Inspection on 22/02/06 for Kingston House

This inspection was carried out on 22nd February 2006.

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 21/09/05

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 09:30 22 February 2006 nd Kingston House DS0000036988.V265362.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.V265362.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.V265362.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 kingston.house@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 (London) Limited Manager post vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 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-sized single bedrooms on the three floors, all with en-suite facilities, plus a communal areas and garden. The home is in need of some interior decoration. The home provides transport for staff to transport residents. Kingston House DS0000036988.V265362.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 22/02/2006. Records were looked at, including the previous requirements and recommendations. Kingston House has been taken over by the company Consensus Care since the last inspection. Time was spent in the lounge and kitchen chatting and taking note of the residents’ daily routine in the home. The inspector spoke to four residents, three staff members and the new acting manager, who were all most helpful, and this was greatly appreciated. The inspector would like to thank the residents and staff for their time and cooperation during inspection. What the service does well: What has improved since the last inspection? The atmosphere in the home appeared relaxed and happy. The employment of a new acting manager appeared to have a positive effect on both residents and staff team. Improvements for residents included more flexibility, choice, healthier food snacks, activities and education. The acting manager has experience and management skills to improve the service and lead the staff team. Staff meetings now include the views and opinions of staff and the staff rota to include adequate times for staff handover in the morning and evening. The acting manager signs off incidents and accidents and ensures staff receive appropriate guidance, supervision and support. The homes rear garden has been cleared of rubbish and side gate unlocked to allow access in case of emergency evacuation. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 6 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.V265362.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.V265362.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): 2, Residents’ individual needs and aspiration are taken into account but not enough information is sought regarding individuals’ interests and preferences. EVIDENCE: Residents enjoy a variety of activities outside the home but the home does not have regular residents meetings to seek individuals’ interests and aspirations. One relative spoken to stated his son enjoyed physical activities and the acting manager had put in place additional activities for the young man to go to the gym and regular bike rides. A more flexible evening routine had been introduced as residents were going to bed very early. Residents visit clubs and the cinema and at inspection one young man was looking forward to going to the disco so he could dance. The acting manager stated “ these residents are young and need to lead fulfilled lives if they wish too”. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 9 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): 9. Staff support residents to take risks as part of being independent but appropriate risk assessments could be improved to ensure residents’ lifestyles are not restricted. EVIDENCE: Staff appeared kind, caring and supportive of residents needs but lacked confidence in decisions making regarding residents capabilities. Most residents were young and enjoy socialising and going out. Communication between staff and residents was mutually positive, caring and upbeat but one resident who had for many months displayed unprovoked physical outburst was having a negative effect on other residents. One staff member stated residents walk away in fear of the resident, as they are scared. Staff try to keep all residents safe but this had resulted in a degree of isolation for the resident concerned. The acting manager was seeking appropriate advice and assessment for the resident to help find ways of improving communication enabling the resident more expression. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 10 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): 12,17 Activities are limited in the home for residents. Residents are offered a healthy diet and enjoy their meals. EVIDENCE: The new acting manager had encouraged healthier eating for residents and at inspection food stores examined were fresh and menus nutritious and varied. Fruit is now available in the kitchen and one resident was seen happily helping herself to fruit. Meals are taken in the large dining room with staff in pleasant surroundings. One resident stated, “I like the food”. Residents were seen to help themselves to drinks and staff confirmed residents assisted with cooking. The home employs three staff members who enjoy cooking and staff stated the quality of food is much better and residents really enjoy their meals. It was noted staff sat with residents but did not participate in many activities with them in communal areas. The home has music videos but not many games or activities that involve staff participation. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 11 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): 20 The homes medication policy and procedure is being updated. EVIDENCE: The home has an appropriate policy for administration of medication but this was being updated in line with the new company procedures. