Inspection on 23/01/06 for Kingston House

This inspection was carried out on 23rd January 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Kingston House 08/10/07

Kingston House 25/10/06

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Kingston House 10 The Street Kingston Canterbury Kent CT4 6HZ Lead Inspector Wendy Gabriel Unannounced Inspection 10:00 23 January 2006 rd Kingston House DS0000065348.V250512.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 DS0000065348.V250512.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 DS0000065348.V250512.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingston House Address 10 The Street Kingston Canterbury Kent CT4 6HZ 01227 832981 01227 832981 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) CareTech Community Services (No.2) Ltd Vacant Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Eighteen years of age and over. Date of last inspection 04/10/05 Brief Description of the Service: Kingston House is registered to provide care and support for up to nine adults who have a learning disability. The home is a detached, two-storey property, set in its own grounds and within the quiet, rural village of Kingston. All bedrooms are single and one has an en-suite facility. There is no lift and wheelchair access is restricted to the ground floor. There is parking for several vehicles to the front of the premises and the rear garden is accessible for residents from the lounge and has far reaching views over the countryside. There is a pub and a shop in the village. Canterbury and Dover are approximately half an hour drive away. A bus stop is within walking distance of the house. The home has a new, purpose built vehicle with wheelchair access. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection focused mainly on the requirements and recommendations made at the previous inspection. At the time of the inspection, seven residents were living in the home and there were two vacancies; the Deputy Manager and Manager stated that two prospective residents had been identified and each has had an initial assessment. The staffing levels have increased considerably since the previous inspection and there remain three vacancies. The Deputy Manager said that although they were currently seeking applicants for these posts, they had been able to easily cover the rota using regular staff from an agency. There were four support workers on duty at the time of the inspection including the Deputy Manager and a senior support worker. The Manager and activities organiser were also on duty at this time. Residents seen were appropriately dressed for the very cold time of year and the home was comfortably warm, clean and free from unpleasant odours. A full time dedicated activities person has been employed. This member of staff confirmed to the Inspector that she works exclusively on activities with the residents and also drives the new, purpose built vehicle the home has purchased since the previous inspection. Some requirements from the previous inspection have not been fully complied with despite the Manager identifying and reporting to the Company. Requirements for these to be completed were made. The Deputy Manager and the Manager both confirmed that; following identified lack of recording and communication leading to an Adult protection alert last year, communication has improved between staff and Health care professionals. Care plans seen during the inspection had been regularly reviewed and there was written evidence of involvement from Health care professionals. What the service does well: The home now employs a full time, activities organiser and a detailed, daily programme was displayed, indicating the different activities offered to individuals. The new vehicle enables easy access by wheelchair users. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 DS0000065348.V250512.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 DS0000065348.V250512.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): 1.3. Prospective residents or their families receive written information to enable them to make an informed choice about where to live. EVIDENCE: The statement of purpose is used to identify the aims and objectives and range of facilities and services the home offers to residents. The document gives the prospective resident or his or her relative, the opportunity to exercise choice and this can only be achieved if full information about the services offered is provided. The Manager had previously agreed to add or make minor changes to the homes statement of purpose to enhance the contents. This had not been fully completed and the Manager agreed to forward the final copy to the Inspector by the end of January. New residents receive an informative ‘welcome’ brochure explaining to them what their life style will be when living at the home. Each bedroom contains a copy of this. Kingston House DS0000065348.V250512.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): 6.9.10. Residents know that their individual needs are identified in the care plans. Residents know they will be supported to take risks to maintain independence. Residents know that confidential information about them is secured. EVIDENCE: The Inspector noted that up to date information has been recorded in the individual care plans seen at the time of the inspection. Health needs have been identified and there was written evidence of Health care professionals input with residents. Staff sign and date a document to indicate when they have read any changes to residents’ ongoing care. Risk assessments have improved although the Deputy Manager said that these are still being reviewed. The individual assessments identify when staff have to assist residents. There were generic assessments identifying risks in the laundry and kitchen although not individual risk assessments for residents in these two areas. The Manager stated that he would record individual risks if any were identified, but at the time of the inspection, both he and the Deputy Manager believed that the current residents would not enter these areas. He agreed to add this statement to the recorded assessments. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 10 ‘Talk time’ has been introduced for residents who have little verbal communication, to spend dedicated time with staff to encourage and enable choice. An ‘Empowerment’ course has been booked for staff to encourage and improve choice. Confidential information is secured in a locked office and is available on a need to know basis. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 11 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): 12.13.14.17. Residents are enabled to undertake leisure activities suitable to their age and abilities. Residents are welcomed in the local community. Residents special dietary needs are met. EVIDENCE: A full time dedicated activities person has been employed. This member of staff confirmed to the Inspector that she works exclusively on activities with the residents and also drives the new purpose built vehicle the home has purchased since the previous inspection. A weekly rota has been devised with different daily activities. This ensures that all residents have the opportunity to be involved with an activity that suits their choice and ability. Although verbal communication was limited, some residents were able to express that they enjoyed the drawing and colouring and music that they were undertaking and listening to at that time. The Inspector was informed at the previous inspection that the local community is friendly and will greet residents and staff when they are out walking in the village. The meals are prepared and cooked by staff. Health care professionals may advise on special diets as required. Residents eat their meals in a separate dining room that is cheerfully decorated. