’s independence and choice along with supporting them to pursue interest and maintain control of their lives. One relative wrote, “I like the way everyone at Kingston House is treated as an individual and all have their own daily programme of activities. My son has lots of energy and is kept busy and active with a variety of activities. In particular he is supported and loves the evening social events and days out. The holiday last year was a real Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 13 high spot for him too. As parents we are kept informed and staff make us welcome at any time”. Visiting arrangements were open and relaxed and staff promoted contact with the local community. Residents were supported to attend educational and work placements and many residents were enrolled in college courses. The home assists residents to access the local community and provides transport s although at inspection the home was short of drivers. Residents are given choice about how they would like their room decorated, types of furniture and personal clothing. Residents spoken to stated how they enjoyed the food in the home and at inspection one resident was baking a cake for other residents. Residents choose a favourite meal each week, which is incorporated into the weekly menus. Food stores examined were fresh but no fruit was seen, one relative wrote a letter to the home suggesting “ it would be nice if the food at Kingston House included more fresh fruit for snacks and I would love to see a chef employed to cook for everyone and not rely on the staff. Therefore less convenience food would be used. If the house turned to organic food – Brilliant”. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 10,8 Residents receive personal care and support in the way they prefer and have their physical and emotional needs met. EVIDENCE: Residents were assisted with personal care by staff with dignity and respect ensure privacy. Because of the wide age range of the residents living in the home it was noted staff had accessed services for residents ranging from the HRT to, sex education and psychological needs. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Residents and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Residents are protected from abuse. EVIDENCE: Appropriate practices were in place to promote the protection of residents from abuse and staff spoken to at inspection had received appropriate protection of vulnerable adults training and were conversant with the signs or abuse and the procedures for reporting abuse. The home had recorded 21 incidents since the last inspection and these were all examined and recorded appropriately however it was noted they were not signed off by a manager to evidence appropriate outcomes. The complaints process in the home is good with information available to residents in an appropriate format to assist them make complaints. Since the last inspection no complaints had been received in the home. The acting manager has excellent communication skills and had assisted in resolving a problem with a neighbour positively. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,25,20,26 Residents have access to indoor and outdoor communal facilities, however the home is in need of decoration, maintenance and regular routine cleaning. EVIDENCE: The house was furnished to a good standard and residents had helped choose furniture in the lounge however on the day of the inspection it was in need of decoration especially the interior walls, which were chipped and marked. The home was not very clean on the day of inspection and some carpets and flooring was dirty. The acting manager stated due to staff shortages cleaning had not been a high a priority staff were spending their time with residents. The rear of the homes garden was observed to have no facilities for residents to use despite it being a sunny day. The acting manager stated the home had a sand pit, goal post and football skittles but these were not seen. The acting manager stated the home had a large pool for residents, which was being repaired. Staff sat with one resident who completed needlework in the garden but the lawn had not been cut and disused furniture was being stored in one corner of the garden. It was noted the side gate was locked which may cause a fire risk if all staff do not have keys. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28,27,30,36 Residents are supported by competent and qualified staff but the numbers of staff working in the home does not meet the needs of residents needs at all times. Staff are trained and competent to do their jobs. The residents’ benefit from well supported staff but supervision has not been regular during the homes recently unsettled period. EVIDENCE: The staff employed in the home appear to be competent and qualified to support the needs of residents despite a considerable instability in staffing in the home the staff had managed to achieve a good quality of care to residents. Over 50 of all staff working in the home have completed NVQ level 2 or above. It was noted the home accommodated nine residents, four of the residents require a significant amount of one to one support. Rotas examined confirmed the maximum amount of staff working in the mornings was 4 or 5 support workers with only 4 support workers in the afternoon and two waking night staff. The inspector enquired how the staff are able to give one to one care during the day whilst completing domestic duties in the home. One staff member stated the home has been struggling to complete cleaning duties due to staff shortages. The acting manager stated the home had gone through a Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 18 difficult period during transition of management and