Inspection on 18/06/07 for Kinoo Lodge

This inspection was carried out on 18th June 2007.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kinoo Lodge 30/06/06

Kinoo Lodge 19/10/05

Kinoo Lodge 12/04/05

Kinoo Lodge 16/02/05

Kinoo Lodge 13/09/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Kinoo Lodge 86 Gladys Avenue North End Portsmouth Hampshire PO2 9BH Lead Inspector Neil Kingman Unannounced Inspection 28 June 2007 14:00 Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 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 Kinoo Lodge DS0000011738.V339110.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 Adults 18-65. 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. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kinoo Lodge Address 86 Gladys Avenue North End Portsmouth Hampshire PO2 9BH 023 9261 4219 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) Mrs Bibi Saheyda Keeno Mr Abdool Taleb Keeno Mrs Bibi Saheyda Keeno Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 June 2006 Brief Description of the Service: Kinoo Lodge is a registered home providing care support and accommodation for up to 11 adults with a learning disability. At the time of the inspection there were 5 people accommodated, four within shared bedrooms. The registered manager Mrs Keeno also owns the home jointly with her husband. They live in accommodation, which adjoins the care home. Members of their immediate and extended family including Mr and Mrs Keeno, provide all staffing at the home, which covers 24 hours per day. The home has links with local health and social services teams for people with a learning disability, including local day care services run by Portsmouth City Council. The building consists of a conversion of two houses into one property. Communal facilities comprise a lounge, kitchen-dining area and a recreation room, communal toilets and bathroom and a small garden. The home is located in Gladys Avenue, Portsmouth about a half mile from the main shopping areas of Northend and Kingston. Weekly fees are determined by the social services funding arrangements and currently range between £335 and £850. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Kinoo Lodge and brings together accumulated evidence of activity in the home since the last key inspection on 30 June 2006. Part of the process has been to consult with people who use the service; including two Social Services Care Managers who have contact with the home. Included in the inspection was an unannounced site visit to the home by an inspector on 28 June 2007. The registered manager Mrs Keenoo was available on the day, as was her husband who also works in the home. At the visit we had an opportunity to tour the building, speak with staff on duty and meet all five people who use the service. We also looked at a selection of records. Prior to the site visit the manager sent to the Commission a range of information about the service including an Annual Quality Assurance Assessment (referred to as the ‘assessment’ during the report), which has been used with other information to inform the various judgements made about the service. What the service does well: What has improved since the last inspection? Improvements made to the environment include: • • • • • Hallway and stairs - redecorated. Dining area – Furniture upgraded. Ground floor – New laminate flooring laid throughout. Outside – Double-glazed replacement windows throughout. Two bedrooms redecorated and new laminate flooring laid. DS0000011738.V339110.R01.S.doc Version 5.2 Page 6 Kinoo Lodge • The development of a residents’ leisure room. What they could do better: Two areas for improvement were identified: • Every effort needs to be made to access an advocacy service for those people who have no one independent of the home to represent them, or assist and support them to make decisions about their own lives. This was identified as a recommendation at the last inspection. The manager confirmed that she had sought advice in this area from Social Services but had received not help or advice. • All staff must be given opportunities to access NVQ training linked to the Learning Disability Award. This is important in providing staff with the underpinning knowledge specific to providing a service for with people with learning disabilities. This was identified as a requirement at the last inspection and remains outstanding. The manager said she had experienced difficulty in accessing such training but felt there was an opportunity with Havant College commencing September 2007. 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. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 – People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that the care support needs of the people who use the service will be met by undertaking a proper assessment prior to them moving into the home. EVIDENCE: The manager confirmed that there had been no new admissions to the home since 2002; the most recently admitted person having moved on to another service in 2003. All five people currently using the service have lived at Kinoo Lodge for over twelve years. Each person has an individual plan, which covers his or her needs and aspirations. The inspector noted they contained an assessment of their individual needs. