Inspection on 31/08/06 for Kingswood

This inspection was carried out on 31st August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kingswood 08/05/08

Kingswood 10/05/07

Kingswood 18/01/06

Kingswood 17/05/05

Kingswood 30/09/04

Kingswood 28/04/04

Similar services:

Snydale Care Home

Abbey The

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Kingswood 48 West Street Scarborough North Yorkshire YO11 2QP Lead Inspector Gill Sample Key Unannounced Inspection 31st August 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 Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 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. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingswood Address 48 West Street Scarborough North Yorkshire YO11 2QP 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) 01723 363263 Mr Robert Leonard Devine Mrs Brenda Devine Mrs Karen Eyre Care Home 18 Category(ies) of Old age, not falling within any other category registration, with number (18) of places Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 18 Elderly Service Users 5 of whom may also have dementia 19th January 2006 Date of last inspection Brief Description of the Service: Kingswood provides personal care and accommodation for a maximum of eighteen older people up to five of whom may also have been assessed as having a significant dementia. The home does not provide nursing care. The home is located in the South Cliff area of Scarborough and is conveniently situated for all of the main community facilities and the public transport network. Mrs. Karen Eyre is the registered manager for the home. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. The weekly fee is quoted by the provider as between £317.00 and £350.00 per week as at September 2006. Additional costs are made for private chiropody of £10, aromatherapy of between £10 and £15, and varying costs for hairdressing. Kingswood is built on three floors with a passenger lift serving all floors with bath and toilet facilities on each floor. The communal space consists of two lounges and a dining room situated on the ground floor. There is a garden area with seating at the front of the building. Unrestricted parking is available on West Street. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report gives the findings of a key inspection including a visit to the service which was made on 31st August 2006. The visit focussed on the key standards and those requirements and recommendations made at the last inspection. A total of five and a half hours were spent at the home. There were sixteen residents living at the home. Prior to the visit, the registered manager Mrs. Karen Eyre had provided information about the service and recent events and contact between the home and the Commission was analysed using records held at the Commissions York office. At the visit, the premises were seen including some bedrooms, bathrooms, living areas, the kitchen and laundry. A range of written records and documents were also examined and practice was observed during the visit. Individual discussions with residents, the registered manager and staff on duty at the time formed part of the key inspection. At the visit to the service, written comment cards were distributed to service users and the views of visitors were gathered. What the service does well: What has improved since the last inspection? The registered provider Mr. Devine closed Continental Lodge a registered care home earlier in the year and some service users and staff transferred to live and work at Kingswood. This transition appears to have been successful in that service users have settled well into their new home and staff say that they have fitted in well into the new staff group. The registered manager has implemented recommendations made at the last inspection of the service. She has put in place a staff training programme summary so that now all staff training completed and needed can be easily identified. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 6 There is an overall improvement in record keeping, particularly of staff records which are now well organised and maintained. A number of staff from overseas are employed at the home and service users enjoy the different experience this brings them and value the contribution that they bring to the home. 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. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 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 Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 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): 3. Standard does not apply. Quality in this outcome area is good. Service users can be assured that their needs will be properly assessed and recorded before entering the home and make an informed choice about going to live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records of one service user were examined who had been admitted in the week of the visit to the service. These showed that an assessment had been made covering aspects of the service users physical, social and health care needs and had information on the personal background of the individual. Information was available to staff about medication being taken at the time of admission, and an inventory of personal clothing, money and valuables and belongings which the service user had brought to the home. Daily records noted any issues which related to the newness of the situation for the service Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 9 user and staff were seen throughout the site visit assisting this new service user to navigate her way around the home and were heard giving reassurance and information to the service user. Earlier in the year the registered provider went through the process of closing another registered care home which he jointly owned. Rather than assume that all service users would wish to come to Kingswood he ensured that all service users were referred for a care manager for reassessment of their needs. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. Health care, social, and personal needs are met and service users are supported by a safe medication system. