CARE HOMES FOR OLDER PEOPLE
Kingston Nursing Home Kingston House 7 Park Crescent Leeds Yorkshire LS8 1DH Lead Inspector
Kathleen Firth Unannounced Inspection 16th February 2006 10:45 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 Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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 Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Kingston Nursing Home Address Kingston House 7 Park Crescent Leeds Yorkshire LS8 1DH 0113 2666520 0113 2664171 kimkahachi@yahoo.co.uk 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) B & C Holt Limited Mrs Kim Mahachi Care Home 37 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (37), of places Terminally ill over 65 years of age (5) Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 15th September 2005 Brief Description of the Service: Kingston House is a thirty-seven 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 facilities 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 DS0000001349.V282228.R01.S.doc Version 5.1 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 February 16th, 2006. The inspector looked around the building, examined records including care plans, staff rosters, Quality Assurance report, residents’ contracts and medication records. Residents and staff were very helpful and joined in the process. The inspector was able to speak with the homeowners, residents and staff and the manager was present throughout the inspection. What the service does well: What has improved since the last inspection?
Up to date photographs of staff are now in their file. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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 DS0000001349.V282228.R01.S.doc Version 5.1 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 Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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): 2, 3, 4 All residents have a contract containing the terms and conditions at the home. Residents and relatives can be sure their needs will met. EVIDENCE: All of the residents have an individual contract stating the terms and conditions of the home and what they can expect from the service. It also explains to residents what is expected of them. The contracts contain all financial transactions and commitments concerned with the resident’s stay at the home. These are kept in individual files in the Administrator’s office within the home. The manager visits all prospective resident and completes an assessment of need. Once this has been completed and an admission agreed people, their relatives and friends can be sure that their needs will be met at the home. This pre-admission information is kept in their file and together with an admission assessment and any information provided by other interested parties helps to formulate the care plan. The manager will not agree admission unless she is sure that the home can meet the needs of the prospective resident.
Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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): 7, 8 and 9 Staff are aware of the residents’ needs and there is good communication amongst them. Residents are treated with dignity and their privacy maintained. EVIDENCE: Each resident has a comprehensive care plan in place that contains all their needs and the tasks staff need to do in order to meet these needs. The plans are clear, concise and easy to follow and contain health, social, psychological and spiritual needs. Where required very specific instructions are in place as are risk assessments with coping strategies. There is evidence that the plans are reviewed and updated on a regular basis. Some but not all of the care plans are signed by the resident to say that they agree with them. The manager was able to offer an explanation where the plans have not been signed. The residents are registered with five GP practices and are able to keep their own GP if they are willing to visit. The GPs offer good support to the home and a Nurse Consultant from one of the practices is a very useful resource. The home receives full support from the St. Gemma’s community Palliative Care team. Five beds at the home are used specifically for Palliative Care.
Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 10 None of the present residents are able to manage their medication and the home has a policy and procedure in place to take care of this for them. The home uses the Venalink System that has different disposable coloured cards for different times of the day. The manager orders the medication and is responsible for disposing of any that is unused. There is a safe system in place to dispose of any used medication. All records concerned with medication were correctly maintained and everything was stored in a suitable way. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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 and 15 Various activities are organised at the home that take into account individual preferences and abilities. A good, varied and nutritious diet is served at the home. EVIDENCE: The home offers a varied activities programme that meets with individual choices and abilities. They visited the Christmas lights in December and went for a special lunch. The manager is looking into booking a day out over the Easter period. This week they made Valentine cards in honour of the day. The residents enjoy knitting, doing jigsaws, playing board games and watching T.V. A “One Man Band” visits the home on a monthly basis to give a performance and this is very popular with the residents. People enjoy attending the monthly service held by the local Anglican Vicar. A Eucharistic Minister visits each week to give communion to the Roman Catholics at the home and other religious ministers visit as and when they are requested. The local Salvation Army visit twice per year to play for the residents and the next visit is due in April. The home works from a four weekly menu cycle and residents are able to choose their meal. There is always a choice of two main meal options at lunchtime and they can have a hot or cold meal at teatime. Some residents
Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 12 eat breakfast in their own room whilst others prefer to eat in the dining room; the choice is down to the individual. One resident eats a vegetarian diet and the staff try very hard to provide her with suitable meals. A Caribbean diet has been introduced to meet the preferences of the residents from this background and they enjoy this very much. Other specialised diets are provided where required including liquidised meals for some of the palliative care residents. Residents spoken to say that they enjoy the meals at the home with one man saying “the grub is good”. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 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): 16 and 18 Residents and their relatives have their views listened to, taken seriously and action is taken to resolve any issues that may arise. Residents are protected from abuse. EVIDENCE: The home has a complaints procedure in place and residents are given their own copy on admission. Residents and their relatives are able to speak to the manager and staff if they have any worries or concerns and know that these will be dealt with appropriately. The recent quality assurance questionnaires sent to residents and their families showed very positive results and lots of compliments about the service were seen. Only two relatives requested a meeting with the manager following the survey and she did this. All staff now have dates to attend Adult Protection training the first ones starting the week after the inspection. The home has a very comprehensive policy and procedure in place to deal with Adult Protection issues and all staff are aware of this. There have been no referrals to POVA in the past year and no need for any investigations. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 14 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): 20, 22, 25 and 26 The home offers a safe, well-maintained environment for the residents and they live in clean and pleasant surroundings. EVIDENCE: The home offers a welcoming; comfortable atmosphere and residents are able to access all areas of the home and the garden outside. The home was clean and tidy throughout and nothing was seen that could cause a hazard to the residents. Specific domestic staff are employed. A conservatory recently added is proving very popular with the residents and a few were sitting there during the inspection. They said they found it a very pleasant and comfortable place to sit. Some were watching T.V. and others reading. The communal areas are furnished and decorated to a good standard and offer enough space for the residents to follow their own pursuits. Specialist equipment is available for residents where it is required including Profile beds, pressure mattresses, individual chairs and mobility aids. The home is able to access specialist resources and equipment for the people
Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 15 admitted for palliative care. Other residents are able to access any equipment they require through Occupational Therapy assessment if it is not already available at the home. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 16 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): 27, 28 Residents are supported and protected by the skill mix of staff on duty at any time. EVIDENCE: The home was fully staffed and the numbers of staff on duty were sufficient to meet the needs of the residents. Staff, residents and the rosters confirmed that this is normal practice at the home. There is a good support network within the team and staff enjoy working at the home. Agency staff are not used at the home and the care staff group have mainly been at the home for a long period. This makes sure that there is continuity of care for the residents. The home does not have a quick turnover of staff. Overseas nurses working towards their adaptation tend to work at the home for around six months and the home manager is their mentor. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 17 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, 32, 34, 36, 37 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 the position she holds. She is a qualified nurse, holds the Registered Manager’s Award and supervises the Adaptation Programme for overseas nurses working at the home. She operates an open door policy and staff approached her on several occasions during the inspection to seek advice or information. Resident meetings did not prove popular so the manager now invites relatives to join in the social activities arranged at the home and this helps her to maintain good contacts with people. Good interactions were seen between the manager, the owners of the home, staff and residents throughout the inspection. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 18 The replies from the recent quality assurance questionnaires were seen to be very positive and people had also written compliments. People appear to have a very high opinion of the staff and the care they give. There are sufficient safeguards in place at the home to make sure that it is financially viable. Formal supervision sessions are in place with written records being maintained. All the required policies and procedures are in place at the home to make sure that the rights of the residents are safeguarded and all written records are well maintained. Training takes a high priority at the home and staff are able to access appropriate courses. Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 19 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 3 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X 3 X 3 X X 3 3 STAFFING Standard No Score 27 3 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 X 3 3 X Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 20 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. Standard Regulation Requirement 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. Refer to Standard Good Practice Recommendations Kingston Nursing Home DS0000001349.V282228.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Aire House Town Street Rodley Leeds 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 DS0000001349.V282228.R01.S.doc Version 5.1 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. 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!
