Inspection on 07/11/05 for Kingswood House

This inspection was carried out on 7th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 House 25/02/09

Kingswood House 28/12/06

Kingswood House 04/05/05

Kingswood House 17/02/05

Kingswood House 29/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Kingswood House Hollington Road Raunds Northants NN9 6NH Lead Inspector Mrs Sarah Smart Unannounced Inspection 7th November 2005 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 House DS0000060028.V264391.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. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kingswood House Address Hollington Road Raunds Northants NN9 6NH 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) 01933 624298 01933 626871 Kingswood Home Limited Claire Suzanne Swailes Care Home 18 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (18), of places Physical disability over 65 years of age (2) Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. The number of service users must not exceed a total of 18. The number of service users in the category of OP - old age not falling within any other category, must not exceed 18. Once a total of 18 service users are accommodated in the home, no further service users may be admitted. The number of service users in the category of PD(E) must not exceed 2. Once the number of service users in the category of PD(E) is 2, no further service users may be admitted within the category. The number of service users in the category of DE(E) must not exceed 8. Once the number of service users in the category of DE(E) is 8, no further service users may be admitted within this category. 4th May 2005 Date of last inspection Brief Description of the Service: Kingswood House is a care home providing personal care and accommodation for 18 older people over the age of 65 years to include 2 people with a physical disability and 8 people with dementia. Kingswood House is an established care home. The home is located close to the centre of the small town of Raunds within its own grounds. The home has 14 single bedrooms and 2 shared rooms. Bedrooms are located on the ground and first floors with a stair lift providing access to the first floor. The home has a large well maintained garden. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced inspection was undertaken between the hours of 9.30am and 3pm. The inspection included a site visit of the new rooms awaiting registration. Preparation for the inspection included review of the previous inspection report and requirements, and variation application, and took approximately 2.5 hours. The primary method of inspection used was ‘case tracking’. This involves selecting a number of service users and tracking their care and experiences through review of their records, discussion with them, the care staff and observation of care practices. The following areas were covered during the inspection: case tracking, medication, sample of policy review, staff rota, staff supervision, a tour of the new rooms, the statement of purpose, service users finances, complaints records, previous requirements made, and staff and service user interviews. Three service users were case tracked. Two staff members, plus the manager, were interviewed at length, and several others briefly, whilst four service users were spoken to in detail. What the service does well: What has improved since the last inspection? Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 6 Care plans and risk assessments were up to date. The storage of oxygen cylinders has been overcome. 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 House DS0000060028.V264391.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 Kingswood House DS0000060028.V264391.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 Service users needs are met, but further information should be provided to prospective service users. EVIDENCE: The statement of purpose was an informative document, and contained valuable information, however it did not cover all of the areas outlined in schedule 1. In addition to this, once the owner and manager have decided upon the details of the extension awaiting registration, further information will need to be added in relation to the meeting of the service users needs in this area, and the type of service users to be accommodated. From reviewing documentation during the inspection, and speaking to staff and service users, the inspector was satisfied that the service users current needs are met. Kingswood House DS0000060028.V264391.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): 7,8,9 Medication practice was poor, and some care plans could be more specific and demonstrate the service users agreement in their content. EVIDENCE: Care plans were identified in all areas, and were dated, reviewed and evidenced the writer, however the care plans could contain more specific instruction to staff, and did not contain evidence of the service users involvement in their writing. The home have introduced a pressure sore risk assessment tool, however other healthcare assessments were not being recorded. In one particular instance where a service users dietary intake was inconsistent, and staff were unable to weigh her, it is considered that such an assessment would be beneficial. The manager may also wish to introduce continence assessments for example. The daily summaries were not completed on a daily basis. The rationale for this was discussed with the manager. The storage and recording of medication was satisfactory, however very poor practice was observed by one senior carer during the inspection. This was brought to the attention of the manager and deputy, who stated that action Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 10 would be taken before this staff member administers further medication. Therefore an immediate requirement has not been made. The medication policy did not state that the Commission for Social Care Inspection must be advised of drug errors. Consent should be obtained from the GP before homely remedies are administered, to ensure that adverse interactions do not occur. Kingswood House DS0000060028.V264391.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): 12,14,15 partially Service users are happy in the home, and are afforded choices. EVIDENCE: Service users files contained a social assessment, outlining hobbies and previous lifestyles etc. Service users spoken to stated that they are enabled to visit the nearby town centre if they wish, whilst one service user goes out alone. The service users stated that they are able to choose what time the retire to bed etc. There was evidence of various activities throughout the week and an activities organiser is employed. Service users advised the inspector that the food is nice. At the time of the inspection, lunch looked and smelt appetising. The cook said that service users are asked during the morning if they would like an alternative preparing to the main meal. Kingswood House DS0000060028.V264391.