Inspection on 09/11/05 for Kingston House

This inspection was carried out on 9th November 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 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 14/06/07

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 Unannounced Inspection 9th November 2005 09:15 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.V264807.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 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.V264807.R01.S.doc Version 5.0 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 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) Greensleeves Homes Trust Mrs Carol Mather Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Kingston House is one of a number of care homes in England that are run by the Greensleeves Homes Trust. Kingston House was purpose built as a convalescent home and became a care home for older people in 1978. The accommodation is on two floors and each service user has their own single room. All rooms have an en-suite toilet and wash hand basin and some rooms also have a bath. A passenger lift is available between floors. There are communal rooms on the ground floor that include a choice of lounges, a dining room and an art/activities room. The home stands in its own grounds and has gardens that are accessible to the service users. Kingston House is the service users permanent home, however one room in the home is reserved for people who wish to have a temporary/respite care stay. Service users receive 24-hour personal care and support from a management and staff team. A keyworker system is in operation. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 9.15am and lasted for six hours. Four service users were spoken with in the privacy of their own rooms and several other people were met with in the communal areas. The home’s manager was available throughout the inspection. The administrator and care staff members were spoken with and there was an individual meeting with one member of staff. The communal areas of the home and some of the service users’ rooms were seen. Records were examined, including health & safety, quality assurance, staff recruitment and training. What the service does well: What has improved since the last inspection? What they could do better: The review of how activities are provided is needed because some service users may benefit from a more individual approach. Consideration should also be given to whether the arrangement by which staff members do shopping for service users provides adequate safeguards for both parties. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 6 The windows in the service users’ rooms are the original ones and some service users find these difficult to operate. The manager is aware of the problem and there are plans to change the windows. However, concern was raised during the inspection that their replacement may be delayed because of the attention being given to the planning of an extension. The arrangements for quality assurance in the home need to include the production of an action / annual development plan. 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 DS0000028549.V264807.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not looked at on this occasion. Standard 6 did not apply at this time. (Standards 1, 2 and 3 were inspected at the last inspection. Standards 1 and 2 were met and standard 3 was almost met). EVIDENCE: Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 and 10 Service users benefit from the day to day support that they receive with their medication. However the benefit for some service users may be reduced by a lack of reviewing of their medication. Privacy and dignity are respected and service users benefit from the approach that is taken by staff members. (Standards 7 and 8 were inspected and met at the last inspection). EVIDENCE: The majority of service users were receiving support with the management and safekeeping of their medication. The Greensleeves Homes Trust has produced a comprehensive policy and procedure covering the medication arrangements. Responsibility for medication is restricted to specific, named staff, usually seniors, who are deemed competent to do so following training. There were suitable storage facilities in place and the medication is prepared in a location that is quiet and usually away from other activities. The medication is administered from a monitored dosage system. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 10 Medication records were up to date. P.R.N. (‘as required’) medication was limited to some prescribed painkillers. One service user’s medication was administered as P.R.N., although the label stated four times a day, which the manager said was an error. Overall the medication facilities and documentation looked well organised. The arrangements for reviewing medication were discussed with the manager. The manager recognised the importance of supporting service users with medication reviews, but said that this met with a mixed response when raised with GPs. It was agreed with the manager that it is important that the need for medication should be kept under review, particularly as certain medication may not be appropriate for long-term use. One service user spoken with was complimentary about the support that she received with medication and said that staff always came to find her when she needed to have her eye drops. Service users said that they were treated with respect by staff members and felt that they could be private in their own rooms. Many service users have chosen to have their own telephone. A pay phone in an enclosed booth is also available. Service users said that their post is brought to them. Each bedroom has a nameplate on the door showing how the service user wishes to be addressed. