Inspection on 15/09/05 for Kingston Nursing Home

This inspection was carried out on 15th 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 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 Nursing Home 09/02/09

Kingston Nursing Home 08/03/08

Kingston Nursing Home 27/02/07

Kingston Nursing Home 16/02/06

Kingston Nursing Home 20/10/04

Kingston Nursing Home 15/07/04

Kingston Nursing Home 16/01/04

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Hawkhills

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

CARE HOMES FOR OLDER PEOPLE Kingston Nursing Home Kingston House 7 Park Crescent Leeds LS8 1DH Lead Inspector Kathleen Firth Unannounced 15 September 2005 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 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 Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingston Address Kingston House 7 Park Crescent Leeds LS8 1DH 0113 2666520 0113 2664171 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) B & C Holt Ltd K Mahachi Care Home 37 Category(ies) of Physical disability (1) Terminally ill (5) Old registration, with number age(37) of places Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The place for PD is specifically for the service user named in the variation application dated 7 March 2005. Date of last inspection October 2004 Brief Description of the Service: Kingston House is a thirty-six bedded care home for older people situated in the north of the city of Leeds and provides nursing care. The home is registered to care for five people within the registered number who are suffering from terminal illness and require specialist care. The bedrooms are located over two floors, these are accessed by a passenger lift and are a mixture of single and double rooms. Assisted bathing facilites are available as is other specialised equipment. The home operates a no smoking policy. The home is off the main road but regular bus services are in operation. There is parking available at the home for visitors with cars. There are gardens to the front of the building and a conservatory has been added to the rear. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over three hours by one inspector on Thursday 15th September 2005. The inspector looked around the building, spoke with staff, residents and the manager, examined residents’ records including care plans, menus, staff rosters, financial records, staff files and the Service User Guide. Staff and residents were very helpful throughout the inspection and were happy to join in the process. Five staff members and seven residents were spoken to. What the service does well: What has improved since the last inspection? There were no requirements or recommendations from the last inspection. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 standard(s) 1, 3, 5, 6 People are able to make an informed decision about the home from the written information they receive and what they see when they visit. EVIDENCE: A copy of the Service User Guide given to prospective residents was seen, and found to be very comprehensive. It contained sufficient information to enable the person to make an informed choice about the home. The terms and conditions of the service anyone staying at the home can expect to receive is in the guide along with sample menus and other pieces of useful information. The manager or her deputy goes to assess anyone referred to the home with another member of staff. This is to ensure that the home can meet the needs of everyone wanting to live at the home. They look at the person as a whole and assess physical, social, healthcare needs as well as psychological ones. The manager speaks to as many people as possible about the person and social services provide their care assessment where appropriate. Risk assessments are also carried out where required. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 9 All prospective residents are invited to visit the home prior to admission. Residents spoken to during the inspection confirmed that they had done so. They may stay for a meal or just have a chat with residents and staff. Relatives are also welcome to look around and sometimes do so on behalf of their relative. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 10 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 standard(s) 7, 8, 9, 10, 11 Staff are aware of the residents’ needs and there is good communication amongst the staff group. Residents are treated with dignity and their privacy is maintained at all times. EVIDENCE: Care plans looked at were very comprehensive, contained the needs of the residents and what tasks staff need to do in order to meet these needs. The plans were clear, concise, easily understood and contained healthcare, social and religious needs. Very specific instructions were recorded where appropriate along with risk assessments and coping strategies. Evidence that residents and or family are involved in drawing up the care plans was seen as was that they are reviewed on a regular basis. Residents said that they are treated with dignity and staff maintain their dignity and privacy whilst meeting their needs. The residents are well supported by the local GP surgery that has allocated one GP to care for them. Arrangements were seen to be in place for Dental, Optical and Chiropody care. Specialised services including the Tissue Viability nurse can easily be accessed when required and the home enjoys a good professional relationship with the local CPN service and the Primary Care Trust. Residents are weighed on Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 11 admission and then on a monthly basis unless there are indications that this needs to be done more often. The healthcare team is included in the decision making process where a resident chooses to remain at the home until their death as they may need to offer help and support. None of the residents manage their own medication and the home has a comprehensive policy and procedure in place to do this for them. All of the qualified staff have completed the Administration of Medication training. The home uses the Vena link system using different coloured cards to denote the time of day. The manager orders, checks in the medication and is responsible for the destruction of any that is unwanted/not needed. There is a photograph of all residents in the medication file and all records examined were correctly maintained. All medication was stored in the correct way. There was evidence that their wishes following death were discussed with residents. All the necessary information was recorded in their individual files along with who needs to be contacted. Where a resident is admitted with a terminal illness a palliative care worker provides a mentoring role. Staff are able to ask for advice and assistance at this time. Support is offered to family and friends. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 12 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 standard(s) 12, 13, 14, 15 Residents are encouraged to be part of the decision making process and make choices about their lives. They are supported to maintain contact with family and friends. A good, varied and nutritious diet taking into account individual choices is provided at the home. EVIDENCE: The home offers a varied range of activities to meet the individual choice and ability of the residents. An activities organiser comes to the home twice a week and assists the residents to take part in craft sessions, play games, complete jigsaws and musical entertainment. A group recently visited the home and carried out a reminiscence therapy session that the residents really enjoyed. Trips out are arranged using a charity that uses converted ambulances for transport. Taxis are used to take the residents to more local places. Staff try to ensure everyone has a chance to go out and include as many residents as possible. In good weather staff take residents to the local shops or park in wheelchairs. The residents spoken to said that they had enough to do during the day and enjoyed the trips out. Visitors are welcomed at the home and residents go out with their families if this has been agreed. One resident said she goes out with her relatives each week. There is not a great deal of community activity for the residents to join Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 13 in with. Religious ministers visit the home regularly to offer spiritual support to the residents including a service held by the local Church of England. Residents are able to go to bed and get up at times they choose. They are encouraged to choose their own clothes and are able to eat in their own rooms if this is what they want to do. The meal served during the inspection was well presented and looked appetising. Staff were seen to offer residents support where required to ensure that they could enjoy their meal. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 14 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 standard(s) 16, 17, 18 Residents and their relatives have their views listened to, taken seriously and action is taken to resolve issues. Residents have their rights protected and are protected from abuse. EVIDENCE: The appropriate policies and procedures are in place and the residents receive a copy of the complaints policy when they sign their contract. Staff receive training in how to handle a complaint. The manager said that she felt that people would approach her or the staff if they had any concerns or worries. Residents spoken to confirmed that they would do this and that they find everyone approachable. If the manager becomes aware of any issue she is pro active and approaches the resident or family herself to discuss it. Staff are due to have training in Adult Protection shortly and the home has a policy and procedure in place to deal with this issue, this is in line with the Leeds Multi Agency Adult Protection procedures. The manager is confident that staff are able to recognise the signs and symptoms of abuse and know how to deal with them. Residents confirmed that they are able to vote if they wish to. The postal system is set up for the residents although the manager said one resident chooses to go to the polling station. The home informs the residents and their families that they can have access to their records. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 standard(s) 19, 21, 23, 24, 25, 26 The home offers a safe well-maintained environment for the residents and provides appropriate bathing and toilet facilities. EVIDENCE: The home offers a welcoming, comfortable, safe and pleasant environment for the residents. There is a maintenance person employed at the home with a maintenance programme in place. The home was clean and tidy throughout and nothing was seen that could cause a hazard to residents, staff or visitors. The communal rooms are nicely decorated and furnished to a good standard. A conservatory has been added to the home since the last inspection offering more space for activities. There is a call system throughout the building and this was heard during the inspection. Bedrooms are of a good size and there is evidence that people are able to bring their own possessions when coming to live at the home. Where a room is shared there is a curtain down the middle of the room to ensure privacy for Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 16 each occupant. All rooms can be locked and the residents can have a key if they wish. Staff were seen to knock on bedroom doors before entering. There are sufficient toilets and assisted bathing facilities at the home. Soap and towels were seen in the toilet areas. There are also two shower areas in the home. No issues were seen relating to heating, lighting, water supply or the ventilation in the home during the inspection. There are four profile beds at the home with plans to purchase more. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29, 30 Residents are supported and protected by recruitment procedures in place. Staffing numbers and skill mix ensure that the residents’ needs can be met. EVIDENCE: The staff numbers were appropriate at the time of the inspection and residents and staff were able to confirm that this is normal practice. Staff rosters viewed for a period of time confirmed the numbers and grades of staff on duty. There is a good team spirit amongst the staff and they all said it was a good place to work. Recruitment is carried out to comply with equal opportunities and two written references; CRB, POVA, Visa and work permits checks are made. Health checks are carried out including HIV and chest x-ray where appropriate. All of these are done before anyone is allowed to start working at the home. Staff files were seen to contain all necessary documentation except for photographs. Training is seen as important at the home and staff confirmed that they have easy access to appropriate courses. All of the care staff have completed or are working towards an NVQ at varying levels. Staff said that they have received excellent training in Palliative care including how to grieve. They stated that the manager offers them good support when any resident dies. Qualified staff are able to keep up with their Post registration profiles. Staff meetings are held three to four monthly with an agenda and written minutes. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 35, 36, 38 The home is well managed, the interests of the residents are seen as very important to the manager and staff and are safeguarded at all times. EVIDENCE: The manager is well qualified and experienced for her position at the home. She is a qualified nurse, holds the Registered Manager’s award and supervises the Adaptation Programme for overseas nurses at the home. She said she operates an open door policy and both staff and residents confirmed this. The manager has held residents meetings but they were not very popular so, now she ensures that she keeps good contact with everyone by holding social events involving residents, staff and families. A Quality Assurance questionnaire is sent to relatives, staff and residents on an annual basis to elicit their views. A good number of thank you letters from grateful families and friends were seen confirming that people think the service Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 19 offered at the home is very good. Regular staff supervision sessions are in place with written records kept. All of the financial records concerning residents’ monies were correctly maintained. The manager takes responsibility for Health and Safety in the home. Fire alarms are tested on a weekly basis with all other checks being made monthly. Hoists are available for moving residents with training given thus ensuring safe practise for residents and staff. The home employs a laundry person who is responsible for all the washing ensuring that things are washed at the correct temperature. There is a control of infection policy in place. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x 3 x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 x 3 x 3 3 x 3 Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 21 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 Regulation Requirement There are no requirements from this inspection. Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 29 Good Practice Recommendations Up to date photographs of staff members should be included in their file. Kingston Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley LS13 1HP 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 Nursing Home 20050912 Kingston IR0 J52 V226622 S1349 Stage 4.doc Version 1.40 Page 23 - 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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