Inspection on 08/06/05 for Kingswood Park

This inspection was carried out on 8th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Park 19/11/08

Kingswood Park 24/11/06

Kingswood Park 21/10/05

Kingswood Park 18/01/05

Kingswood Park 28/04/04

Kingswood Park 11/03/04

Similar services:

Claremont House

Oak Ridge

Coopers Mill Ltd

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Paradise Lodge

Bilney Hall

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

CARE HOMES FOR OLDER PEOPLE Kingswood Road Kingswood Road March Cambridgeshire PE15 9RT Lead Inspector Don Traylen Announced 8 June 2005 12:00 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 Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Kingswood Park Address Kingswood Road March Cambridgeshire, PE15 9RT 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) 01354 652381 01354 660304 home.mat@mha.org.uk Methodist Homes for the Aged Mrs Sumiyo Berkeley Care Home 44 Category(ies) of Dementia - over 65 years of age (18), Learning registration, with number disability over 65 years of age (2), Old age, not of places falling within any other category (44) Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Staffing levels must not fall below 7 care staff from 7.30am – 10.00 pm and three waking night staff throughout the night. Date of last inspection 18-01-2005 Brief Description of the Service: Kingswood Park is situated in a quiet residential area of March. It is owned by Methodist Care Homes, who purchased the property from Cambridgeshire County Council in November 2001. The home is registered to provide for 44 elderly people. Included in that number are a maximum of 18 people with a formal diagnosis of dementia and 2 people who have a learning disability. The home is divided into 5 units: Cherry, Redwood, Rowan, Maple and Willow. Each unit has 8 or 10 bedrooms, a dining room, a lounge and a kitchen. One unit is designated for people with dementia and another unit is for service e users with high dependency needs. These two units are accessed via a door with a combination lock. All bedrooms are on the ground floor of the building. The manager’s office, the administration office, a staff meeting/training room, staff toilets and relaxation room and staff kitchen are situated on the first floor. A large central room is used for a community Day Centre provision. This operates three days each week on Monday, Wednesday and Friday and offers 22 places. The Day Centre is staffed as an independent provision, separate from the home’s staffing arrangements. On Tuesdays and Fridays the room is used by service users who participate in various social activities, organised by the home’s activities co-ordinator. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 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 on the 8 June 2005 and included tracking a complaint to the 14 July 2005. 4 relatives and 5 service users and 3 care staff spoke to the inspector. The inspector discussed all the proposed requirements and recommendations made in this report with the manager during the inspection. What the service does well: What has improved since the last inspection? What they could do better: • The home should promote better engagement with service users and relatives. When staff need to leave a group of service users they should engage with them on return, rather than leave them in isolation. The v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 6 Kingswood Road home should aim to promote a person centred approach, as soon as possible. • • The induction programme for new staff should include abuse training. The procedures for respite care arrangements made by the home must be improved in the following ways: The home must analyse the assessment details they are provided by Care Managers so they fully understand their undertaking and that full and comprehensive assessment details are in their possession before agreeing to provide respite care. These assessment details must be satisfactory for the home to decide whether they can fully meet the assessed needs of the service user. The manager should consider whether the home need to make their own assessment, as they do when deciding to admit a service user for permanency. A formal and documented greeting with significant relatives or whomever accompanies the service user to the home (at the time of admission) should be considered as respectful and good care practice and should become an integral part of their admission procedure. The home should treat this meeting with the accompanying relatives/family/friend and service users as the initial opportunity to contribute to the care planning arrangements and to ascertain any additional assessment information, such as contact details and emergency contact details. Two Requirements and two Recommendation have been made as a result of a complaint made about the home. • Staff rosters should be recorded so that the hours worked are written more clearly and similar to the training matrix all staff designations are included in the listing. Records of rosters worked and of the staff training matrix should include the additional information indicated in ‘Staffing’ section and in Recommendation No3 and in Requirement No 3. • 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 Road v218002 i53_s0000015196_kingswood park_v218002_230505 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 Road v218002 i53_s0000015196_kingswood park_v218002_230505 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) 1,2,3,4,5 Service users are generally assured that their full assessment details are known to the home prior to admission, but the detailed assessment information can be improved. EVIDENCE: The home has produced a very informative and well presented Statement of Purpose and Service User Guide. The home does not provide Intermediate Care. One assessment document received from a Care Manager did not include sufficient details of care for one diabetic service user with insulin dependent needs whose respite care had been arranged without details of how his diabetes should be managed. Following the investigation of a complaint made to the home there have been two Requirements and two Recommendations made in relation to the admission arrangements and to respite care placements made by Care Managers. These improvements were fully discussed with the manager following a complaint investigation carried out by the home. Important information given to the home by relatives at the time of a respite admission had not been recorded and had not been used as part of care planning consultation. The family stated they felt they had not been listened to, or Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 9 greeted by care staff when they accompanied the service user to the home. It was concluded that the home can improve their communication with service users and representatives, both prior to and especially at the point of admission, when the opportunity for consultation about Care Plans should be conducted. The inspector and manager discussed the methods the home could use to improve the assessment information when a Care Manager may not have been able to provide this in sufficient detail, or in enough time to enable the home to have a complete picture of a prospective service user’s habits and resultant needs. Four relatives confirmed they were given an open invitation to visit the home prior to admission. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 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 standard(s) 7,8,10,11 Care Planning has been identified as an area for improvement through meaningful consultation with service users and their representatives. EVIDENCE: Care Plans are well presented and address an adequate range of needs. However, the investigation of one complaint indicated ways that the inclusion and consultation with relatives and representatives would improve staff awareness and skills and help establish essential details of service users needs. It was discussed that the admission procedures could be an ideal time to sit and talk with prospective service users, their family or representatives and to build communications that would make it easier to establish the sensitive or routine details that are necessary to provide individualised care. The home responds to service users’ health needs by effective use of community health professionals such as District Nurses, GPs and Community Psychiatric Nurses as well as referring to emergency service when appropriate. Service users are looked after as long as the home is able to continue providing the appropriate type of care. The manager stated she is aware of changing needs that might determine whether the home can continue to provide appropriate care. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 11 One relative stated that although she feels included and informed about her sister’s care and has attended reviews, she is not fully aware of why a nurse visits her sister and was not aware of any key workers with responsibility for her sister. She commented that, ‘the home seems short of staff at weekends’. Another relative who was visiting her mother stated that, ‘staff do not have clear instructions what to do’ when referring to her care. This service user’s Care Plan identified a key worker; showed irregular records of mobility since 24-7-2002; the reviews contained many ‘no change’ entries without any other comments and her nutritional screening did not inform or relate to aspects of her care. Her dependency levels did not correspond with other written details of her care that indicated high dependency needs. There were no records in her Care Plan of visits or attention by the District Nurse. There is an expectation that Care Plans accurately reflect care arrangements. The Statement of Purpose that states care is ‘person centred’, must be mirrored in the Care Plan and in the personal interaction when giving care. This has not been shown when tracking this service users’ care planning. The Service User Guide that states Care Plans, ‘detail all your nursing………requirements’ and ‘your keyworker will use the care plan to inform other staff of your particular needs and wishes’, was not on this occasion observed to be upheld. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 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 standard(s) 12,13,14,15 Daily routines are adapted to suit the needs and interests of service users. EVIDENCE: The home has an activities co-ordinator who informed the inspector she arranges bingo, card games and gentle exercises and sing-along. She explained that she includes all service users from each of the home’s units on a rotational basis and added that she has a stronger interest to participate from the service users in the Dementia related needs unit. The home does not have any transport and relies on the local charity Fenland Association Community Transport (FACT) for arranging service users’ outings. A nutritious meal was seen being prepared by the kitchen staff. A record of meals and diabetic needs are incorporated in to a low or sugar free diet provided for service users. A variety of sources for purchasing fresh vegetables and fresh meat was described by the chef during the visit to the kitchen. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 13 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) 16,17,18 The home has a satisfactory history of being open and responding immediately and positively to complaints. EVIDENCE: ll staff have satisfactory CRB checks and nearly all staff have undertaken Adult Abuse training organised by Cambridgeshire Community Services. The manager stated that arrangements have been made for recently recruited staff to complete the Adult Abuse training. The home has responded positively and openly to previous complaints and to one ongoing complaint at the time of inspection. The manager maintains a record of all complaints. Staff stated they were aware of abuse but were not confident about how to report abuse or where the telephone contacts were kept when asked. The Assistant manager’s office did not have any noticeable telephone contacts for Police or Social Services/PCT on display. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 14 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 environment is safe, clean and well maintained and has sufficient space for service users to remain private or make use of communal areas as they choose. EVIDENCE: The environment of the home has previously been established as high quality and well maintained. Observations of the very clean kitchen, bathrooms and toilets, communal areas, bedrooms, the record of kitchen cleaning routines, food temperatures and fridge/freezer temperatures was combined and continuing evidence of attention to high standards. However, one part of the home where there are a group of bedrooms to the immediate left of the main entrance, smelt of stale urine. The offending smell must be eradicated. An ongoing maintenance programme is in place. A handyman/maintenance and gardener is employed by the home. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 15 Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 16 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) 27,28,29,30 Service users are safeguarded by the homes’ thorough recruitment policies and procedures. EVIDENCE: Kingswood Park employ a total of 47 care staff that includes 4 assistant managers and 10 relief staff. 18 staff hold NVQ level 2 awards. 3 staff have left since the last inspection in January 2005. The manager stated that she expects 50 of the staff to have achieved NVQ level 2 awards by December 2005. The company offers comprehensive induction training and ongoing inhouse company training in Dementia care and ‘nutrition and the elderly’. One visiting relative stated that, ‘the home seems short of staff at weekends’. The home has a condition of registration that requires 7 staff at all times during the daytime working shifts. Staff rosters showed there were 6 care staff plus an assistant manager on duty, a manager, a cook, an admin assistant and one or more domestics. The working day consist of 7 staff working between 7.30 –10am; 6 staff working between 10am –3pm; 6 staff working the 2.3010pm shift. 