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13 and 14 The lifestyle in the home generally suits service users. They maintain contact with their relatives and there is good information for visitors. Many service users enjoy group activities in the home, although some people would benefit from more individual support. (Standards 12 and 15 were inspected and met at the last inspection). EVIDENCE: Some service users were met with in their own rooms and others in the communal rooms, where there are a variety of seating areas with different outlooks. It was evident from conversation with several service users that there is no pressure to fit in with a particular routine. Service users can choose where they wish to spend their time. The communal rooms lend themselves to different activities and are well used for events that take place as part of the home’s weekly activities programme. Information about the day’s events was displayed in the main lounge. On the day of the inspection this included two musical activities. There was also advance notice of events and social activities that are coming up. An Advent fayre had been arranged. A religious service is held in the home each Sunday. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 12 One service user said that she would like more frequent support with being able to go for short walks outside the home and that this was more important to her than attending a group activity. She acknowledged that staff were busy but would be happy to know that this could be arranged a few times a week. A number of service users spoken with, mainly in the lounge, said that they enjoyed the activities programme. Some other service users in their rooms found it more difficult to attend and appeared to be less aware of the activities being arranged. Service users said that they could meet with their visitors in their own rooms or in one of the lounges, where they could talk in relative privacy. Inside the home’s front hall there was a good range of information for visitors, which included the home’s ‘Statement of Purpose, Quality Manual and ‘Suggestions, Comments and Complaints’ leaflets. There were also copies of inspection reports and details of an advocacy service. During the afternoon, service users were being asked about their choice of courses for the tea meal and for lunch on the following day. ‘Satellite’ meetings are being held, when service users have the opportunity to comment on events in the home and to be updated by staff on any changes that affect them. Service users had been told about the plans for an extension to the home, which are still at an early stage. A letter about this was also displayed in the front hall. There are policies and procedures in the home, which cover confidentiality and service users having access to their personal records. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users are protected by the guidance that staff members receive about abuse. The home’s procedures help to safeguard service users although the arrangements for personal shopping are open to abuse. (Standard 16 was inspected and met at the last inspection). EVIDENCE: A policy and procedure in respect of abuse are included in the home’s Quality Manual. The contents of the manual cover the National Minimum Standards and follow a similar format. This provides a good way of ensuring that the information for staff covers all relevant areas. The manual also includes information about good practice in respect of ‘Restraint’, ‘Whistle Blowing’ and ‘Gifts, Gratuities and Legacies’. The manager provides training in the prevention of abuse, using a pack produced by outside consultants. This was last done in November 2004. New staff members initially receive guidance as part of their programme of induction. There is an arrangement in place whereby a staff member may receive money directly from a service user who has asked them to do some shopping on their behalf. This informal type arrangement is solely between the service user and the staff member and does not go through the home’s usual administrative channels. This has been mentioned at previous inspections and that staff members complete a record of any shopping that they have done. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 14 Service users may value such an arrangement although it is recommended that this arrangement is reviewed and consideration is given to whether it provides sufficient safeguards for both parties. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Service users appreciate the home environment. They have benefited from new facilities and refurbishment of the home in recent years although the design of the home’s original windows is not helpful to service users. The home is kept clean and tidy. (Standards 19, 20 and 24 were inspected at the last inspection. Standards 19 and 24 were met. The home was commended in respect of standard 20 for the variety and choice of communal areas that are available to service users). EVIDENCE: Standard 19 was looked at during the last inspection. There was further discussion about windows in the service users’ rooms and the ease in which these can be used. It was reported at the last inspection that the maintenance person has tried to make the sliding windows easier to use, although this has had limited success. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 16 The manager has confirmed that there are plans to replace the windows with a more suitable type, although this is now being planned in conjunction with a new extension. Service users will appreciate having new windows and concern was raised during the inspection that there would be a delay in starting the work. The maintenance person has been making changes to some of the bedroom door locks. One service user said that she would like to be able to use a lock on her door but one had not been fitted. The manager thought that this particular door had been overlooked. The home looked clean and tidy, with no unpleasant odours. Domestic staff were working during the inspection and cleaning schedules have been produced. Service users expressed satisfaction with the cleaning of their own rooms. One service user commented that staff came in to clean her room very quietly and at a time when it did not intrude. