Inspection on 15/04/05 for Kirk House Nursing Home

This inspection was carried out on 15th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Kirk House Nursing Home 08/10/07

Kirk House Nursing Home 24/10/06

Kirk House Nursing Home 11/10/05

Kirk House Nursing Home 12/10/04

Kirk House Nursing Home 20/04/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Kirk House Nursing Home Balance Street Uttoxeter Staffordshire ST15 8JE Lead Inspector David Cowser Unannounced 15 April 2005 09.30 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. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Kirk House Nursing Home Address Balance Street Uttoxeter Staffordshire ST14 8JE 01889 562628 01889 56300 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) Uttoxeter & District Old Peoples Housing Society Mrs Ciceley Jane Fountain Care Home with Nursing 26 Category(ies) of PD -10 registration, with number PD(E) - 26 of places MD(E) - 2 TI - 4 Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1 - PD(E) Minimum aged 60 yrs Date of last inspection 12 October 2004 Brief Description of the Service: Kirk House is a 26-bed Care home providing personal care and nursing care to elderly persons over the age of 60 years with physical disabilities, terminal illness (4 beds), or dementia (2 beds). The home is owned and operated by the Uttoxeter & District Old People`s Housing Society Limited, which is a voluntary organisation. The establishment is an extended three-storey detatched property situated close to the town centre of Uttoxeter, and within easy access to all local amenities and public transport. A homely environment has been created throughout. Hotel services and facilities including laundry and catering are very good, with adequate staffing levels. Activities, hobbies and entertainment all take place and transport is provided when required. Families and friends are encouraged to take part in activities and trips out. A hairdressing salon is provided on the ground floor of the home. Care is delivered by registered nurses and care assistants, led by the Care Manager who is a first level nurse. Staff training is given a high priority, and there has always been a low turnover of staff working in the home. Health service professionals such as district nurse, community psychiatric nurse, and physiotherapist are accessed when required, and local GP’s and a pharmacist service the home. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This routine unannounced visit was made on the 15 April 2005 at 09.30hrs. The inspection was undertaken using the National Minimum Standards for Older People as a reference. The total time spent for the inspection, including pre and fieldwork, amounted to 6hrs. The registered care manager (RGN) was in charge of the home accompanied by two more registered nurses and four care assistants. Ancillary staff on duty included; cook and catering assistant, two domestic staff, laundry worker, maintenance/ gardener, and a business support worker. These staffing levels were adequate to meet the needs of current 25 residents in the home. The total of 25 elderly residents included; 19 receiving nursing care for needs associated with physical disablement, 1 with a dementia related condition, and 4 people receiving personal care for needs associate with old age. The inspection included the following elements; a tour of the building, inspection of records relating to provision of care, discussions with eight residents and four relatives, discussions with the staff members on duty, observation and sampling of other services provided such as catering and laundry, and an inspection of the managerial aspects such as staffing, quality assurance and health & safety. Since the last inspection on 12 October 2004; there had been no changes to the management of the home, no complaints had been received and no additional visits had been necessitated. It was evident that aspects of care had been addressed well, with residents able to choose the home following an assessment and invitation to visit the home. Service user plans had been well written, based on the community care plans completed by social workers. Health, personal and social care needs had been met and well documented. Privacy, dignity and choice aspects for residents were being upheld. No complaints, incidents or reports of abuse of any kind had been received since the last inspection and policies and procedures seen covered these issues. One resident had attended an A&E with a fracture, and one resident had a pressure area, which had almost healed. There had been only three deaths since the last inspection. The home was fit for purpose, well maintained, and provided a safe environment for the residents and staff. A homely atmosphere had been created, and the premised were very clean, warm and tidy. Adequate areas for residents were provided including; communal space, dining/activity space, bathing/toilet facilities, and bedrooms. Services and facilities including Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 6 catering and laundry were adequately provided. Health and safety aspects had been given a high priority and no shortfalls were noted. Staffing levels and skill mix had been adequate to meet the assessed needs of the existing residents. Recruitment and retention of staff aspects were good. Staff training had been given a high priority, with induction training being followed by NVQ training, and staff had received supervision. The home appeared to be managed well by a qualified and competent care manager. General management aspects were good with quality assurance taking place. Records had been correctly filed and stored. The home is a registered charity and assurances were given regarding the positive financial viability of the home, and that suitable accounting/business procedures are adopted. No requirements or recommendations, against the regulations or the minimum standards, had been made in the last inspection report and none were made during this inspection. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made as a result of this inspection. Plans have been drawn up and are to be submitted, for alterations and extensions to the home, which will provide additional single bedroom Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 7 accommodation. Currently 16 beds out of the total 26 beds (61 ) are in single bedrooms. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 8 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 Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 9 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) 3 Individual health, personal and social cares needs had been established and were being met by staff, which individually and collectively had the necessary skills and experience. EVIDENCE: The documentation seen, and a discussion with residents/representatives, evidenced that residents had been assessed prior to admission and they had been enabled to make a choice about the home. All involved had the opportunity to visit the home prior to choosing to stay. One resident spoken to had visited the home, and had a meal prior to deciding to stay, and this was seen documented within the care plan. The community care plans provided by the social worker, as part of the individual needs assessment process, were seen within the service user plans. Residents and relatives asked confirmed that they had been fully involved and in agreement with the assessments. The records seen and a discussion with the staff evidenced that nursing and care staff, individually and collectively, had the necessary experience and qualifications to meet the assessed needs of the current service users. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 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) 7,8,9,10 The assessed health and personal care needs of residents had been well documented and were being met, with good standards of care being delivered. There was a safe system for the receipt, storage, administration and disposal of medicines. Residents were treated with respect, and privacy and dignity were afforded to them, during the caring process. EVIDENCE: Eight service users and two relatives spoken to all commented positively about the care being provided. The service user plans and associated documentation was well written, meaningful and reflected the current condition of residents. The documentation seen and a discussion with both residents and staff members evidenced that health and personal care needs were being well met. NHS facilities and professionals including community nurses, medical consultants and clinical nurse specialists had all been accessed when required, and these events were seen recorded. A local GP practice and a local pharmacist service the home, and there is a good working relationship with them. Records of their visits were seen. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 11 The medicines within the home, medication administration records, controlled drugs book and drugs returned book, were all checked and no errors were noted. It was observed that a safe system was in place, and that the comprehensive medicines policy documentation seen was being complied with. The documentation seen evidenced that only trained nurses administered medicines and that no resident was ‘self medicating’. During the inspection it was observed that privacy and dignity were being afforded to residents during there interaction with staff. Staff were seen knocking on doors before entering. Residents told the inspector that they were treated with respect, and that the staff were very good. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 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 Residents were satisfied with their lifestyle in the home, and they were able to exercise choice and influence decisions affecting them. Contact had been maintained with relatives and friends of residents. Opportunities to access the local community had been made available. Catering aspects were very good with balanced nutritious meals being served, along with resident consultation and choice. EVIDENCE: All residents spoken to told the inspector that they were happy with their stay in the home, and that the staff were very good to them. They said that their views were listened to and that they had been able to influence decisions made by the manager. A check on the records and a discussion with eight residents, three relatives and several staff evidenced that activities, entertainment and trips out, had been well arranged and enjoyed by residents. The records of events was seen up to date. Visitors to the home, when asked, said that they were always made welcome and that communication with the management of the home was very good. The residents and visitors spoken to evidence that that they had been able to influence decisions concerning the running and organisation of the home, and Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 13 this was seen documented. The minutes of residents meetings were seen documented. Several residents spoke of their satisfaction with the meals and choices offered. The menus and catering records were examined and evidenced that the dietary requirements of residents were met, particularly with the very poorly nursing patients with specific needs of nutritional intake. The cook when asked said that fresh good quality food from local suppliers was delivered on a weekly basis, the records seen confirmed this. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 Complaints or grumbles are listened to and resolved. The home policies, procedures and staff training, protected residents from aspects of abuse. EVIDENCE: An examination of the complaints book, the relevant policy and procedure documentation, and a discussion with staff and residents, evidenced that complaints and grumbles were listened to and dealt with in the correct manner. Since the last inspection no complaints had been recorded or brought to the attention of this commission. Many ‘thank you’ and complimentary cards were seen from appreciative relatives. No incidents of neglect or abuse of any kind has been reported. The policy documentation seen, and a discussion with staff confirmed that residents are protected from all forms of abuse. Documentation seen evidenced that the above issues had been discussed at length during staff induction, training and on-going supervision. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 15 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) 19,26 The home provides a safe and well-maintained environment for residents. The home was very clean, warm and tidy, and had a comfortable atmosphere. EVIDENCE: A tour of the building, and a check on the maintenance documentation, verified that the premises were fit for purpose, clean warm and tidy. The duty rosters evidenced that adequate ancillary staff were employed. The two domestic staff told the inspector of their knowledge on infection control, and showed him the documentation and also schedules that they worked to. Adequate hand washing facilities were available throughout the home. The sluicing and laundry facilities were seen to be fully compliant. The records evidence that maintenance of the premises was being given a high priority. On going painting and re-decorating was seen being done. Hot water temperature checks, and emergency lighting/fire alarm testes were seen up to date and correct. There are no outstanding issues known from the Fire Prevention or Environmental health departments. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 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 The assessed needs of service users had been met by an adequate number of suitably trained staff. Recruitment procedures had been correctly addressed which had contributed to the protection of service users. Staff training had been given a high priority. EVIDENCE: The duty rosters seen, and a discussion with the care manager and the staff, evidenced that adequate numbers of staff had been on duty to meet the needs of the existing service users. The following care staff had been on duty or exceeded for the 25 residents; a.m. 1RGN 4 Care assistants ( Care manager RGN for 5 days), p.m. 1RGN 3 Care assistants, nights 1RGN 1 Care assistant. The care manager and her deputy also provide an on-call system. In addition to the above adequate ancillary staff had been rostered on duty throughout the week. Six residents asked stated that staff were available when requested, and that the staff were capable. The records seen evidenced that in addition to first level nurses the home had 55 of care assistants trained to NVQ level 2 or above. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 17 The home recruitment policy, procedures and documentation were examined and recruitment issues had been handled correctly. Staff had been subject to POVA/CRB comprehensive checks, and these were seen recorded. Staff asked stated that they had job descriptions and contracts of employment. Training had been given a high priority and the training records of individuals were seen. The records evidenced that both trained nurses and care assistants had benefited from ‘in house’ and external training which had covered the needs of the registered client group. Staff told the inspector that they had been afforded the time off and encouraged to study. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 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) 33,35,38 The home appeared to be well managed and quality assurance was in place. Financial aspects were correctly addressed and recorded with safeguards to residents. Health and safety issues had been given a high priority and managed well. EVIDENCE: From observations made, discussion with service users, and discussions with the manager and staff, it was evident that the home was being run in the interests of service users. Quality assurance, including feedback from residents and their representatives, was seen documented. Documentation seen evidenced that the views of visiting professionals had also been established, and included in the review process. A check on the records and a discussion with both residents and representatives evidenced that all service users had the opportunity to handle their own finances and all residents and families had chosen to do so. Day to day monies of residents were checked and money held reconciled with the Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 19 ledger. Inventories of valuables and belongings brought into the home were seen recorded. No health and safety issues were noted during this inspection, including a tour of the home. The documentation seen for checks and examination of plant and equipment was all correct and up to date. The manager and staff spoken to confirmed that health and safety issues are given a high priority. Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 21 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 Regulation none Requirement Timescale for action 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 none Good Practice Recommendations Kirk House Nursing Home E51-E09 S22345 Kirk House V220886 150405 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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. 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