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 12 Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 13 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): 18.19.20.21. Personal support, emotional and health care is given according to the assessed needs of the individual residents ensuring their needs may be met. Specialised training for staff will improve the medication administration procedures. Residents know that their ageing, illness and death will be handled appropriately and with respect. EVIDENCE: Care plans identify the support required by each resident. The pre admission assessments form the basis of this information. Care managers and Health care professionals provide additional information as appropriate. As stated in the summary, communication and recording has improved since a concern was raised last year by community nurses about lack of reviewing. A new medication administration system has been provided since the previous inspection. Only senior staff may administer medication. Medication is secured in a locked unit within a locked environment. A requirement was made for a suitable medication administration training course to be undertaken by staff. The home will seek professional advice and support when caring for the ageing, illness and death of a resident. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 14 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): 23. Residents’ protection from abuse may be compromised without a whistle blowing procedure for staff and management. EVIDENCE: A requirement was made at the previous inspection for a whistle blowing policy and management procedure to be provided. This has not been undertaken and a further requirement has been made for this to be written. The procedure should detail what actions the Company would take to respond to suspicion or evidence of abuse. The home maintains an adult abuse policy and procedure. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 15 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): This standard was not inspected at the time of the inspection. EVIDENCE: Although not inspected at this time the home was seen to be clean, tidy and free from unpleasant odours. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 16 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): 34.35. Residents know that staff recruitment has improved with further recruitment ongoing. Further training is required to ensure residents’ needs are met. EVIDENCE: The home has appointed three members of staff since the previous inspection and is advertising for three more full time posts. The Deputy Manager said that they are able to complete the weekly rota easily by using agency staff and that they always used the same agency workers to ensure continuity of care for the residents. The Manager and Deputy Manager have identified the training needs of the staff, but have to await courses to be arranged for them by the head office of the owning Company. A requirement was made for the training, as specified in the National Minimum Standards, to be undertaken including specialised medication administration training. The Manager and the Deputy Manager have a good understanding of identifying courses to meet a range of needs of the residents. These include: Makaton, Empowerment, Aspiration difficulties, Adult protection, Epilepsy, Autism, Onset of dementia and Visual impairment awareness. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 17 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): 42. Residents know that the Manager has a good understanding of what is required to improve the home, but their health and safety could be compromised if identified maintenance is not undertaken promptly. EVIDENCE: The Manager and the Deputy Manager indicated an awareness of generic health and safety issues and these are recorded. The Deputy Manager discussed the importance of all staff being aware of health and safety and taking responsibility for the environment as well as just reporting any health and safety issues. He went on to say that he hoped to improve their awareness by training and supervision. COSHHE items are securely stored. The owning company takes responsibility for organising maintenance work. There was written evidence of the Manager reporting maintenance concerns to head office. Although an engineer has viewed the emergency lighting system that is not fully operational, the remedial work has not yet been carried out. A requirement was made at the previous inspection for this work to be Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 18 undertaken and another requirement was made at this inspection as an urgent health and safety matter. The rear door to the garden from the lounge is badly fitted and large gaps are in evidence when the door is closed, allowing cold draughts into the room. This compromises the comfort of the residents in the lounge. A requirement was made for this to be repaired or renewed. A recommendation was made for another radiator to be put into the lounge to increase the comfort levels for residents. Health and safety in the laundry has been improved greatly by the addition of automatic feeders for washing and conditioner liquids to the machines. The rear door in the laundry had washing bins partially blocking the exit. The Deputy Manager said it was not a fire exit but a requirement was made for this area to be kept clear. A bath seal and panel are to be repaired following the work recently undertaken to install water temperature regulators. A repair to the crack in the wall plaster in the en-suite bathroom would improve the homeliness of that area. The laundry was clean, tidy and hygienic at the time of the inspection. The kitchen was also clean and tidy and the home has a weekly rota for night staff to undertake cleaning in there. Some bedrooms were viewed and were noted to be clean and homely. Kingston House DS0000065348.V250512.R01.S.doc Version 5.0 Page 19 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 2 X 3 X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingston House Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score X X X X X 2 x DS0000065348.V250512.R01.S.doc Version 5.0 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 4 5 6 Standard Regulation 23 23 18 13 12 4 Requirement A clear exit is to be maintained from the laundry external door. Identified maintenance is to be completed. Staff training to be completed in line with the National Minimum Standards. A whistle blowing policy is to be provided. Suitable medication administration training to be undertaken by staff. Statement of purpose is to be completed. Timescale for action 23/01/06 17/02/06 01/04/06 30/01/06 01/04/06 30/01/06 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 24 9 Good Practice Recommendations Consider installing another radiator to the lounge to ensure heating is maintained at a comfortable level. Individual risk assessments to be written for use of laundry and kitchen areas. DS0000065348.V250512.R01.S.doc Version 5.0 Page 21 Kingston House Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000065348.V250512.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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