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Decisions about peoples’ lives are determined by assessment and recorded in individual personal plans. The home provides care and support for people with intellectual impairment and limited communication skills to make decisions about their daily lives within a risk assessment framework. However, one area for improvement would be the introduction of advocacy in some independent form to people who have no representation. EVIDENCE: Personal plans – Each person who uses the service has an individual personal plan. A sample of three plans was viewed during the site visit. It was noted that information in personal plans is very ‘person centred’ and includes: Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 10 • • • • Current issues Aims Plans and achievements Risk assessments Headings are broken down into specific areas of the individual’s daily life including: Communication, activities and hobbies, likes/dislikes, medication, behaviour, significant events and other information. All five people who use the service have profound learning disibilities and significant communication deficits. While none was able to speak about their experiences of living at the service they all were noted to be relaxed and interactions between them and the staff were warm and good natured. A Social Services Care Manager who visits the home highlighted their care and support for people with profound disabilities as being one the home’s strengths. It was felt by the care manager that the home was not so good with people who were more able and independent. Decision making At the last inspection of the home it was judged that the degree to which people are enabled to make decisions appeared to be limited by their disability as well as poor staff training. This was a reference to the fact that at that time no member of staff had any service specific training in the form of an NVQ linked to the Learning Disability Award. This is covered in more detail later in the report. Given the needs of the five residents the use of advocacy from outside of the service was very low, and needed to be improved, especially for those people who do not have naturally existing family support networks who can assist with advacocy. At this site visit the manager said that she had explored the availability of an advocacy service with Social Services and had been given no help or advice. In discussions the introduction of advocacy in some independent form was recognised as important by the manager. However, greater effort must be made to try and source an appropriate advocacy service for those who are not represented. The home’s assessment covers this area by commenting: Although residents’ verbal communication is limited, every effort is made to ensure every single resident is happy with decisions being taken. In both formal and informal ways the residents are assisted to make decisions by using pictorial illustrations. Due to their level of disability the residents find it easier to understand and choose if the picture is a real representation. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 11 For example during the period of redecoration of the home residents were asked to choose the colour of paint for their rooms, a selection of colour were placed in front of them and they are asked to point to the one they like best. Risk taking – During the site visit we noted specific risk assessments on residents’ personal plans, with clear guidance for staff on how risks are to be managed. At the last inspection one example was noted of a person’s behaviours challenging a local day service attended by this person. There was evidence that the manager had made a good deal of effort through liaison with the day service, Psychiatrist, Community Psychiatric team, optician and speech therapist to come up with practical solutions to resolve the problem. Advice has been noted in the individual’s personal plan and appointments have been made with other health care professionals for further exploratory work. The care manager confirmed in a telephone discussion that improvements had been noted in personal plans and especially risk assessments since the manager had received training. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are encouraged and supported to make choices about their lifestyle and develop life skills. A range of activities meets individual’s likes, dislikes and expectations. People are supported to maintain regular contact with the local community and routines help to promote their independence. They are offered meals they enjoy, which are varied and healthy. EVIDENCE: Education and occupation The manager and staff said the home has explored different activities to stimulate and challenge the residents. All five have profound learning disabilities and complex communication and sensory difficulties. Their assessed needs are such that seeking jobs for them is not appropriate. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 13 e Education and training is limited to that which is offered through the day services they attend throughout the week. Community links, social inclusion and relationshipsIt was clear from the inspector’s observations and from information in personal plans that people who use the service enjoy going out from the home. On the day of the unannounced site visit arrangements had already been made for them to be taken out to a local restaurant for their evening meal. The home has a large people carrier, which comfortably accommodates all residents together or individually. A weekly programme of activities ensures their lives are varied and interesting. Staff treat residents as individuals and support them variously to visit local clubs, restaurants, cafes, a specialist drop-in centre and places of interest and entertainment. They go out for day trips as a group, or individually to places that interest them. The manager confirmed that they have a yearly holiday away from the home, which last year was Cornwall and this year has yet