3 care staff work the 10pm- 8am night shift. At one point during the inspection the inspector could not find a member of staff. Three service users who were observed to be sitting in the dining area after lunch were not noticed by passing carers, nor were they spoken to directly by care staff when care staff did re-appear. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 17 Observable evidence shows that staff are not attendant to service user at all times and that they are not all sufficiently engaging with service users and are not all delivering person centred care. However, in the part of the home for people with dementia care needs, it was noticed that one care worker was very engaging with all service users in an understanding and sensitive manner that was considered to be positive person- centred care. Staff rosters do not show individual daily dates. Hours worked were not easily read because of amendments made and there were no codes indicated for the lettering used to record amendments. Staff recruitment is supported by company policies and is thoroughly conducted to ensure service users are safe from abuse by checking CRBs, POVA list and two references and employment history checks. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 18 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) 31,32,33,36 The management of the home is professionally adept and open in style. EVIDENCE: The manager continues to meet Standard 31. She is service user focussed in her approach to managing. A service user survey/ questionnaire was available in the main hallway along with the Statement of Purpose and Annual Report. The home is subject to Methodist Homes’ internal service inspection, but more attention to communication and care planning arrangements should be the focus of quality assurance. Supervision records are kept and staff confirmed they receive supervision every two months. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 19 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 3 3 2 2 2 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 2 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 2 x x 3 x x Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 20 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 3 Regulation 14(1)(a,b, c) & 14 (2)(b) Requirement Timescale for action 1.09.05 2. 7 15(1) 3. 4. 26 27 16(2)(k) 17(2), 17(3)(a) & Schedule 4, para 7) The home must analyse the assessment details they are provided with from PCT employed Care Managers so they fully understand their undertaking and ensure that full and comprehensive assessment details are in their possession before agreeing to provide respite care. The registered manager must 01.09.05 ensure there is effective consultation with service users or their relatives or representatives in the preparation of a written Care Plan and that Care Plans must be accurately recorded and contain all care arrangements. All parts of the home must be 01.09.05 free from offensive odours and not smell of stale urine. Staff rosters must be written in a 01.09.05 manner that includes staff job titles, a code of the lettering used for ammendements and clarity of ammendments. 5. 6. 7. Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 21 8. 9. 10. 11. 12. 13. 14. 15. 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 3 Good Practice Recommendations When the home is considering providing respite care the manager should consider whether the home has enough information provided by the Care Manager and if they should conduct their own assessment, as they do when deciding to admit a service user for permanency. A formal and documented greeting with the service user and his relative/representatives whom might accompany the service user to the home at the time of admission, should be considered as respectful and good care practice and should become an integral part of the admission procedure. The home should treat this meeting with the accompanying relatives/family/friend and service users as a major opportunity to contribute to the care planning arrangements and to provide any additional assessment information, such as contact details and emergency contact details. A formal and documented greeting with the service user and his relative/representatives whom might accompany the service user to the home at the time of admission, should be considered as respectful and good care practice and should become an integral part of the admission procedure. The home should treat this meeting with the accompanying relatives/family/friend and service users as a major opportunity to contribute to the care planning arrangements and to provide any additional assessment information, such as contact details and emergency contact details. A formal and documented greeting with the service user v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 22 2. 3 3. 4 4. 5 Kingswood Road 5. 7 6. 30 and his relative/representatives whom might accompany the service user to the home at the time of admission, should be considered as respectful and good care practice and should become an integral part of the admission procedure. The home should treat this meeting with the accompanying relatives/family/friend and service users as a major opportunity to contribute to the care planning arrangements and to provide any additional assessment information, such as contact details and emergency contact details. A formal and documented greeting with the service user and his relative/representatives whom might accompany the service user to the home at the time of admission, should be considered as respectful and good care practice and should become an integral part of the admission procedure. The home should treat this meeting with the accompanying relatives/family/friend and service users as a major opportunity to contribute to the care planning arrangements and to provide any additional assessment information, such as contact details and emergency contact details. The training matrix that is kept for staff should be maintained only for current staff and should indicate the date they started employment, their designation and all training undertaken and any future taining arrangements. Communications and Care Plan arrangements should be the focus of quality assurance. The home should aim to promote and encourage a person centred approach to giving care, as soon as possible. 7. 8. 33 7 Kingswood Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Road v218002 i53_s0000015196_kingswood park_v218002_230505 stage 4.doc Version 1.40 Page 24 - 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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