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 The home’s recruitment arrangements help to ensure that service users are protected from unsuitable staff. Service users are supported by competent staff. (Standard 27 was inspected and met at the last inspection). EVIDENCE: Examples of two staff members’ personal recruitment and employment files were looked at. These were well organised and contained the required references and documentation in respect of criminal record and other checks. Training events and courses are arranged in conjunction with the Greensleeves Homes Trust’s Training & Administrative Co-ordinator. There is a comprehensive training matrix, which shows the range of training activities provided and relevant dates for attendance and refresher courses. The manager maintains individual staff records for staff, which are a good way of monitoring progress with meeting individual training needs. New staff members undertake a T.O.P.P.S. induction programme. 40 of care staff had achieved NVQ at level 2. The manager was hopeful that this would rise to over 80 by the end of the year. A staff member met with said that there were good opportunities for training and felt that the relevant subjects were being covered. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Service users benefit from the management approach in the home. They have the opportunity to comment on things that affect them. Feedback and standards are being assessed although the system for quality assurance is lacking in the area of action and annual development plans. Arrangements are in place for maintaining health and safety in the home. These help to ensure that service users are safe, although a programme for the fitting of radiator covers has not yet been completed. (Standard 35 was inspected and almost met at the last inspection). EVIDENCE: The manager, Carol Mather, has good management experience and is well qualified for her role. She has achieved a range of relevant qualifications, including the registered managers award and NVQ at level 4 in care and in management. An O.U. course in ‘Mental Health Problems in Old Age has been Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 19 completed. The home’s deputy manager has also attended relevant courses and achieved NVQ in care at level 3. Some service users commented on their appreciation of the management team and were pleased to have the manager back after a period of time working for the Trust in another capacity. The satellite meetings are a way in which service users can comment on the day to day service that they receive. The Greensleeves Homes Trust has produced a system for auditing standards in the home and the home’s Statement of Purpose refers to the issuing of questionnaires to service users and stakeholders. The information about standards and the views gained were not contributing to an action / annual development plan for the home. It was agreed with the manager that this is an important part of any quality assurance system. It is recommended that a statement on quality assurance is produced, which details the different components and the timescales that apply. The home’s fire log book was up to date. Other records seen showed that a range of health & safety measures is in place. These included in-house checks and routine maintenance, as well as the involvement of outside contractors to service particular facilities and items of equipment. A yearly plan had been produced which sets out the frequency for the checking and monitoring of different areas of the home. The manager has consulted with an environmental health officer in order to prioritise the fitting of radiator covers as part of programme of works. Some radiators in the communal rooms remain uncovered. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 20 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 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 21 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 OP9 Regulation 13(2) Requirement Information about the administration of medication must be accurately maintained in accordance with the GP’s instructions. The needs and wishes of individual service users must be taken into account as part of the review of the home’s activities programme. A date for the replacement of the windows must be confirmed with the Commission. That, where requested, an appropriate door lock must be fitted to the service users’ rooms. A development / improvement plan must be produced as part of the home’s system of quality assurance. A date for the covering of the remaining radiators must be confirmed with the Commission. Timescale for action 10/11/05 2. OP12 12 10/11/05 3. 4. OP24 OP24 23 23 31/12/05 31/12/05 5. OP33 35 31/03/06 6. OP38 13(4) 31/12/05 Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 22 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. Refer to Standard OP9 OP18 OP33 Good Practice Recommendations That service users are supported to have their medication reviewed on a regular basis. That the arrangements for personal shopping are reviewed in order to ensure that appropriate safeguards are in place. That a statement on quality assurance is produced, which details the different components and the timescales that apply. Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingston House DS0000028549.V264807.R01.S.doc Version 5.0 Page 24 - 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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