to be decided. One response to the visiting relatives survey was received from the next of kin of one person. Comments were limited as the individual was not able to visit the home regularly. However, it was made clear that positive responses would be given throughout, with special mention being made of Kinoo Lodge being a caring environment. The home’s assessment outlined what they do well and includes: • • Each resident has specific activities they attend to during the week. While at home they have the choice of what they do. There is a variety of activities they can get involved in such as board games, pool or playing a musical instrument. They can also choose to watch TV, listen to the radio or have their own private time. The residents are taken out for short trips and day trips frequently. Relatives or next of kin are kept up to date with any changes in the residents state of health and wellbeing. Only one residents relative is active in his care. One resident does not have any relative and the relatives of the other residents have chosen not to be actively involved in their care. Residents are able to move freely in the home. There are no locked doors inside the house. Residents can go out to the garden if they wish to. • • • • • • Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 14 Daily routines Bedrooms were seen to be spacious, reasonably well decorated and personalised. Staff respect their privacy and were seen to knock before entering their rooms. As previously mentioned in the report people who use the service have no verbal communication but observations during the site visit showed the interactions between staff and residents to be very positive with non-verbal signs being understood. There was good humour and sensitivity. The mix of staff and people who use the service is multi cultural and the manager and staff were very clear that cultural differences are recognised and catered for with menu planning, and observance of religious festivals and special occasions. The manager and staff were very clear that residents do not have the cognitive ability to assist for any length of time with housekeeping tasks. Meals – Choice of food is available to people by the use of photographs. The home does not have a menu plan but maintains a record of each meal, including individual diets. This was seen to provide a varied and nutritious diet. It was clear from discussions with the manager and staff that they knew well the likes and dislikes of people through many years of experience. The home’s assessment highlighted the fact that residents’ meals were what they do well: • Meals are provided in a comfortable environment with the involvement of all residents. Their individual choices are catered for by a wide selection of freshly cooked and cold dishes. Each resident is provided with their meal in the texture that is suitable for them, for example those who require soft or diced food. Assistance is provided with feeding whenever required. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff provide flexible but consistent support for people and are responsive to their changing needs. Healthcare needs are assessed and people are supported to receive healthcare checks at appropriate intervals. Medication is securely held and appropriate records maintained. EVIDENCE: Personal support – At the time of the inspection there were five people resident at Kinoo Lodge and all are fully mobile so aids and equipment are not necessary. People’s individual plans identify their needs and wishes, and outline how best to meet any personal care needs. Staff use a person centred approach to deliver care and support and meet people’s changing needs, e.g., some need more help and support with routine tasks than others. This was noted during the site visit with staff encouraging Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 16 individuals to take responsibility for their actions where it was clear they were able. The home’s assessment outlined what they do well: • Residents are supported/assisted with all their personal care and support. They are helped with their personal hygiene, washing and dressing although independence in always promoted and encouraged. They are also helped with grooming, shaving and selecting their clothes. Healthcare – Personal plans showed that peoples’ health care needs are regularly addressed and records of healthcare visits are maintained together with action to be taken. They receive checks from the GP, dentist, optician and specialist health care professionals, all of whom are located in the Portsmouth area. All health care needs are identified in their Health Action Plans. The manager confirmed that the home enjoys a good liaison with the Community Psychiatric Nursing team. The home’s assessment outlined what they do well: • The home organises routine health checks for each resident on an ongoing basis to ensure they are in a good state of health. This includes GP appointments, optometrist, dentist and chiropodist and any other therapist that might be required. Those who require ongoing treatment are helped to ensure their appointment are maintained and they receive the appropriate treatment. Medication Three of the five people who use the service require regular medication, which, due to their assessed needs is administered by staff. This was confirmed in discussions with the care manager. We looked at the home’s arrangements for residents’ medication with the manager who has been trained in the safe handling of medicines. At the time of the site visit medication for people was securely held, and records relating to its safekeeping and administration were found to be in good order. The home’s assessment outlined what they do well: • Medications of the residents are managed by local pharmacist and overseen by the home’s manager to ensure prescriptions are ordered as and when required. Medications are reviewed periodically by the residents GP to ensure they are still relevant for the resident. None of the residents are able to administer their own medication therefore the home’s manager administers the medicine for them. DS0000011738.V339110.R01.S.doc Version 5.2 Page 17 Kinoo Lodge Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be sure their complaints are treated seriously and given an appropriate response. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. EVIDENCE: Complaints There had been no complaints about this service since the last inspection visit. The service has a written complaints procedure that is included in documentation and information about the home, and is available to people who use the service, relatives and external stakeholders. However, all residents have complex communication and sensory difficulties and cannot understand the written word. The manager and staff said that experience of working with the current resident group over the years had given them a good understanding of the non-verbal signs that showed when they were unhappy about something. As outlined earlier in the report it is important the home explores all avenues to accessing some form of advocacy to give people a voice that is independent of the home. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 18 The one response to the visiting relatives survey was unable to represent their relative’s views but praised the manager for keeping them informed whenever a significant issue had arisen. Safeguarding adults The home’s assessment indicated that policies, procedures and codes of practice are in place, including clear guidance for staff in the area of safeguarding adults and the prevention of abuse. Records showed that the manager has had recent training in safeguarding adults and the management of aggression and challenging behaviour. She confirmed that she herself had provided the training for staff. This was confirmed in discussions with one member of staff who showed a good understanding of the issues and the need to report any concerns without delay. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home’s premises are suitable for its stated purpose. They are comfortable, safe and well maintained. On the day of the site visit the home was clean, hygienic and free from unpleasant odours. EVIDENCE: Premises Kinoo Lodge comprises 2 large Victorian terraced houses joined together, with one being the end of terrace. The owners’ private accommodation is sited on one half of the building with a number of these rooms registered but not used to accommodate residents. Residents are accommodated in the other side of the building. All alarm systems are linked across the building. It was evident through observations during a tour of the building and from conversations with the manager that significant improvements had been made Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 20 to the environment in recent months. The following refurbishment and redecoration has been carried out: • • • • • • Hallway and stairs - redecorated. Dining area – Furniture upgraded. Ground floor – New laminate flooring laid throughout. Outside – Double-glazed replacement windows throughout. Two bedrooms redecorated and new laminate flooring laid. The development of a residents’ leisure room. In general terms the home is suitable for its stated purpose; accessible to all residents; safe and well maintained. Four of the five people who use the service share rooms. Mr Keenoo confirmed that it has been their choice to share rooms, and they had done so for many years. As there are now only five of a maximum eleven people accommodated rooms are available to enable each to have a single room. Mr Keenoo said they had offered the choice and in one case an experiment had proved distressing for two who had shared for many years. The home has a good-sized lounge, comfortable and homely, with adequate seating, and a very large flat screen TV. There is a kitchen and open plan diner and a separate leisure room with pool table and various games for residents’ use. The premises are bright, airy and comfortable. The home has sufficient bathing and toilet facilities to meet the needs of residents and staff. Cleanliness During the site visit all areas were noted to be clean, tidy and free from unpleasant odours. There is a utility room where the home’s laundry is carried out. This room is accessed via the kitchen and Mrs Keenoo confirmed that soiled articles are always double wrapped in appropriate bags to prevent the risk of cross infection. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 - People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff and people who use the service would benefit from all staff having an opportunity to receive learning disability training to fully meet the needs of the people who live there. A robust recruitment procedure ensures residents are protected. EVIDENCE: Staff recruitment Kinoo Lodge is run as a small family business. Not only do the owners live on the registered premises they and family members make up the staff group. Staff recruitment records were checked at the last inspection and a requirement was made for the registered person to take up two references on any staff as part of the checks needed to assess suitability. Testimonials must not be used in place of references that must have been sought by the registered persons. At this site visit the manager confirmed