Inspection on 23/05/06 for Kingsway Care Home

This inspection was carried out on 23rd May 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Kingsway Care Home 05/05/09

Kingsway Care Home 03/11/08

Kingsway Care Home 15/05/08

Kingsway Care Home 22/05/07

Kingsway Care Home 18/10/05

Kingsway Care Home 13/04/05

Kingsway Care Home 02/11/04

Kingsway Care Home 01/06/04

Kingsway Care Home 25/02/04

Similar services:

Park House

Huntercombe Centre

Wellburn House

First Step

St Helens Care Home

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

CARE HOMES FOR OLDER PEOPLE Kingsway Care Home Kingsway Langley Park Durham DH7 9TB Lead Inspector John Trainor Unannounced Inspection 23rd May 2006 09:30 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.V293405.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. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 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.V293405.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 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. The current fee level ranges from £412 residential to £412 free nursing element from the PCT for nursing care assessed within the recognised banded range. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and the visit to the home took place over 7 hours. All of the key national minimum standards were inspected. The inspector spoke to some people who use the service, staff and the manager and inspected some of the records in the home including care plans. Prior to the visit to the home the manager completed a self-assessment document to give the Commission for Social Care Inspection information required to aid inspection. What the service does well: What has improved since the last inspection? What they could do better: Some doors and woodwork needed painting. Repairs had been left unfinished and some areas required redecoration. There were not enough assisted bathrooms to meet the needs of the people resident. Improvements to care practices were needed to correctly record what medication people had been given. People must have their own individual clothing and toiletries, use of communal stores must be stopped. Policies and procedures must be available at all times in the home as a reference point for staff. Refurbishment of the home needed to be done in a planned way with identified timescales for bringing standards up. Infection control procedures needed tightening up to keep things safe for people. Care plans would benefit from inclusion of the detail of what people like to enable staff to meet all of their needs. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 6 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.V293405.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 Kingsway Care Home DS0000000724.V293405.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): 1,3, 5 and 6. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some information was available to people prior to admission. Improvements were needed to ensure people could make an informed choice that the home could meet their needs, based on a holistic assessment. EVIDENCE: The statement of purpose and service user guide had been revised following recommendation after the last inspection to improve information for people. Files inspected had pre admission assessments and care management assessments so that a decision could be made about whether the home was able to meet the needs of the individual. This was not always confirmed in writing to enable prospective residents or their families to make an informed choice. Assessments did not always address people’s social and occupational needs. There was a 24 hour notice period included in contracts, on either side, during the trial period. Kingsway Care Home DS0000000724.V293405.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, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People’s physical and personal care needs were planned for and met, though inclusion of personalised task specific detail and social and occupational needs would improve the care planning and delivery. The recording of the administration of medication was not good. EVIDENCE: Care plans included assessment and management plans for moving and handling, nutrition, breathing, psychological needs, pressure area care and dependency. There was input from primary and secondary care involvement with G.P. and Specialist Community Nurse involved. The recording of the administration of medication was not good and so errors were possible in administration meaning people could get the wrong dose or that medication had not been given. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 10 Improvements to social and occupational care plans were needed to detail individual expectation. Kingsway Care Home DS0000000724.V293405.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, 13, 14 and 15. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People had some activities though would benefit from more individually focussed occupational programmes to enhance individual choice and expectation. EVIDENCE: There was a dedicated activities co-ordinator employed by the home. People were observed to be sitting during the inspection with little stimulation or activity. People would have a better quality of life if the activities they were offered reflected their individual expectations. Relatives could visit any reasonable time. Food was reported to be good though some efforts could be made to make pureed foods look more appetising. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 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): 16 and 18. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People could be assured complaints would be investigated and recorded and staff had awareness of measures to take in case of abuse of a vulnerable adult. EVIDENCE: The home had a complaints procedure, people felt sure if they had concerns the manager would address them. There was evidence on file of the home using adult protection processes appropriately and staff could demonstrate in discussion appropriate action to take if they suspected abuse. Policies and procedures were not on the premises due to being taken away for review and there was not a copy of the multi agency strategy document. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment was adequate but needed improvements. Hygiene was poor. EVIDENCE: Corridors, lounges and bedrooms were in the main well presented and clean. One toilet needed the flooring repaired on the pedestal below the toilet. The laundry needed repair to the floor to make a waterproof seal. Toilets did not have bins in them for paper towels or soiled pads. One toilet had a used pad left on the side. There were not sufficient assisted bathrooms to meet the needs of the people resident. Some doors needed painting and woodwork needed attention and the stairwells needed redecoration. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 14 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, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff were deployed in sufficient numbers and had sufficient training to meet the needs of the people resident. EVIDENCE: Staffing levels met the requirements of the residential forum and over 50 of staff were trained to NVQ 2 or above. There was a commitment by the provider to encourage staff to train. Although staff had adequate induction and training some practices did not look after peoples dignity to an adequate standard. It is hoped this can be improved by change of practice and supervision. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 15 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People would benefit from robust management practices, recognising deficits and taking necessary action to improve them. EVIDENCE: There were health and safety checks to ensure a safe environment. Service user finances were auditable and accurate. The manager was qualified and capable. Improvements were needed to both the fabric of the building and some care practices requiring management intervention. Formal supervision did not appear to be taking place at least 6 times per year as required by the standard Infection control was poor. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 16 Management in the home was open and made sure people were in the main safe. A refurbishment programme was needed to improve some areas. Staff were deployed in sufficient numbers and had training but some care practices did not maintain the dignity of the individual and therefore a more robust supervision framework was required to ensure people put good practice into place. Care plans were stored in an office on the day of the visit left unlocked and unattended meaning people’s information was not stored securely. The manager was aware of shortfalls in the home and did feel, though progress had been made, there was still scope for improvement. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 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 3 X 2 X 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 1 X X X X X X 1 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 1 2 Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 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 OP9 Regulation 13 (2) Requirement The registered person must take measures to ensure administration of medication is correctly recorded from the day of inspection and to be maintained thereafter. The policy and procedure must be followed for the protection of service users. People were sometimes clothed in socks, tights and net pants for pads drawn from a communal supply. This practice must stop to:a) And b) Minimise risks from cross infection. Timescale for action 23/05/06 2 OP10 12(4(A)), 13 (3) 23/05/06 3 OP18 13 (6) People must have their own supply of clothes, including net pants for pads, and never have the indignity of having to wear pants or clothes previously used on someone else. The home must retain copies of policies and procedures on the premises and obtain a copy of DS0000000724.V293405.R01.S.doc 31/07/06 Kingsway Care Home Version 5.1 Page 19 4 OP19 23 the multi agency strategy document on adult abuse so staff have a reference point to confirm what to do in any given circumstances. The registered person must 31/08/06 produce a comprehensive refurbishment plan, based on an audit of the environmental needs in the home and detailing timescales for implementation to improve the environment to an acceptable standard. This must include:Plan for increasing the number of assisted bathrooms in the home from 2 to 4. It is recommended one bathroom on each floor which is unsuitable for assisted bathroom status could be turned into a walk in shower facility. Plan for the redecoration of woodwork and doors in the home Plan for the redecoration of stairwells. This plan must be forwarded to the Commission for Social Care Inspection before 31st August 2006. The home must ensure infection control policies and procedures are fit for purpose and implemented to maintain an infection free environment for people. This will need to include measures to:Fix the pedestal floor under the toilet opposite room 17. Fix the laundry floor. Ensure toilet areas are kept free of infected waste and clean. Ensure toilets have bins for the disposal of infected waste and DS0000000724.V293405.R01.S.doc 5 OP26OP38 13 (3) 31/07/06 Kingsway Care Home Version 5.1 Page 20 6 OP38 13 (3) 7 OP37 17(3) paper towels. The home must ensure infection 31/07/06 control policies and procedures are fit for purpose and implemented to maintain an infection free environment for people. This will need to include measures to:Fix the pedestal floor under the toilet opposite room 17. Fix the laundry floor. Ensure toilet areas are kept free of infected waste and clean. Ensure toilets have bins for the disposal of infected waste and paper towels. The registered manager must 31/07/06 ensure all records including policies and procedures, relating to the protection of service users are up to date and complete. (Previous requirement not met by 18/10/05.) Records must be stored securely. 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 OP3 Good Practice Recommendations Pre admission assessments should include information to enable the home to determine individual social and occupational expectation and so allow for a clear choice to move in to the home based on holistic assessment. Individual contracts should be reviewed to ensure they meet current office of fair trading guidance and allow for the regulatory “reasonable notice” within the trial period. Care plans should contain detail of people’s social and occupational expectation to allow care staff to meet their needs in this area. The registered manager should audit all care plans in the home to ensure all have adequate planning and review of care needs. DS0000000724.V293405.R01.S.doc Version 5.1 Page 21 2. 3. OP5 OP7 Kingsway Care Home 4 OP36 The registered manager should ensure staff receive formal supervision six times per year in line with the standard and uses this opportunity to ensure good practice is maintaining the dignity of the individual. Kingsway Care Home DS0000000724.V293405.R01.S.doc Version 5.1 Page 22 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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