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): 16,18 Service users were adequately protected. EVIDENCE: The complaints procedure in the statement of purpose differed to that in the policy file. The complaints policy must state that the Commission for Social Care Inspection can be contacted by a complainant at any time. The manager stated that the home has not received any complaints. The abuse policy was written to a very high standard. Staff spoken to were asked what action they would take in the event that they received a complaint, or witnessed abuse. The answers given were satisfactory. Kingswood House DS0000060028.V264391.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): 19,20,21,22,23,24,25,26 The environment of the registered part of the building is satisfactory. Some issues must be addressed before registering the lodge. EVIDENCE: The home have recently converted a property in the grounds of the home to provide accommodation to a further three service users. This area was viewed during the inspection for registration purposes, along with the communal areas of the main house, and one service users bedroom. The home was maintained to a high standard, as were the gardens. Communal space was light and airy, and accessible to all service users. Washing and bathing facilities were adequate. The three new bedrooms all have ensuite facilities. Grab rails have been fitted to stair ways. The manager should assess the need for rails in the bathrooms according to the service users needs. It is not anticipated that the lodge will accommodate service users who use a wheelchair. The bedrooms were noted to be of adequate size, and fully furnished. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 14 The locks fitted to service users bedroom doors in the lodge were not of an acceptable type. These must be changed before registration will be granted. Radiators in the main house and the lodge did not have low surface temperature covers in place. The manager is required to carry out a risk assessment as a minimum in relation to this. All areas of the home viewed were clean and tidy. The laundry for the lodge will be carried out in the main building. Other information relating to the registration of the lodge will be addressed in a separate communication. Kingswood House DS0000060028.V264391.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 Staffing levels are adequate. EVIDENCE: The staffing rota was viewed. This indicated that staffing levels are adequate to meet the current needs of the service users residing in the home. There were no staff members working excessive hours. The rota did not include staff surnames, and it is recommended that these are added, in order that staff can be clearly identified. A service user stated that the staff “are a lovely lot…….this is a very happy home.” Kingswood House DS0000060028.V264391.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): 35,36,37,38 Some health and safety issues require attention, however generally the management of the home is acceptable. EVIDENCE: A sample of service users finances were viewed. it is recommended that the manager records two signatures when handling service users monies to ensure that systems are robust. One very minor discrepancy was found, which was corrected by the manager. Therefore a requirement has not been made. The manager, acting manager and the inspector discussed the requirements of staff supervision, as the current method of staff supervision was causing some difficulties in the home. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 17 A sample of policies were viewed. The confidentiality policy should contain additional information in relation to telephone enquiries, media contact, and conversations between staff members outside work. Cleaning chemicals were stored in an unlocked cupboard in the lodge. The manager must carry out a risk assessment as a minimum in relation to this. A first floor bedroom window was found to be unrestricted in its opening, and a service user could potentially fall from it. The manager must carry out an urgent risk assessment in relation to this, and ensure that corrective action is taken as soon as possible. Service users files contained a fire risk assessment for each service users, which was noted to be a useful document. The inspector was advised that a service user walks some distance to visit his family. Although the manager demonstrated that the risks associated with this have been identified, a recorded risk assessment has not been carried out. In two instances service users were observed to be transported within the home in wheelchairs without footrests in place. The manager stated that one of these service users refuses to have them, however this was not documented in her care plan, and alternative safety measures had not been put in place. A fire door leading into a lounge was observed not to shut properly. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 18 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 X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 3 3 2 Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 19 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 2 3 Standard OP1 OP9 OP25 Regulation 4 13(2) 23(2) Requirement The statement of purpose must contain all of the information outlined in schedule 1. Administration of medication must be in line with current guidelines. A risk assessment must be carried out in relation to radiators without low surface temperature covers, and identified action taken. A risk assessment must be carried out in relation to first floor windows which are not restricted, and identified action taken. A risk assessment must be carried out in relation to service users who go out of the home alone, and identified action taken. Wheelchairs must not be used without footrests in place. The manager must ensure that all fire door close correctly. Timescale for action 31/12/05 20/11/05 30/11/05 4 OP38 12(1) 20/11/05 5 OP38 12(1) 30/11/05 6 7 OP38 OP38 12(1) 12(1) 30/11/05 30/11/05 Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 20 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 2 3 4 5 6 7 Refer to Standard OP7 OP8 OP9 OP16 OP27 OP35 OP37 Good Practice Recommendations Care plans should be more specific, and contain evidence of the service users involvement in their content. Further healthcare assessments should be introduced, for example, nutritional and continence assessments. Consent should be obtained from the GP before using homely remedies. The complaints policy should state that the Commission for Social Care Inspection can be contacted at any time by a complainant. The rota should detail staff surnames. Two signatures should be obtained when handling service users finances. The confidentiality policy should contain additional information. Kingswood House DS0000060028.V264391.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 House DS0000060028.V264391.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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