that the staffing arrangements remained as they were at the last inspection and no new staff had been Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 22 recruited. However, she explained that to ensure the requirement was met a reference enquiry form had been produced and would be used for all new recruits to ensure that two written references were in place before they commenced work. A copy of the new form was available for inspection. Staff training, development and competencies We looked at the staff training achievement certificates during the site visit, which showed that the manager accesses regular training on a wide range of subjects. All staff are currently qualified in the main mandatory subjects of first aid, health and safety and fire awareness. The manager confirmed that in addition to in-house training, which she herself provides staff are sent for training as and when it becomes available. There was evidence that staff variously had achievement certificates in: • • • • • First aid Fire training Manual handling Health and safety Infection control A concern identified at the last inspection was that less than 50 of the staff group were trained to NVQ with the Learning Disability Award (LDAF). At this site visit the manager said that while she had experienced difficulty in sourcing this training there were opportunities to commence the LDAF training at Havant College commencing September 2007. As a year has elapsed since the last inspection and, excepting Mr and Mrs Keenoo, no significant progress has been made with NVQ or LDAF training for other staff it is important that the Commission is kept informed of the progress made. In discussions Mr Keenoo said that he had almost completed the training for NVQ at level 3. The manager said that she had now obtained the necessary documentation from Portsmouth City Council to introduce the ‘Common Induction Standards’ under Skills for Care and any new staff would be started on this programme. . Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a home where the registered manager is fit to be in charge, has experience and is working to achieve the qualifications to run the home and meet its stated purpose, aims and objectives. Quality assurance measures are in place to ensure the home is run in peoples’ best interests, and the home’s policies, procedures and staff training ensure as far as is reasonably practicable, peoples’ health and safety. EVIDENCE: Management – At the time of producing this report the manager Mrs Keenoo has completed the NVQ level 4 Registered Managers Award course for registered managers of care homes and is waiting for it to be ratified. There was evidence in the form of correspondence from Havant College that this was the case. She has many Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 24 years experience of working with the current resident group, all of them having lived in the home for over twelve years. The home has a computerised records system, which aids the effective running of the home and policies and procedures are in place to guide staff in those areas identified in the standards. Quality assurance – The home is relatively small and domestic in scale. It is considered that due to the residents’ cognitive impairments a written resident survey would not be the most appropriate means of gauging their satisfaction with the service. In discussions with the manager and staff and observations of their interactions with the residents it was clear that they have a good understanding of residents needs and wishes, gained through years of experience of working with them. It was noted that an improvement and development plan for 2007 had been produced, covering environmental and staff training needs. As covered earlier in the report the introduction of independent advocacy for people who have no family contact would also inform the home’s quality assurance process. Health and safety Care support staff undertake statutory training, which includes first aid, health and safety and fire safety awareness. At the last inspection it was judged that generally the arrangements for the health, safety and welfare of the people who use the service were in place and management systems were relevant to a care home providing a service to six adults with learning disabilities. The home’s assessment indicated that policies and procedures relating to health and fire safety are in place and that regular maintenance of equipment takes place. During the site visit a sample of records was viewed including accident records, fire alarm tests, public liability insurance, and gas and electrical certificates, all of which were in good order. Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 26 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 YA7 Regulation 12 Requirement To make every effort to access an advocacy service for those people who have no one independent of the home to represent them, or assist and support them to make decisions about their own lives. To ensure that all staff have opportunities to access NVQ training linked to the Learning Disability Award. This is important in providing staff with the underpinning knowledge specific to providing a service for with people with learning disabilities. Written confirmation must be forwarded to the Commission to confirm that training has been scheduled. (This requirement remains outstanding from the last inspection). Timescale for action 31/08/07 2 YA32 YA35 18 31/08/07 Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 27 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Kinoo Lodge DS0000011738.V339110.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!