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Case records confirmed good practice. The needs of the service users are set out in detailed and individualised care plans. Recording of regular reviews was seen to assist staff in delivering the most appropriate care to meet those needs. Recording was made of physical care given and the monitoring of physical care which may affect health such as the monitoring of weight where weight loss had been noted. Notes were seen recording service users behaviour, activity and help given throughout the night when service users had had a disturbed night. The response of staff to one service user seen was in line with those needs noted, in that the service user was given food on every occasion when food was requested. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 11 The system for administration of medication was seen and the changeover of records for the end of the month. The system is a monitored dosage system supplied by a pharmacist in which ongoing medication records are pre printed and any short course medication, such as antibiotics, is added to the record sheets by hand. Some staff had undertaken a course on the safe handling of medicines and information supplied prior to the site visit confirmed those staff who have proven competence in administering medication. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. Daily life and social activities offer service users opportunities to live their preferred lifestyle and retain relationships in the wider community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People resident at the home have a range of abilities: some are able to make all decisions about their lives and how they wish to spend their day, while others have a degree of confusion and need prompting and explanation. Service users were seen singing together and talking together. Staff were observed spending time with residents in discussion, though there were no organised activities during the visit to the service. Two visitors were spoken with during the visit to the service. One said that she made a visit to the service several times a week and had done so over five years. She commented that the staff were “very kind” and that she is always made welcome at the home. The other visitor expressed some concerns about the cleanliness of the person she visited and commented that the service user’s room had smelt of urine at times. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 13 The home’s dining room can seat twelve people at any one time and is a pleasant place in which to eat. At the site visit, there were sixteen service users resident and consequently several service users were given their meals in the sitting rooms. These service users appeared to be those affected by dementia and the registered manager said that the situation is that some service users do not wish to sit in the dining room with others who have dementia. The issue appears to be one of insufficient space in the dining room for all service users to eat their meals at table. If all service users could be accommodated in the dining room, staff could sit and assist service users with greater needs and avoid disturbing others. Lunch was seen being prepared, cooked and served. The meal used fresh ingredients, looked and smelt appetising and was served attractively. Staff were attentive to individual service users during the meal and ensured that service users had time to eat at their own pace. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. Service users have access to information if they wish to make a complaint or raise any concern about their service and are protected by the awareness of staff of potential abuse, though recruitment procedures continue in failing to make all proper checks before staff start to work at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure is in place and service users have written information on the procedure. Service users said that if they had any concern or complaint about the service, they would speak with the manager Karen Eyre or Robert Devine, the owner. The manager demonstrated her awareness of the need to protect service users from potential abuse in discussion but was unclear on the proper procedure for referral to the lead authority. However, a copy of the local authority’s protocol for the protection of vulnerable adults is available for reference by the manager and staff and several staff had undertaken training on how to recognise and prevent abuse. Staff recruitment records seen continue to show poor practice in obtaining criminal records disclosures to ensure that only people suitable to work with vulnerable adults are employed. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is adequate. While people living at the home live in a generally clean environment there are areas of maintenace which need attention which would improve the facilities offered by the service. This judgement has been made using available evidence including a visit to the service. EVIDENCE: All the general areas of the home were seen, and the bedrooms of service users whose care records were examined. Most areas were clean and well decorated and there were no unpleasant odours. Of the four bedrooms seen, one on the ground floor had poor carpeting, little comfortable furniture and was in need of refurbishment. A lifting hoist for use for any service user was being stored in this bedroom. The service user whose room this was said that he spent a lot of time in the sitting room. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 16 The building is similar to those in the surrounding area and is not immediately identifiable as a registered care home. The two sitting rooms were decorated and furnished to a good standard. The dining room is small but was a pleasant place in which to eat a meal and gives service users access to the kitchen. Bathrooms varied in decoration and the bathroom mostly used by service users assisted by staff was comfortable and domestic in style with a hoist fitted to the bath. Some damage to wall covering was seen in some areas of the building. There were some areas in need of maintenance in the building: a downpipe to the front of the property was leaking, the rear ground floor window frames were rotten in places and in need of painting. The garden area at the front of the building was well tended and had seating available to service users. The home’s laundry, sited on the first floor, was seen. This had a commercial sized washing machine capable of washing at high temperatures and a commercial tumbler dryer. It was noticed that lint from the air outlet of the dryer was being blown into the rear yard area and the manager said she believed that a filter was missing from the machine. The laundry is sited so that dirty laundry is not near any areas where food is stored or prepared. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission 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 adequate. People living at the home are supported by a caring staff team who are trained properly but are not fully protected by robust recruitment procedures. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users had praise for the carers saying, “they’ve been wonderful” “they’re good people”. Four staff records seen showed that service users are usually protected by the home’s recruitment and selection procedure. Proper application, two written references and a clear criminal record disclosure had been obtained in three of the four records checked. In one instance a concern had been raised with the Commission about a member of new staff starting work at the home without a new criminal records disclosure being obtained, and this concern was founded. This had also been found at the previous inspection of January 2006. A number of care staff are overseas workers and police checks from their country of origin were on records seen. Analysis of staff rotas requested at the visit to the service showed that staff are on duty at times of high demand and day and night staffing level Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 18 requirements are met. A number of staff at the home were previously employed at the providers other home which closed earlier in the year. Discussions with two of these transferring staff confirmed that they had felt able to become part of the staff team at Kingswood and one said “I feel really settled over here”. Information supplied prior to the site visit showed that of the nine care staff, one had obtained an NVQ qualification and both Deputy Managers are undertaking qualification to NVQ Level 4 in care and the Registered Managers Award. The target of fifty per cent of care staff achieving qualification to NVQ Level 2 in care is still to be met. A record of staff training is now maintained showing all training completed and required by staff, which was recommended at the last inspection. A training programme of mandatory health and safety topics and subjects pertinent to the care of service users is available on a rolling programme and one staff member confirmed the training she had undertaken and her intention to undertake further academic qualification in social care. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 19 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 and 38 Quality in this outcome area is adequate. Service users can be assured that the service is managed by a competent person supported by the provider, though the development of a formal quality assurance system would assist the manager to identify areas of service which could be improved. The certified safety of the supplies and services at the home will mean that service users can be sure they are in a safe building. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There is no formal system to ensure that the quality of service is being monitored. The manager said that the views of service users are taken into account in the day to day running of the home, but there is no strategic Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 20 method of identifying where improvements can be made nor in implementing improvement. This was discussed and advice was given on how to capture this information so that the registered manager and provider know when expected standards are or are not being met. Water temperatures were checked in two of the home’s three bathrooms and were found to be hotter than recommended in the ground floor bath and cool in the third floor bath which is the bathroom most used by service users. Ensuring that water is delivered at a consistent temperature means that service users are kept safe from risk of scalding but have sufficient hot water for their needs. A range of documents and records were examined covering the arrangements to ensure that the home complies with health and safety and other legislation. • • • • • • Passenger lift examination and test dated 21/04/06 Current Employers’ and Public Liability insurance Records of testing of fire alarms, emergency lighting and detection systems Manual handling risk assessment of service users in case of fire COSHH risk assessments Staff training records in mandatory health and safety topics The home’s gas safety certificate, normally done annually, was dated 2004 and the registered manager agreed to send a copy of the updated certificate. There was a North Yorkshire Fire Risk Assessment document dated 2003. While other fire records and precautions were up to date, this document is recommended to be completed by the Fire and Rescue Service on a regular basis. Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 21 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 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 1 X 3 X X 1 Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 22 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. 1. Standard OP29 OP18 Regulation 19 Schedule 2 Requirement Confirmation of a criminal records disclosure at an enhanced level must be obtained on all staff to ensure that they are suitable to work with vulnerable people. There should be a quality monitoring system in place based on the views of service users and others in measuring the quality of care provided by the home. A safety certificate for the home’s gas installation must be obtained and a copy sent to the Commission. Timescale for action 30/09/06 2 OP33 24 30/09/06 2. OP38 13(4)(c) 30/09/06 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 Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 23 1 1 2 OP15 OP19 OP38 The registered provider should keep under review the dining arrangements and dining space to best meet service users’ assessed needs. A maintenance programme for the building should be developed, implemented and progress recorded. Hot water should be delivered at a temperature suitable for service users’ needs at approximately 43 degrees Celsius Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 Kingswood DS0000007653.V311012.R01.S.doc Version 5.2 Page 25 - 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!