CARE HOMES FOR OLDER PEOPLE
Kingswood Lodge Long Street Wigston Leicestershire LE18 2BP Lead Inspector
Helen Abel Unannounced 1 July 2005, 10:00am
st 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 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 Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Kingswood Lodge Address Long Street Wigston Leicestershire LE18 2BP 0116 2815582 0116 2884632 None Mr David W Barnacle Mrs Janet Barnacle Mrs Jane Adkin Care Home 21 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Old Age (21) registration, with number of places Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: The CSCI is in the process of removing the named variation. Dated 26.9.00 Date of last inspection 28th February 2005 Brief Description of the Service: Kingswood Lodge is registered to provide personal care and accommodation for up to twenty-one older people. The home is situated close to Wigston town centre near shops, pubs, library and other amenities and accessible via public transport. Car parking is available to the front of the home. The home is a large property converted with en-suite bedrooms over two floors. The home has level entry access to the front and rear of the home. Bedrooms on the first floor are accessible via the stairs or the passenger lift. There are sufficient number of toilets, bathrooms and washing facilities. Service users have the option of three lounges on the ground floor, of which one is a designated smoking lounge that looks on to the landscaped garden to the rear.The home is clean, safe and comfortable with a bright, cheerful, décor. The staff are committed, cheerful and have a good relationship with each other and the service users. Staff training is provided on a regular basis with a large proportion of staff completing various levels of the National Vocational Qualification awards. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and was unannounced. A tour of the premises took place and care records, policies and procedures were inspected. There was an opportunity to talk with four residents, a visiting relative and staff. The Registered Manager joined the inspection later in the afternoon. The Registered Provider was present at the home near the end of the inspection measuring up rooms for new carpets. What the service does well: What has improved since the last inspection?
There have been improvements around National Vocational Qualification (NVQ) training in Care with good progress made by staff; and with the Registered Manager playing an active role in supporting staff through their NVQ’s. A range of specialist training has also been provided, Safety Compliance and Dementia Awareness Courses. A new gardener has been employed and is making good progress with the garden areas. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 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 standard(s) 1, 3 There is written information available about the home and assessment systems for new residents are fully implemented. EVIDENCE: The Statement of Purpose /Service User Guide is available to new residents and is presented in a colourful folder. This document now requires updating to ensure it includes all the information required to meet this Regulation. A senior staff member confirmed the assessment process and the consultation between the new resident, family members and other professionals. The Registered Manager and a senior attend assessments for any new resident. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 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 standard(s) 7,8,9 Residents health, personal and social care needs are satisfactory and set out in an individual plan of care. EVIDENCE: Care plans were examined and found to hold the appropriate and relevant information. Residents with significant health care needs were found to be given good support and care by staff. A resident’s room should be arranged so as to ensure health care equipment is better sited and to minimise cross infection. The Registered Manager agreed to arrange this in consultation with the resident. The Registered Manager confirmed a good working relationship with the Community Pharmacist. The recording of half tablets was discussed and counting down systems. It was agreed the Community Pharmacist would be consulted on this matter. Medication records were found to be of a good standard. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 10 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 standard(s) 12, 13, 14, 15 There are sufficient, social, cultural, religious and recreational interests to meet the expectations and preferences of residents. EVIDENCE: Music from years gone by is provided in the communal lounges. A film show is regularly provided, and a mixed singing group performs on occasions. Residents went on a barge trip last summer and have been invited to musical productions at local schools. There are regular coffee mornings and bring and buy sales. On a residents birthday a tea party and cake is often provided. Sometimes the family will organise the whole birthday tea. Visitors are welcome at any time during the day and evening. The chef was clearing away the dinner and spoke of the meal he prepared earlier fried egg/fish and chips and bread and butter. The chips were home cooked. Treacle sponge and custard followed this. The chef was preparing the tea a variety of sandwiches with either brown or white bread. Meals are served in the three lounges /dining rooms which all overlook the garden areas. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 11 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 standard(s) 16,18 Residents are sure their complaints will be listened to and taken seriously; with policies and procedures in place around protecting adults from abuse. EVIDENCE: The complaints procedure is included in the Statement of Purpose/Service User Guide and should be updated to include the title of the Commissions. Residents confirmed they felt able to raise any concern with staff. The Registered Manager confirmed obtaining a copy of the sixth edition of the Protecting Vulnerable Adults Policy and Procedure and agreed to update the existing adult protection policies and procedures. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 12 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 standard(s) 19, 20,21,22,23,24,25,26 The premises are well maintained, clean and hygienic with good processes in place to minimise any risk of cross infection. EVIDENCE: All areas of the home were safe, comfortable and clean. Resident’s rooms are decorated with a pink, blue or green colour scheme. Each room is personalised with resident’s possessions and items of their own furniture. The laundry area was clean and very well organised. There are three communal lounges / dining rooms named pink, blue and green, lounge, one of which is designated for smokers. The home has three cats that wander around the home. A resident was observed talking and stroking a cat on her lap in the lounge. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 13 All of the carpets in the communal areas and the hallways were worn and marked and needed replacing. The Registered Provider arranged on the day of inspection for a carpet representative to come into the home and measure up for carpets. Following on the inspection the Registered Manager confirmed new carpets will be fitted within the next two months. Several broken wooden chairs were left over turned in a corner of one of the lounges. They appeared unsightly. It was agreed with the Registered Manager they would be removed the same day. The outdoor areas are well maintained with large pots with flowers at the front of the house and a green lawn and garden furniture at the back of the home. The Registered Manager reported some residents enjoy sitting outside in the warmer weather. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28, Resident’s needs are met by the numbers and skill mix of staff. EVIDENCE: There were good levels of staff observed during the unannounced inspection, and staff were effectively deployed to support residents needs. Staff were seen to be sensitive when dealing with an anxious resident and gave additional time and reassurance. Residents said, “Yes, I like it here”. “It’s not so bad. The majority of staff are okay” A relative said, “The staff are friendly, my granny looks happy when I come and visit her. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 37 Resident’s rights and best interests are safe guarded by the home’s record keeping policies and procedures. EVIDENCE: All records examined were secure and generally up to date. The policies and procedures file content should be reorganised for improved access to this information. Hot water temperature testing records were inspected and should be carried out more regularly with records of any action taken. It was agreed all the water outlets accessible to residents would be tested at the beginning of July. There are regular residents meetings. Consultation is also ongoing as part of daily living. Residents are consulted around choice of bedroom, clothes, menu options, what pets to have in the home and films to watch. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 3 x x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 3 3 3 3 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 Standard No 16 17 18 Score 3 x 3 x x 3 x x x 3 x Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 17 No Are there any outstanding requirements from the last inspection? 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 1 Regulation 4 Requirement The Registered Person must update the Statement of Purpose to include a statement of matters listed in Schedule 1 of the Regulations. Timescale for action 1st September 2005 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. Refer to Standard 8 9 16 18 37 37 Good Practice Recommendations Provide a storage facility for health care materials in the identified residents bedroom. Contact the Pharmacist for guidance on counting down medicines and the systems for recording this on medicine records. Update the complaints procedure on all printed information. Update the adults protection policy and procedures in line with new guidance/good practice. Re-visit the policy and procedure file and reorganise. Undertake regular hot water temperature tests with records held of any action taken. Kingswood Lodge C51 C01 S1738 Kingswood V235633 010705 STAGE 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 5 Smith Way Grove Park Enderby Leicestershire LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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