Inspection on 08/11/05 for Kingston Residential Care Home

This inspection was carried out on 8th November 2005.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kingston Residential Care Home 01/06/07

Kingston Residential Care Home 19/09/06

Kingston Residential Care Home 18/07/05

Kingston Residential Care Home 25/09/04

Kingston Residential Care Home 19/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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 Residential Care Home Kingston Residential Care Home 27-31 Westbrook Road Margate Kent CT9 5AU Lead Inspector Brenda Pears Unannounced Inspection 8th November 2005 09:30 Kingston Residential Care Home DS0000023485.V260395.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 Residential Care Home DS0000023485.V260395.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 Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingston Residential Care Home Address Kingston Residential Care Home 27-31 Westbrook Road Margate Kent CT9 5AU 01843 292412 Telephone number Fax number Email address 1Provider 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) Parkcare Homes Limited Mrs Joanne Jeavons Care Home 21 Category(ies) of Learning disability (21), Physical disability (7) registration, with number of places Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th July 2005 Brief Description of the Service: Kingston provides residential accommodation and care for adults with differing degrees of learning disability. The service users may have an additional physical disability. The Home, owned by a large Company, is a Victorian terraced property on three floors. It is situated in a residential area of the seaside town of Margate and is within walking distance of all local amenities, including the seafront and local shops. There is on road parking to the front of the property. The Home provides 24-hour staff cover, including staff on wake-duty at night. There is always a senior member of staff on duty or on call, to deal with any queries or emergencies. The health care needs of the residents are met by the local primary health care team. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the inspection consisted of speaking with the manager, staff and service users. The methods of inspecting the home included checking records, tracking service user care plans, observations and a tour of the building. The focus of this inspection was on monitoring the requirements and recommendations from the last inspection and on the quality of life for service users in the home. While Kingston Residential Care Home is currently registered to accommodate 21 people, the inspector was informed that the home now only offers accommodation for 17 people. This has occurred as double rooms have become vacant and these rooms have then become single occupancy, a variation of registration is therefore required to ensure full compliance with regard to the registered status. The home has not been well maintained and is in poor decorative order throughout. This is currently being addressed through an ongoing refurbishment and redecoration programme that has been put into place. The external wall to the front of the property is being rebuilt and the front of the building is to be repainted. New carpet is now in corridor areas and service user rooms are to be redecorated following choices being made by the individual in each room. Staff are working hard to improve recording systems and all care plans are currently being reviewed and rewritten with risk assessments being more fully completed. However, particular attention must be given to information regarding communication. Specific details of communication needs must be clearly recorded and easily accessed, to support both service users and staff in the home. While the fabric of the building is being addressed and improved, staff must recognise that the atmosphere in the home can be greatly improved by conversation and full interaction at all times. The staff group on shift during the majority of this inspection did not appear to interact in a relaxed and open manner and did not fully include service users at this time. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 6 What the service does well: What has improved since the last inspection? What they could do better: Care plans contain useful information but must also contain all communication needs to support care staff and ensure all service user needs are met appropriately and fully. While care plans do contain information in clearly set out sections, staff cannot access a complete care plan without reading through an entire file for each person. This does not ensure staff are fully aware of all service user needs and does not give a clear picture of each service user, their personality or how a person has developed or progressed in the home. A format must be developed to identify how each person likes to start the day and what routines are needed to fully support them at all times. This is also essential to the well-being of each service user and ensures continuity of care. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 7 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 Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 8 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 Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Needs are assessed and risk assessments have been rewritten on each care plan to address individual needs. EVIDENCE: Care plans and risk assessments are being rewritten by the deputy manager and one other member of staff, this process should be completed by the end of the year. The Craegmoor organisation is to issue a new format for care plans that has been trialled by some homes and is in a more useful format. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 10 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, 7 & 8 While care plans are being reviewed and rewritten, information must clearly reflect individual needs and in particular, communication needs to fully support service users. Staff ensure advocates are available to support service user choice and independence. The staff group on duty at this time did not demonstrate they fully include service users at all times. EVIDENCE: While staff are working hard to ensure care plans are reviewed, the information currently contained in care plans is put into sections, but this does not enable staff to find information quickly or easily. Information is found after going through the file and most current information is placed at the end of each section, which again means that staff have to go through a great deal of paper before finding the appropriate information. Staff must also ensure that Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 11 all records are appropriately dated and signed to support the review process and ensure information is current. Service user meetings are currently being undertaken, with advocates where necessary, the manager stated that each service user chooses to attend and meetings are stopped if anyone becomes distressed or unsettled. Staff did not introduce the inspector at this inspection and appeared very reluctant to discuss daily events or activities at this time. Service users will not be encouraged by an inactive staff group and a relaxed and inclusive atmosphere needs to be created throughout the home. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 12 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): 14, 15 & 17 The home works with family members to ensure service users are supported to maintain contact and staff ensure this is carried out in an appropriate way, recognising the individual needs of service users. The kitchen was found to be clean and all areas were in good order. The cook showed a good awareness of service users’ nutritional needs. Staff must undertake full interaction with service users to encourage participation in activities and to generate an inclusive atmosphere. EVIDENCE: The manager explained that staff ensure contact with families is arranged and carried out in a way that supports the service user. Firstly, visits are only undertaken when the service users chooses to do so and subsequent arrangements are carried out following the needs of the individual and ensuring full support of emotional needs is considered. Staff and service users were found, in the main, to be passing time in the lounge area. When joining people in the lounge area, staff did not introduce Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 13 themselves or service users. When directly asked about activities or outings during the day, staff did not respond until they were encouraged to do so. The atmosphere needed to be livelier to encourage participation and fully include all those sitting in this area. Service users will not want to take part in any activities unless the atmosphere in the home is creating an open and friendly environment. Staff must take control of situations in the home to ensure the full inclusion of service users at all times. The kitchen was found to be clean, all areas were well organised and in good order. The cook showed a good awareness for the nutritional needs of service user, particularly with regard to alternative choices, fresh and natural foods for good health and allergies and reactions to certain ingredients in foods. Fresh vegetables and fruit are supplied locally and frozen food is only kept for emergency use. Menus are rotated to accommodate seasonal foods and regular meetings are undertaken to establish food choices. Stock is clearly dated and kept to a minimum to ensure freshness and full stock control. Daily notes contain details of what has been eaten at each meal and cultural and dietary needs are met. Appropriate cutlery utensils are used by service users where required to support dignity and independence Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 14 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): 19 & 20 The home works with organisational healthcare support teams and must continue to seek appropriate healthcare agencies to provide support to service users. A medicine fridge is required for the safe and appropriate storage of medication The window in the medication room must be obscured for safety. The floor in the medication storage area is grubby and marked and does not currently provide a suitable environment in which to store medication. EVIDENCE: The organisation provides support for staff through the local Clinical Governance Team, from the area Learning Disabilities Team and the Behavioural Specialist Team. The fridge currently in use is a domestic fridge that is used for the storage of other goods. A medicine fridge must be used to ensure the safe storage of medication and to provide the appropriate temperature for medicine storage. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 15 The area currently being used for medicine storage is to have new flooring as the current floor covering is damaged and rather grubby. While the flooring is to be replaced in this area, the floor still requires regular cleaning and was very sticky and dirty at this inspection. Medical administration records sampled at this time were clearly completed and contained pictures of each service user and guidelines for the administration of medication. The window in this room is not currently obscured and the manager stated this is on the schedule of works for the home .This room became quite hot and stuffy after a time and attention must be given to ensuring medication is stored at the appropriate temperature at all times. The local pharmacy has observed routines, recordings and storage in the home to assist staff in ensuring good practice regarding all areas of handling medication. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 16 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): While these standards were not directly inspected at this time, the home does have a complaints procedure in place that is being strengthened following the last announced inspection and staff have undertaken adult protection training. EVIDENCE: Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 There is currently an ongoing refurbishment and redecoration programme in place to improve the environment. The home was, in the main, clean and odour free at this time. EVIDENCE: The outside of the building is to be repainted, the external wall to the front is being rebuilt and all windows are to have new curtains. New carpeting is in place throughout all corridor areas. Service user rooms are to be redecorated and refurbished following consultation with each person and when all their preferences have been obtained. All radiators are not currently covered but this is also being addressed starting with the lounge area and then followed by each service user room. Restrictors are in place on the hot water system and this was newly installed this year. Rooms are personalised and pictures of outings and special celebration are on display throughout the home. A notice board, supported with pictures, indicates the staff on shift and what activities are to be undertaken on each day. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 18 One area has some odour and the manager is aware of this specific problem and this is currently being addressed with regular cleaning routines and the carpet in this are is to be replaced if odours continue. Some floors have unacceptable scuffing and markings that give a very poor impression and do not create a homely environment in individual rooms. The manager stated these matters are all to be rectified and are on the ongoing programme of redecoration. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 19 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): 33 & 36 Staff did not appear to be taking the initiative with service users regarding activities or to be encouraging/promoting inclusion at this inspection. Supervision is regularly booked, as are team meetings, and all training needs are being individually assessed at supervision sessions. EVIDENCE: Staffing at this time consisted of the manager, a team leader, a senior carer, a support worker, one member of staff undertaking one to one support, one domestic, one part time domestic, one maintenance person and one cook. The activities co-ordinator and one carer were on a training course. The manager of the home is available to undertake care as required. There are two waking night staff and night checks of all service users are undertaken hourly. To monitor staff morale and support the staff group, regular supervision is being undertaken and staff meetings are also regularly being carried out. Job descriptions are being reviewed and reissued at staff supervisions along with the identification of individual training needs. There is an appointed training co-ordinator within the organisation that monitors staff training and ensures refresher courses are booked where appropriate. Monthly reports are also Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 20 issued to the training co-ordinator to ensure all staff are attending appropriate and regular training. The home has maintained the core staff group and staff remain loyal and supportive in the home. The home has recently achieved their Investors in People award and staff have worked hard to improve recording systems in the home, resulting in a positive report following the last visit from the contracting department. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 21 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 & 43 Monthly quality assessments of the home are currently being carried out by the manager. The manager expressed an awareness of areas in the home requiring improvement and also discussed staff that need additional support to achieve the aims of the home. Fire instructions in the home must be displayed in the appropriate way to support each service users. EVIDENCE: The manager has two years experience of managing a staff team and has previously worked with older people and has expertise in fields covering mental health needs and learning disabilities. The manager is also currently in the process of completing the RMA award. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 22 The instructions to be followed in the event of a fire are currently only in written form. This must be reviewed and all signs/instructions must be presented in an appropriate format to ensure the full safety of service users in the home. Kingston Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 2 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kingston Residential Care Home Score X 2 2 x Standard No 37 38 39 40 41 42 43 Score X X X X X 2 3 DS0000023485.V260395.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? YES 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 YA2 Regulation 14 Requirement To continue with the review of care plans while ensuring all communication needs are clearly recorded. That risk assessments continue to be undertaken as care needs are reviewed and activities developed for each service Staff must interact with service users in all situations to encourage participation and ensure full inclusion. That the home continues to maintain a clean and hygienic environment, particularly during the ongoing redecoration and refurbishment programme. Timescale for action 31/12/05 2 YA2 15 31/12/05 3 YA8YA7 12 & 13 08/11/05 4 YA24 23 31/12/05 5 YA41 17 That all records are appropriately 08/11/05 dated and signed by staff to support the review process and ensure information is current. The registration certificate to accurately reflect the bed numbers in the home to meet requirements and ensure the full safety of service users. DS0000023485.V260395.R01.S.doc 6 YA41 23 31/12/05 Kingston Residential Care Home Version 5.0 Page 25 7 YA42 23 Fire signs/instructions must be presented in an appropriate format to ensure the full safety of service users in the home. . 31/12/05 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 Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 26 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 Residential Care Home DS0000023485.V260395.R01.S.doc Version 5.0 Page 27 - 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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