staff had left the home due to personal reasons, however five new support staff were due to start work in the home in the next few weeks which would address staff shortages plus a new staff cleaning rota had been introduced. No staff were seen to be completing cleaning during inspection only cooking and the home has had to employ agency staff to fulfil shortages. One staff member stated the time training agency staff is consuming and again adds to shortage of time for caring. The acting manager has had to deal with many issues since being in post and has coped very well. The acting manager has prioritised to ensure residents come first at all times but this has resulted in lack of non urgent work being completed such as formal supervision and cleaning. The acting manager stated since being in post she has had to complete a backlog of work, which was incomplete and is trying to reorganise the home and its office to help staff work more effectively. Staff spoken to at inspection was very supportive of the acting manager and confirmed the home had been through a difficult period of transition. It was noted the communication between staff residents and management was very positive and mutually respectful and one letter received recently from a relative stated, “The staff at Kingston House go the extra mile to help my son. All staff work hard at helping him to feel understood and safe and secure. He is treated with respect and valued as an adult.” Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,37 Residents 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 her responsibilities fully supported by a good registered provider. Residents’ benefit from an ethos, leadership and management approach of the home. The home is run in the best interest of residents and the homes record keeping policies and procedures safeguards residents’ rights and best interest. EVIDENCE: The acting manager who has been in post since April 2005 has applied to the CSCI for the registered managers position in the home. The acting manager has a clear development plan and vision for the home and had applied to undertake NVQ level 4 in health and social care management. The acting manager had many years of experience working in learning disabilities including two and a half years training as a Mental Health Nurse. Although the acting manager did not have management experience prior to working at Kingston House she appeared to be very competent, creative, Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 20 enthusiastic and committed. The registered provider supports the acting manager and minutes confirmed the registered provider visits the home regularly, to take part in staff meetings and regulation 26 visits. The home arranges the completion of questionnaires each year from residents and relatives to form part of a quality assurance and monitoring system. The acting manager stated this years report would be forwarded to the CSCI in the next few months. Staff confirmed the registered manager is supportive and approachable but staff had not received regular formal supervision. One staff member had only received three formal supervision sessions in the two years. However staff stated they are able to voice their views and opinions in staff meetings, but minutes examined did not evidence staff views. The homes policies and procedures are being updated. It was noted some the policy for sexual health was not personalised to the home but the acting manager was in the process of updating policies. The registered manager had introduced new polices for personal issues which arose in the home i.e. hair pulling. It was observed the acting manager had worked hard through a difficult time and gained management experience since in post. Further appropriate management training would assist her develop her role. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 2 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingston House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 2 X X X X X DS0000036988.V252672.R01.S.doc Version 5.0 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA24 Regulation 23(2) Requirement the homes premesis must be kept in a good state of repair and kept clean and reasonably decorated at all times. The home must employ adequate numbers of suitable qualified staff to meet residents needs at all times. Staff should receive regular health and safety training and specialised training in epilepsy, autism and aspergers. All staff must have access to keys to enable emergency exit from the homes rear garden. Timescale for action 01/12/05 2. YA33 18(1) 01/10/05 3. YA35 18( c ) 01/12/05 4. YA38 23 4 (b) 19/09/05 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. 2. Refer to Standard YA13 YA15 Good Practice Recommendations The home should ensure suitable drivers are available to transport residents. The home should promote healthy food snacks for residents including fresh fruit. DS0000036988.V252672.R01.S.doc Version 5.0 Page 23 Kingston House 3. 4. 5. 6. 7. YA17 YA24 YA36 YA31 YA37 Incidents should be signed off by the registered manager/provider to evidence appropriate outcome. The garden should be kept free from unused furniture and maintained to benefit residents. Staff should receive formal supervision at least 6 times per year. Staff views and opinions should be recorded to evidence inclusion into decisions in the home. The homes policies and procedures should be personalised and updated regularly. Kingston House DS0000036988.V252672.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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 DS0000036988.V252672.R01.S.doc Version 5.0 Page 25 - 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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