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 12 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): 22,23 Residents’ views are listened and protected from abuse neglect and self-harm. EVIDENCE: Key workers, the staff and the acting manager in individual one to one sessions, listen to residents but the home does not have regular residents meetings. The home has received no complaints since the last inspection but has suspended one staff member who is being investigated under the protection of vulnerable adults. The home has had many incidents for one resident who has physically attacked staff and other residents. Not all regulation 37 had been submitted to the CSCI. The inspector informed the acting manager of concerns regarding the affects of the incidents for other residents and was assured this was being given urgent attention. Staff employed undertake appropriate robust recruitment checks and receive training in protection of vulnerable adults and whistle blowing as part of their induction. The inspector asked staff why they had not disclosed their concerns regarding the suspended member of staff and was informed staff did not know how to contact the CSCI. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 13 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): 24 The home is comfortable and clean but in need of redecoration and insulation in some parts of the home. EVIDENCE: At inspection the home appeared worn and some parts, in need of decoration. The lounge and one residents room was draftee. All radiators were checked and in good working order but the two rooms that were draftee were not insulated. The staff toilet is not heated. There is no maintenance and renewal programme for the home but the acting manager has approached the registered provider with proposals for environmental changes, decoration and inclusion of a sensory room for residents use. The acting manger stated the home employs a handy man but his times are limited to work in Kingston House. Staff stated the homes windows have never been cleaned and some residents do not wish to participate in cleaning so they were taken away from caring to complete cleaning duties. The acting manager stated she was trying to recruit extra care staff hours to be used for cleaning purposes. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 14 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): 31,35,36. The new company is reviewing staff roles and job descriptions and training is ongoing. Residents receive care by a team of staff who are supported by an experienced competent acting manager. EVIDENCE: The acting manager advised the inspector that the new company were currently reviewing staff roles, job descriptions and terms and conditions. Staff stated the new company had informed them there would be no changes but they had not yet meet formally with staff to discuss changes. The staff team appeared competent and very supportive to residents’ needs and recently experienced difficult changes due to change in management and provider. It was noted the acting manager had a good awareness of the needs for staff training and had requested training makaton, understanding autism, key working skills, sensory room, assertiveness, therapeutic activities and report writing. Staff confirmed they had received regular formal supervision and how approachable they felt the acting manager was. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 15 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): 37,38,39,4042. The home is well run and the acting manager has the skills and experience to lead and manage the home. There is no monitoring system in place at present and the new company is reviewing policies and procedures in the home. Fire checks are not done regularly. EVIDENCE: The new acting manager has a wealth of experience in residential care and a suitable qualification in care management equivalent to NVQ level 4. Staff appeared happy with the new acting manager and confirmed the home is now much calmer for both residents and staff who can approach the acting manager at any time to give their views and opinions knowing she would listen. Staff meeting minutes confirmed the new acting manager empowers staff and encourages them to give their views and opinions taking more responsibility for care. The acting manager appeared approachable to staff and residents during inspection. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 16 Examined files confirmed no fire evacuation checks had been completed since November 2005. The acting manager was requested to give this urgent attention and stated she was to obtain a new fire logbook and complaints book for the home. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 17 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 3 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingston House Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 2 3 X 2 X DS0000036988.V265362.R01.S.doc Version 5.0 Page 18 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 premises must be kept in good state of repair, reasonably decorated and free from drafts at all times. Timescale 1/12/05 not met. Regulation 37 must be completed for all serious incidents in the home and a copy sent to the CSCI. The home must seek the views and opinions of residents their relatives and other significant others and complete a quality assurance and monitoring report to demonstrate how the service is to progress. A copy of the report should be sent to the CSCI. A fire log must be kept and regular fire drills and checks completed with outcomes to responses. Timescale for action 01/06/06 2 YA23 37 01/03/06 3 YA39 39 01/06/06 4 YA42 23 (4) 01/03/06 Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 19 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 3 4 5 Refer to Standard YA9 YA12 YA22 YA23 YA24 Good Practice Recommendations Risk assessments should be updated for residents with regard to one to one care, behaviour management and activities outside the home. The home should provide more recreational activities in the home for residents, which include staff participation. The home should arrange regular residents meeting to seek the views and opinions of residents with regard to choice and activities. The contact details of the CSCI should be displayed in the home for residents, staff and their relatives. The home should produce a maintenance and renewal programme for the home. A copy of which should be sent to the CSCI. Kingston House DS0000036988.V265362.R01.S.doc Version 5.0 Page 20 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.V265362.R01.S.doc Version 5.0 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!