CARE HOMES FOR OLDER PEOPLE
Kingsway Care Home Kingsway Langley Park Durham DH7 9TB Lead Inspector
Belinda Parker Announced Inspection 18th October 2005 09:00 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 Kingsway Care Home DS0000000724.V257891.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. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Kingsway Care Home Address Kingsway Langley Park Durham DH7 9TB 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) 0191 3736167 0191 3735945 Ancyra Health Limited Andrea Blenkinsop Care Home 47 Category(ies) of Past or present alcohol dependence (4), registration, with number Dementia (10), Dementia - over 65 years of age of places (47) Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th April 2005 Brief Description of the Service: Ancyra Health Limited is the owners of Kingsway Care Home and based in Langley Park, County Durham. The home was first registered in 1992. The home is registered to provide 24hr care for 47 service users 65 and over with mental health problems, the additional category allows them to take 10 service users under 65. Accommodation is provided over two floors and all bedrooms offer single accommodation Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place on the 18/10/05 over a period of 7.5 hours. During the inspection time was spent talking to service users, staff and a relative. The inspector toured the building and a number of records were examined. Two of the three requirements made at the last inspection require further development to meet the National Minimum Standards. What the service does well: What has improved since the last inspection?
Since the last inspection a new Activities Co-ordinator has been appointed, offering a range of activities for service users to join in if they so wish and also inviting the local community to attend various fund raising events in the home for service users comfort fund. The appearance of the garden areas have improved due to the appointment of a new gardener, who when spoken to during the inspection had enthusiasm for his work and development of the garden. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 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. Kingsway Care Home DS0000000724.V257891.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 Kingsway Care Home DS0000000724.V257891.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): 1, 4 and 5 (Standard 6 is not applicable). The home’s Statement of Purpose and Service User Guide presents the services the home provides in a positive manner. Identified areas of information included in these documents need to contain more detailed information to enable prospective service users and their family’s to make an informed decision as to whether they consider the home to have the capacity to meet their individual needs. EVIDENCE: The home has in place a Statement of Purpose and Service User Guide, produced in an appropriate format. The manager was advised that further development of these documents was required to meet the national minimum standard. The manager was able to demonstrate the homes capacity to meet the assessed needs of the service users admitted to the home. The manager said most of the admissions to the home are planned. Prospective service users are welcome to visit the home prior to admission but due to high dependency levels this visit tends to be undertaken by the social worker or their relatives on their behalf. All admissions to the home are on a trial basis.
Kingsway Care Home DS0000000724.V257891.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): 7, 9, 10 and 11 The care planning and medication process in this home is not at an acceptable standard to ensure the care needs of the people living in the home are fully met and that service users are protected from potential harm. It was evident that staff, service users and relatives have formed positive relationships EVIDENCE: Since the last inspection a new care plan format has been introduced, but it is disappointing that staff responsible for transferring/recording information in new care plans have not paid attention to detail in many areas. This could potentially have an affect on the care staff not having adequate knowledge to meet the needs of the service users due to incomplete information. Since the last inspection a new medication system has been implemented. An audit of medication showed that staff responsible for receipt of medication into the home had not signed the MAR sheets to show that the medication and the amount received was correct. Hand written entries also lacked a signature. On 17/10/05 the Controlled Drugs Register only had evidence of one signature with no evidence of a witness signature when medication had been administered.
Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 10 One MAR sheet examined had an error on the times of an individual’s medication to be administered, the manager had not been made aware of this issue. Potentially this could have put the service user at risk. Fridge temperatures for the storage of certain medication were recorded but again the manager had not been made aware the temperature of the fridge were above the recommended guidelines. A relative spoken to said even though her family member lacked capacity staff always treated her appropriately and said “ Even though my relative cannot talk, staff know her well enough to recognise facial expressions of need”. Service users spoken to during the inspections commented that the staff are kind to them. A member of staff commented, “ Staff here have the right attitude towards caring”. A policy and procedure in the event of death and dying was in place. The manager said the wishes of the service user and their family will be respected at all times. Kingsway Care Home DS0000000724.V257891.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 The activity programme in the home provides service users with a range of activities, offering choice and enhancing the service users social opportunities. EVIDENCE: Since the last inspection a new activities co-ordinator has recently been appointed. Staff and a relative spoken to said the activities co-ordinator was very enthusiastic and was already developing a programme of varied activities to meet the collective interests of the service users, as well as involving the community in fund raising events in the home. A programme of weekly activities was displayed in various locations around the home for service users information. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 12 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): EVIDENCE: This set of standards was not assessed at this inspection. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 13 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, 20, 21, 22, 23, 24, 25 and 26 The standard of décor, furniture and soft furnishings in this home still requires improving to enhance the environment and comfort for the people who live in and visit the home. EVIDENCE: On touring the home it was observed that refurbishment with regard to renewal of furniture, soft furnishings and carpet renewal in the main foyer was still outstanding (Quotes for carpet in foyer and lounge available). The internal environment lacked brightness and colour. Although a relative spoken to commented, “ I like the homely environment”. Bedrooms had been painted but lacked personalisation and appeared bare and uninteresting especially for people who were on bed rest. One bedroom had plaster damage due to damp. The manager said this was being addressed. The manager said premium single rooms are being developed (formerly double rooms), one completed was viewed during the inspection.
Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 14 Externally the outside of the building was currently being redecorated. With the appointment of a new gardener there had been an improvement in the overall appearance of the gardens providing a pleasant outlook for the people in the home. Care plans should include information to show that an assessment as to disability aids required by individual service users had been carried out (Refer to Standard 7). It was noted that the home was clean and free from any offensive odours. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 15 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 and 29 After a period of instability in staffing there is now a good match of wellqualified staff offering consistency of care within the home. EVIDENCE: Staffing levels in the home are adequate to meet the collective needs of service users, with no agency staff having to be employed for quite some time. Staff members spoken to during the inspection commented, “ Good team working”, “ If you have a problem, the manager is approachable”, “ Good working environment”. Staff information is currently being transferred into new personnel files. Files examined contained the required information to ensure service users are protected. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 16 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): 36 Arrangements in place for monitoring staff work performance are good, ensuring people EVIDENCE: Evidence was available to show that staff receive formal supervision on a regular basis, which includes discussion about all aspects of care practice, philosophy of care in the home and career development needs. Staff confirmed that they have supervision with their line manager and find this a very beneficial process in ensuring that they have the skills and abilities to provide a good standard of service to the people who live in and visit the home. Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 17 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 2 x x 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 X 9 1 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 2 3 2 3 3 3 3 STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X X Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 18 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 OP7 Regulation 15 Requirement The registered manager must implement and review all areas of an individual service users care plan ensuring all needs have been identified from the initial assessment of need. Where a risk has been identified an appropriate risk assessment must be put in place for the protection of the service user. A record must be maintained of care plan review on a monthly basis. The registered manager must ensure staff adhere to : The policy and procedure for receiving medication into the home. 18/10/05 Hand written entries must have an accountability signature. Medication times for administration must be accurate with the prescription if a hand written entry is made. The Controlled Drugs Register must contain two signatures for all administered medication
Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 19 Timescale for action 01/12/05 2. OP9 13 deemed as Controlled Drugs. The policy and procedure must be followed for the protection of service users. The registered manager must ensure all records relating to the protection of service users are up to date and complete The registered manager must have the flaking plaster in room 16 repaired. 3. OP37 17(3) 18/10/05 4 OP19 23 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP22OP20 Good Practice Recommendations The registered manager should monitor care plans regularly to ensure they contain all the necessary information to enable staff to meet the needs of the service users. The registered manager should develop the Statement of Purpose with regard to admission criteria, fire policy and a copy of the Terms and Conditions of Residency. 2 OP1 Kingsway Care Home DS0000000724.V257891.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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