Inspection on 23/02/06 for Kirkland House

This inspection was carried out on 23rd February 2006.

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 but made no statutory requirements on the home.

Other inspections for this house

Kirkland House 06/02/07

Kirkland House 30/09/05

Kirkland House 14/12/04

Kirkland House 13/07/04

Kirkland House 17/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Kirkland House Queensway Yeadon Leeds LS19 7RD Lead Inspector Valerie Francis Unannounced Inspection 09:30 23 February 2006 rd X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kirkland House Address Queensway Yeadon Leeds LS19 7RD 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) 01943 876392 Leeds City Council Department of Social Services Mrs Linda Christine Cox Care Home 31 Category(ies) of Old age, not falling within any other category registration, with number (31) of places Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2005 Brief Description of the Service: Kirkland House is a large building situated in a residential area of Guiseley. The location offers a good bus service to Yeadon and access to the Guiseley shopping Centre. The building is a large detached purpose built care home for older people, which is owned and managed by Leeds City Council Social services. Kirkland House accommodates 31 older people on two floors. There are 31 single bedrooms. The first floor can be reached via a passenger lift. Toilets are strategically placed throughout the building, giving easy access to service users. There are four baths and a level access shower, which provides choice and support at the time of bathing. There is satisfactory parking at the front of the home. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this unannounced inspection between 9.30am and 3.30pm. This is the second inspection carried out within the inspection year both inspections have been carried out on an unannounced basis. There have been no further visits to the home until this unannounced inspection. The previous inspection took place on the 30 September 2005. The term resident is used for the people living in the home; therefore this is the term that will be used throughout this report. During the inspection records were examined, all areas of the premises were seen, such as communal sitting and dining rooms, residents bedrooms, bathrooms, toilets and laundry area. Staff were observed carrying out their work and interacting with residents. Approximately 20 residents were spoken to, either in a group or individually. Four sets of relatives visiting at the time were also spoken to about the care and attention given to their relative living in the home. The registered manager was on long term sick and so was one of the care officers. The other officer was on annual leave. The home was being over seen by a manager from another home who was at the home for the first time. She facilitated this inspection supported by a senior care worker. What the service does well: The staff members offer resident’s care and support in a homely and friendly environment. Staff members are given training that enables them to meet the needs of the people in their care. Staff at the home work hard to make sure that residents and their relatives feel welcomed, safe, and confident that staff will provide them with care that meet their needs in a professional and friendly manner. Residents said staff are always willing to help and they are always friendly, nothing is too much trouble for them to do for you. The manager was said to be approachable and always ready to help. Residents and their relatives were able to tell the inspector who their key worker was for supporting them in their day to day life at the home. Staff made positive comments about the daily routine in the home. From comments made by residents’ staff and visitors, it would appear, that the home is a place where residents and staff are consulted and their views valued by the manager. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 &5. The information about the house is available to prospective residents and their representatives. Care assessments given to the home are not always up to date. EVIDENCE: Each service user has been issued with a contract of terms of residency (Licence Agreement). Those seen had yearly updates of the increase in fees, which has been signed by the member of staff making the changes, to ensure that resident or their representative are quite clear of the changes in their fees they should also endorse these changes. The home receives “Easy Care “, core or other assessment information from the placement agencies, however this is not always up to date which could mean that some new care needs may be missed. Some consideration must be given for the home to carry out a full assessment to make sure that they can meet the needs of the prospective residents. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 9 Leaflets that summarise the service provided at the home are given to prospective residents/ representative at an enquiry visit. A copy can be obtained at the home to take away for them to read in their own time so that they are sure that the home can meet the assessed needs of the individual. There is no restricted time for visiting at the home. A Copy of the home’s visitor’s policy is found in the Statement of Purpose. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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 the following standard(s): 7 & 11. Staff have access to good care plans with an action plan as to how the individual care would be met. EVIDENCE: Three residents care plans were tracked, they all had a life style plan with good information of the care to be provided. Risk assessments for moving and handling and nutritional risk assessments were also present. Information enabled staff to provide effective care and support to individual residents. However, the home must make sure that any resident from a different culture has all their cultural needs met which includes food which may involve any outside agency. There was evidence of resident or relative’s signature agreeing to plans of care. These plans are reviewed on a monthly basis to maintain and promote the health and well being of residents. Residents were able to express their wishes for what they would like in the event of their death, which is recorded in their life style, plan. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 11 If it was their wish to stay in the home, support would be arranged from outside agencies i.e. District Nurses would be involved. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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 the following standard(s): 13,14 & 15. Residents entertain themselves with social activities offered. Visitors are welcomed to the home at any time. There is a good choice of food available at meal times. EVIDENCE: During discussion with residents they said, they were happy at the home and they were able to be involved in activities in the home and outside of the home. There was social interaction between residents, although some of them were asleep others were sitting talking, reading, knitting or playing board games. The atmosphere in the main lounge was busy; there was a constant flow of visitors to residents and residents going out with family or in the access bus to social venues. Contact with relatives are encouraged and supported residents choice of seeing who they wish is supported by the staff team, visiting relatives said they were always welcomed, they can either see their relatives in the main lounges in bedrooms or in the quiet areas on the top floor where they can make themselves a drink. There are no restrictions other than those from residents. One resident was going out for lunch with her daughter who was spending the day with her. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 13 It was clear from observation that residents have the freedom they needed make choices about how they wish to lead their daily lives. All bedrooms are lockable and some people had taken the opportunity to maintain their privacy by locking their bedroom when they are not in it. Resident’s financial affairs are either handled by relatives, solicitors or social services. Meal times are flexible and residents can have their meals either in the dining room or in their bedrooms or any of the communal sitting areas. The chef now uses a range of milk including full fat, for residents who are low in weight. Nutritional risk assessments and monthly weight checks are carried out. Any resident at risk would be monitored and special diets are provided to meet their nutritional need. There was evidence in one of the residents care files that indicated he would prefer food that meet his cultural need, there were no evidence in place to reference that systems are in place to meet this need, the resident was also concerned that nothing was done to support him with his food preference. Most residents were happy with food served and said there was always a choice. One resident was observed having another choice in addition to the two choices that was on the menu. During discussion with residents they said the food was good, they always got what they wanted and they could always have something different from the menu. Hot drinks and snacks are served during the day and night, jugs of cold drinks and glasses were placed in communal areas where residents have the opportunity to help themselves or be served at any time. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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 the following standard(s): 17. There are systems in place to support residents to maintain their rights and independence EVIDENCE: Those resident who have no family or other agent are referred to Age Concern where an advocate is appointed for them to advocate on their behalf. Residents, who have the capacity and wishes at the time, are supported to either attend polling stations or have postal votes. Resident and their representative are aware of their rights to see any information held in relation to them. There are policies in place to support this. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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 the following standard(s): No breaches of health and safety were noted during the inspection of the premises. The building was found to be welcoming and comfortable. EVIDENCE: The building was well maintained and no health and safety issues were noted. There is a ramped area to all entrances to the home. Residents who needed assistance could use all bathrooms; one bedroom and bathroom had a ceiling tracking hoist. All bedrooms seen were personalised to a high standard, it was evident that residents had taken the opportunity to bring with them furniture and items to personalise their room to make them comfortable. The building throughout was seen to be clean to a good standard. There is a range of sitting rooms available to residents; two large sitting areas on the ground floor where resident mainly sit. There are three on the 1st floor. All communal sitting areas are furnished with easy chairs and tables. The atmosphere in the home was happy and homely through out the inspection. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 16 No residents’ rooms have en-suite toilets however there are WC and bathing facilities situated strategically around the home on each floor, to allow residents’ easy access. Some residents have a commode, which are used mainly during the night. There is a loop system in place in the main lounge on the ground floor, to help those people wearing a hearing aide with clearer surround sound. Although hand washing and drying facilities were in place in communal areas it was noted that no hand drying facilities were in place in the bathroom on the ground floor. No malodour was noted at this inspection, the building was seen to be clean and tidy. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28 & 29 Staffing levels at the home needs continual reviewing and staffing levels at nights needs increasing. Systems are in place to make sure that 50 of staff have an NVQ qualification. EVIDENCE: The staffing levels during the day appeared to be sufficient to meet the needs of the current resident group The staffing level of two staff at nights for 31 residents given the lay out of the building needs reviewing to make sure that residents and staff health and safety is not compromised during the night when they are only two staff to care for 31 residents in a large building, with two wings and residents bedrooms on two floors. Ten members of staff had a National Vocational Qualification (NVQ). Training is discussed during one to one supervisions. The management team at the home have access to a robust recruitment and selection policy procedures. The recruitment files of two staff members were looked at. They contained relevant documentation including, notes of interview, application form, two written references and any gaps in employment identified, there was also evidence that Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) disclosure check had been carried out. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents and staff are consulted about the service provided. The manager is experienced in managing services for older people. The health and safety of residents and staff is promoted. There are systems in place to monitor quality of service in the home. EVIDENCE: From discussion with residents and their representatives and staff it was evident from their comments that the manager consults with them about issues that effect the running of the home and matters that effect individuals. The management of the home was said to be open and inclusive. If people had a complaint they would feel comfortable to discuss the matter with the manager and feel that systems would be put in place to resolve it. Regular meetings with residents and staff are carried out to make sure that they have a forum to discuss matters that effects the resident group and any the affect the staff team. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 19 Within the home there is quality survey system in place for feedback from residents and their representative about the care and service provided at the home. However no action plan of the finding were given to people having an input in the survey. Residents and their representatives are able to contribute towards the way in which they feel their needs should be met. Each resident has a key worker, a member of staff who sees to their personal care and social needs. From discussion with residents and their representatives they knew who their keyworker was and his or her role. Residents and staff are safeguarded through Social Service financial and insurance procedures, making sure that insurance covers loss or damages for the business and for legal liabilities to residents and staff. Any money kept on behalf of residents is recorded and transactions carried out are clear and recorded with receipts obtained. Any monies handed over to residents or their representatives a signature is obtained. Staff have monthly one to one supervision with their designated member of the home’s management team and annual appraisal. Records are well maintained and polices and procedures in place are readily available. There were no records for health and safety checks carried out at the home. There was risk assessment information for all potential hazards around the building and for staff and visitors. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 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. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X 3 2 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 X 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 3 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X 3 3 2 2 2 Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 21 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 OP27 Regulation 18 Requirement The Registered Provider must make sure that residents have access to an appropriate number of staff taking into consideration the size and layout of the building. Previous timescale 20/12/05. The registered manager must provide residents and other with feedback for survey carried out. The home must ensure that all potential resident have their care needs assess before they come to live at the home. The manager must make sure that the cultural food needs of residents are met. Timescale for action 30/06/06 2. 3 OP33 OP3 24 14 15/05/06 20/03/06 4 OP7 OP15 20/03/06 Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 22 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 OP3 Good Practice Recommendations The Registered Provider should make sure that all prospective resident have an up to date assessment of care needs. Kirkland House DS0000033261.V280401.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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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