Inspection on 09/05/07 for Kirklands Care Home

This inspection was carried out on 9th May 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 but made no statutory requirements on the home.

Other inspections for this house

Kirklands Care Home 26/04/06

Kirklands Care Home 18/01/06

Kirklands Care Home 01/08/05

Kirklands Care Home 07/03/05

Kirklands Care Home 04/05/04

Similar services:

London Road Neurological and Specialist Care Unit

Carlton Care Home

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

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

CARE HOMES FOR OLDER PEOPLE Kirklands Care Home 2 Fairhaven Kirkby-in-Ashfield Nottinghamshire NG17 7FW Lead Inspector Richard Ramsden Unannounced Inspection 09:30 9th May 2007 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 Kirklands Care Home DS0000036318.V335490.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 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. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kirklands Care Home Address 2 Fairhaven Kirkby-in-Ashfield Nottinghamshire NG17 7FW 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) 01623 723936 01623 723946 Nottinghamshire County Council Suzanne Michelle Dawson Care Home 29 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (29), Physical disability (5) Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Out of the total number of beds (29) there will be 14 beds for DE 55 and over and/or DE(E) Out of the total number of beds (29) 5 may be used for PD 55 and over Service Users shall be within category OP (29) Date of last inspection 20th September 2006 Brief Description of the Service: This is a Local Authority older persons care home offering 29 beds, with attached day centre facilities. The home is on two floors with vertical lift access to the first floor and all service users have single bedrooms. Grab rails and call alarms are sited around the home and there are assisted bathing facilities. The home is set within a secure enclosed garden and is sited in a residential area conveniently close to the town centre of Kirkby-in-Ashfield and close to public transport routes. Accommodation charges for those residents who are self funding would be £1508 per calendar month. A copy of the most recent inspection report is available in the home. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector completed this unannounced visit over one day; it took approximately 8 hours. It included the inspection of care and other records a discussion with the registered manager, a member of care staff and the cook. The inspector spoke with five residents and two visitors to the home. A partial tour of the building was also completed. Three residents were Case tracked, which means that their care plans were examined against the actual care they receive. The inspector also discussed the Commission for Social Care Inspections proposal to reduce some of the restrictions placed on the homes registration categories. Prior to complete in this visit the inspector assessed the home service history and the last three inspection reports. What the service does well: People living at Kirklands Care Home appear very satisfied with the services provided by the home. The residents spoken with said that staff are always friendly and respectful and ensure that their privacy and dignity is maintained at all times. The observed interaction between residents and staff was a generally of a good standard. The visitors who were spoken with confirmed that they could visit their friends or relatives in the home at any time. They said that staff are always friendly and welcoming and that visitors are always offered refreshments. One visitors said that she hopes to find somewhere as good as Kirklands if she ever needs a care home. Three residents said that they are very satisfied with their bedrooms and confirm that they had been encouraged to personalise them with small items of furniture photographs etc. A married couple have chosen to use one of their bedrooms as a double room and the other as a small private sitting room. (This flexibility is good practice.) Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 6 The residents, staff and visitors spoken with during the inspection said that the newly registered manager is very approachable and that she seeks their views about the way in which the home is run. All aspects of health and safety that were checked and during this visit had been satisfactorily maintained. There were aspects of good practice highlighted in the main body of this report. What has improved since the last inspection? What they could do better: The literature supplied to prospective residents must contain sufficient information to enable them to make an informed choice about whether the home will meet their individual needs. The registered person must ensure that where risks to residents or staff are identified, care plans and risk assessments must be implemented, which where possible, reduce or eliminate the risks. The registered person must ensure that there are always adequate supplies of prescribed medication. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 7 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. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3. The literature supplied to prospective residents was being updated but still did not contain all the information required to enable them to make an informed choice about whether the home would meet their needs. The homes staff ensure that they can meet the assessed needs of prospective residents by obtaining full written assessments prior to their admission to the home. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of inspection the manager was in the process of revising the information provided to prospective residents. The new literature contained Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 10 the majority of required information but did not have a copy of the most recent inspection report summary, or the resident’s views of the home. Three residents records were assessed as part of this inspection. All of the records contained preadmission assessments, which had been completed by social workers. The manager stated that residents are never admitted without a preadmission assessment. Kirklands Care Home does not provide intermediate care. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Residents individual care plans generally contain sufficient information to ensure that staff are aware of what support and assistance each resident requires, however the care plans and risk assessments must be more detailed for residents whose behaviour challenges the services provided. The homes medication is generally well managed but staff must ensure that residents always have an adequate supply of prescription medication. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three residents care plans were viewed as part of this inspection, the care plans for two of the residents appeared to address all of the issues highlighted in the assessment process. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 12 All of the care plans had been reviewed and where necessary amended each month. Three of the residents spoken with confirmed that they had been involved in the care planning and review process. Where possible people have signed to confirm their involvement. (This is good practice). One residents daily records identified 16 occasions where the resident was verbally, or verbally and physically aggressive to staff and on occasions other residents. There were also incidents recorded where this resident, who has dementia, had attempted to leave the building, potentially putting herself at considerable risk. These issues were not identified in the residents care plan and staff had not been given any advice how to deal with the residents aggression. No relevant risk assessments had been completed. These issues were discussed with the registered manager who examined the resident’s records and confirmed that the risk assessments and care plan did not address these issues. The care plans and risk assessments were appropriately updated on the day of this inspection. Records show the residents health care needs are being appropriately met this was confirmed by three of the residents and one of the relatives spoken with during the inspection. The homes medication systems have generally been well maintained. None of the current residents have been assessed as safe to administer their own medication. An appropriate risk assessment was available to be completed with any residents who wished to administer their own medication. Medication was stored securely and the records of receipt and disposal of medication had all been well maintained. The homes controlled medication was checked at random and had been well maintained. One of the residents spoken with said that the home does not always have adequate supplies of medication. He stated that his wife had not received her pain relief medication for four days. Medication Records for this person showed that she had not had any of her prescribed painkillers for four days. The staff were in the process of obtaining additional supplies of the medication, however the registered person was advised that she must ensure that residents do not run out of prescription medication. All of the residents spoken with, who were able to express an opinion, said that staff are friendly and respectful and ensure that their privacy and dignity is Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 13 maintained at all times. This was also confirmed by one of the relatives spoken with during the inspection. The observed interaction between staff and residents was a generally of a very good standard. However the inspector did overhear one member of staff asking personal questions about a resident in one of the communal areas. The registered manager immediately dealt with this issue. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. The lifestyle experienced in the home appears to match the residents expectations and preferences. People are encouraged to main contact with their family and friends and the food provided appeared wholesome and nutritious. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides a good range of activities and entertainment to provide stimulation to the residents. The programme of activities was displayed in one of the resident’s lounges. However the writing was a very small and would have been very difficult for many of the residents to read. The registered manager provided this information in a user-friendlier format during the inspection. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 15 All of the residents said that they were satisfied with the level of activities and outings provided. Two people said how much they were looking forward to the planned day trip to Skegness. Residents and their relatives confirmed that visitors are made welcome at any time and that refreshments are always provided. The manager stated that she tries to provide an environment, which encourages residents to make choices. Individual residents care plans also give details of how residents can be encouraged to make decisions about their daily lives. (This is good practice). There are also regular residents meetings where people are encouraged to express their opinions about the way in which the home is run. The lunch on the day of this inspection appeared wholesome and nutritious. All of the residents stated that they are very satisfied with the food provided in the home and confirmed that an alternative will always be provided if they do not want the meals suggested on the menu. It was noted that one resident’s food was liquidised with all elements of the food placed together. The cook stated that normally each element of the food would be liquidised individually, however the resident had specifically requested that it be prepared in this way. The inspector spoke with the resident who stated that the meal had not been liquidised when it was first given to her. The staff tried to mash the food but the resident had still found it difficult to eat it. Consequently she had asked for it all to be liquidised. She confirmed that at home her food is always liquidised in individual elements to preserve the flavour and appearance. The manager was asked to ensure that all elements of the food are liquidised individually in the future. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,19. The home has a robust accessible complaints procedure and staff are ensuring that residents are protected from abuse. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector was informed that all residents have been provided with a copy of the homes complaints procedure. The homes complaints records show that the home has only received one formal complaint since the last inspection. This was thoroughly investigated and appropriate action taken. Residents confirmed that they would contact the manager if they had any concerns or complaints. One of the visitors spoken with during the inspection stated that they would discuss any concerns or complaints with the registered manager. They believe that she would deal with their concerns appropriately. The manager is aware of the local vulnerable adults procedure and a whistle blowing procedure is displayed in the staff room. The member of staff spoken Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 17 with during the inspection was clear about her responsibility to report any incidents of abuse. There have been no allegations of abuse at the home in the last 12 months. Staff records show that they are being provided with training in safeguarding adults. (This is good practice). Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26. The accommodation has been maintained to a good standard it was pleasant and hygienic at the time of this inspection. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial tour of the premises was completed as part of this visit. The purpose-built accommodation has been maintained to a good standard. The residents bedrooms are comfortably furnished and people had clearly been encouraged personalise their rooms with photographs, ornaments and small items of furniture. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 19 A married couple have moved into the home and have used one room as a bedroom and the second room is a small private sitting room. (This flexibility is good practice). All of the residents spoken with, stated that they liked their bedrooms and confirmed that they can use them at any time. Two people stated that they have a Key to their bedroom door. The call system was tested in one of the bedrooms and was answered promptly by staff. Four residents and one visitor confirm that the home is always clean and free of offensive odours. The laundry is a very small but it is well equipped and has washable wall and floor coverings. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Sufficient staff are being employed to meet the assessed needs of the residents, the homes recruitment policies and practices are supporting and protecting residents. The registered person was able to demonstrate a commitment to staff training and development. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The rota provided prior to the inspection and those viewed for the week of this inspection showed that sufficient staff are being provided to meet the assessed needs of the residents. The residents spoken with during the inspection stated that although the staff are always busy they do respond promptly when people require assistance. All new members of staff complete an appropriate induction-training programme. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 21 The staff training records show that out of a total of the 19 care staff 9 people had completed NVQ level 2 or above. A further 7 people were completing the training at this time of this inspection. The personal records of two members of staff are assessed as part of this visit. The records of a recently recruited member of staff contained all the required information and demonstrated that equal opportunities are an integral part of the recruitment process. The second records were those of a member of staff who had worked for Nottinghamshire County Council for over 20 years. Her records did not contain written references or information regarding her criminal records bureau clearance. This information was faxed to the inspector during the inspection. The manager confirmed that staff do not commence employment until all the required information has been obtained. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38. The home is well managed and run in the best interests of the residents. Where checked the health and safety of residents and staff are promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The homes manager has recently successfully completed the interview process to be registered with the Commission for Social Care Inspection. She has considerable experience and has completed the Registered Managers Award. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 23 Residents, staff and visitors to the home said that the manager is very approachable and that she seeks their views about the way in which the home is run. Quality monitoring systems are in place and the manager will use the information gathered to produce an individual development plan for the home. Staff to do manage some residents’ personal allowances, the records were checked at random and were well maintained. The aspects of health and safety, assessed as part of this visit had been satisfactorily maintained. Nottinghamshire county council’s health and safety department completes health and safety inspections of the home. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 24 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 2 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 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 3 X 3 X 3 X X 3 Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 25 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 OP1 Regulation 6 Requirement The registered person must review and revise the Statement of Purpose and service Users Guide, to ensure that it is up to date, and all information contained within the document is accurate. Note the registered person was in the process of updating this information but the work had not been completed. This requirement is outstanding from 09/02/07. It is required that where risks to residents or staff are identified, Care plans and risk assessments must be produced which, as far as possible, eliminate the risks. It is required that the Registered Person ensures that the home always has sufficient medication for the residents. It can cause distress & pain as well as a risk to resident’s health and safety if they do not get the medication prescribed by their doctor. Timescale for action 02/07/07 2. OP7 15 23(b) (c) 09/05/07 3. OP9 13(2) 09/05/07 Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 26 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 OP15 Good Practice Recommendations It is recommended that each element of the food provided to residents, who require a liquefied diet, be liquidised individually to preserve taste and appearance. Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Kirklands Care Home DS0000036318.V335490.R01.S.doc Version 5.2 Page 28 - 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. 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