Inspection on 08/05/08 for Kingswood

This inspection was carried out on 8th May 2008.

CSCI found this care home to be providing an Adequate service.

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

Kingswood 10/05/07

Kingswood 31/08/06

Kingswood 18/01/06

Kingswood 17/05/05

Kingswood 30/09/04

Kingswood 28/04/04

Similar services:

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Hawkhills

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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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Kingswood 48 West Street Scarborough North Yorkshire YO11 2QP Lead Inspector Pauline O`Rourke Key Unannounced Inspection 8th May 2008 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.V364294.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.V364294.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.V364294.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 10th May 2007 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 was quoted by the provider as being between £350.00 and £375.00 per week in May 2008. Charges not included in the weekly fee 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.V364294.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes The key inspection has used information from different sources to provide evidence for this report. These sources include: • • • • Reviewing information that has been received about the home since the last inspection. Information provided by the registered person on an Annual Quality Assurance Assessment Comment cards returned from people living at Kingswood and relatives. A visit to the home by one inspector that lasted for five and a half hours. During the visit to the home five people who live there, four staff, one visitor and two health care professionals were spoken with. Care records relating to three people, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Kingswood for the people living there. The manager was unavailable for the visit. Mr Devine, the proprietor was available for feedback at the close. What the service does well: People who live at the home made positive comments about their care and the staff. Some of the comments were, “All the staff are kind and look after me very well” “We get very well looked after and they’re very good staff” A relative commented, “They keep us fully informed of Dad’s needs” Throughout the visit the staff were observed treating the people in the home with respect and dignity. It was friendly and relaxed and visitors were made welcome. Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 6 The staff who work at the home are thoroughly checked before they start their employment and they receive some training to ensure they have the skills needed to do their job. The home is clean and well maintained and people can access all areas of the building. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Kingswood DS0000007653.V364294.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.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, Standard 6 does not apply. People who use the service experience good quality outcomes in this area. People moving in to the home have an assessment of the help they need and so can be assured that their care needs will be met We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: Three case files seen showed that a proper assessment had been carried out before the people concerned had been admitted to the home. The information covered the physical, health and social needs of the person concerned. The assessment information was detailed and highlighted the individuals right to decide how they wanted assistance provided. The manager was not available during the inspection but the provider was present for some of the time. He said that when admitting someone to the home they try and consider the level of support required by people currently living in the home so that they can be sure they could meet everyone’s needs. Staff said that they received enough initial information to enable the to support people coming in to the home. 1 of Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 9 the 3 surveys returned by people living in the home said that they had enough information about the home prior to them moving in. Kingswood DS0000007653.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, and 10 People who use the service experience good quality outcomes in this area. People receive the care and support they need and this is reflected in the care plan. The staff provide support in a sensitive way that promotes the persons’ independence and dignity We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The files seen each contained a care plan pertinent to the needs of the individual concerned. Several people were aware that the staff kept records about them and did talk to them about the help they needed. There was evidence in the files that the plans are reviewed monthly. Risk assessments were also in place where necessary. Staff keep daily records for people in the home and this information was used to inform the monthly reviews. Some of the recording seen was negative one said ‘ XXXX cannot join in any activities due to her dementia’. Another indicated that the person could not communicate because of their illness. Whilst people may not join in with group activities they can participate in one-to-one activities. Similarly people Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 11 may not be able to verbally communicate their needs but they do communicate through other methods such as body language, facial expressions, and behaviour. When recording staff should look for positive interactions and identify how someone may communicate or interact with staff. The files contained information about their health needs and details of GP visits and district nurses are recorded. People spoken with said that they could see their GP on request and that any visits made either to the home or the surgery, were carried out in private. Two district nurses said that the staff work well with them and follow any after care instructions they may leave. The system for administration of medication was seen. 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. Information supplied during the visit said that staff who handled the medication had undertaken a course on the safe handling of medicines. The recording of medication given was up to date. Storage of medication was secure. Currently there is one person in the home who self-medicates and documentation is kept in their files to support this. During the visit staff were seen to treat all the people in the home with respect and dignity. The issue raised at the last inspection about putting people in their night cloths for their tea has been resolved. People said throughout the day that ‘the staff are nice and will do anything for you’. One person said ‘the staff are very good at dealing with difficult people’. A relative said ‘the staff are always welcoming when you visit and they keep in touch with you if there any problems’ Kingswood DS0000007653.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience good quality outcomes in this area. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a varied diet. The recreational programme needs to reflect the full range of needs in the home. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: There is a mixture of people living in the home, some people who can make decisions about the whole of their life and others who have a degree of confusion. Those people who were able said that they could follow their own routine during the day. Activities are organised on an ad-hoc basis and during the inspection staff were observed spending time with people on a one-to-one basis. The records did appear to reflect the attitude of some staff that people with dementia could not join in with any activities. Staff need to identify what each person enjoys doing and organise activities around those interests for people who have a dementia or confusional state. Several people in the home said that there were not many activities to join in with but they also recognised that other people in the home were reluctant to join in. Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 13 There is a visitors policy in place and people spoken with said that their visitors could come at anytime during the day. One visitor spoken with said that she called at anytime and always found the staff to be welcoming and friendly. She said that the manager keeps her informed of any issues relating to her relative. The home works with a four-week menu where alternatives to the main choices are offered rather than a choice. People in the home said that the food was good and the meals always excellent. The cook said that fresh produce is used when possible. Kingswood DS0000007653.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. People who live at Kingswood and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The home has a complaints procedure in place and details of how to make a complaint where available around the home. Several people spoken to were clear that if they were not happy they would speak to the manager, deputy manager or the proprietor. A visitor said that they would speak directly to the manager if there were any problems. A record is kept of any complaints received and there has been one complaint made in the last twelve moths. This was resolved satisfactorily. There are policies on the protection of vulnerable adults and a whistle blowing policy so that staff can disclose poor practice without fear for their own position. Care staff spoken with said that they would report any suspected abuse to the manager or senior staff, so that people who live at the home would be safeguarded. Several of them were unclear as to the purpose of the Whistle blowing policy and further training in the policy on vulnerable adults and whistle blowing is recommended. All staff are thoroughly checked prior to Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 15 the commencement of their employment to ensure they are suitable to work with vulnerable adults. Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. The home provides a clean comfortable place to live. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: All the general areas of the home, some bedrooms and bathrooms, the kitchen and laundry were seen. Several people had keys to their own rooms and could lock their door when they left it. The home was clean and there was no unpleasant smell. A record of maintenance, replacement and redecoration was seen. People who live at the home are provided with comfortable seating in two sitting areas so that they can choose where and with whom they spend time. Some of the chairs are showing signs of wear and the manager needs to ensure these are repaired or replaced as part of the improvement programme. Kingswood DS0000007653.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. Staff, that, have been thoroughly vetted prior to the commencement of their employment, support people. They are in sufficient numbers to ensure they can provide the support required by the people in the home. Staff should have more access to training to allow them to develop their knowledge and skill in caring for older people. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: At the time of the visit there were three care workers, and one cook on duty. The staff team meets the needs of the people in residence. Staff spoken with said that there was enough staff on duty to allow for more personal interactions particularly on an afternoon. People in the home said ‘the staff are wonderful and will do anything for you’, ‘ Four staff records were seen and they contained an application form, two references, a POVAFIRST check and/or a Criminal Records Bureau disclosure, evidence of training and supervision notes. Staff spoken with all said that they could not start work until all the necessary checks had been carried out. One member of staff who had recently started shadowed another member of staff for a week before being rostered in to the shift. Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 18 Currently 48 of the staff have a National Vocational Qualification level two in care or are working towards it. Staff also have statutory training in manual handling, first aid, fire safety, infection control and food hygiene. There was no evidence that staff had received training in dementia care and it is recommended that such training be provided. The manager should also look at providing training in other aspects of caring for older people. Staff receive formal appraisal but not formal supervision. Care staff and records showed that appraisals were carried out twice a year. Staff should receive supervision at least six times each year. Kingswood DS0000007653.V364294.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience adequate quality outcomes in this area. People can be assured that the service is managed by a competent person although they don’t always find her approachable. The development of a formal quality assurance system would assist the manager to identify areas of service which can be improved. We have made this judgement using a range of evidence, including a visit to this service. EVIDENCE: The registered manager is experienced and has been at Kingswood for three years. Feedback received before and during the visit indicated that not everyone finds her approachable. Some feedback indicated that she was aloof Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 20 and didn’t spend much time with the people in the home. indicated she was a good manager. Other feedback At the previous inspection it was identified that there was no formal system to ensure that the quality of service is being monitored. This remains outstanding and was discussed again with the proprietor. Whilst there was evidence that the opinions of people living in the home are taken in to account it is not formally recorded and any improvements made are not recorded. The quality assurance system should include the views of people in the home, staff, relatives and visiting professionals. Information should be gathered from many sources and an annual development plan for the whole service should be produced to show what is planned for the future. The manager does not handle any monies for people living in the home. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Commission of Social Care Inspection. Kingswood DS0000007653.V364294.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 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 22 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 OP33 Regulation 24 Requirement There must be a quality monitoring system in place based on the views of people living at the home and others in measuring and improving the quality of care provided by the home. This is an outstanding requirement from the previous inspection with a timescale of 31/07/07 Timescale for action 30/06/08 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 OP7 Good Practice Recommendations People’s care plans should fully reflect all of their needs. Including the social activities they can participate in whatever the level of confusion they may have. DS0000007653.V364294.R01.S.doc Version 5.2 Page 23 Kingswood 2. 3. OP12 OP16 4. OP18 5. 6 OP26 OP36 Planned time for social activities should be clearly identified in the home. Staff should be enabled to support people with social activities. Staff should receive regular training in the complaints procedure and the whistle blowing policy to ensure they remain aware of what they should do in the event a complaint is made or they need to make a complaint. Staff should receive regular training in the Vulnerable adults policy and procedures. This will allow the m to fully understand what to do if they witness or someone complains that they are being abused. Several chairs in the lounge are showing signs of wear the Registered Manager should arrange for them to be repaired or replaced. Staff should receive formal recorded supervision at least six times a year. Kingswood DS0000007653.V364294.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V364294.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. 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