Inspection on 26/07/07 for Kismet House Care Home

This inspection was carried out on 26th July 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 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

Kismet House Care Home 21/06/09

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

CARE HOME ADULTS 18-65 Kismet House Care Home 92 Walliscote Road Weston Super Mare North Somerset BS23 1EE Lead Inspector Juanita Glass Unannounced Inspection 26th July 2007 10:00 Kismet House Care Home DS0000068845.V346946.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 Kismet House Care Home DS0000068845.V346946.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. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kismet House Care Home Address 92 Walliscote Road Weston Super Mare North Somerset BS23 1EE 01934 628631 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) Kismet House Care Home Ltd Ms Siobhan Kathleen Dolan Care Home 9 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9) of places Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate Mental Disorder, excluding learning disability or dementia (MD) 9 N/A Date of last inspection Brief Description of the Service: Kismet House is a small home registered for 9 residents with Mental Health Problems. It provides a supportive environment where residents can pursue their chosen life style within an agreed and risk assessed programme. The House is situated close to local amenities and walking distance from the shops and the beach. Current fees are £475 to £690 Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection is the first since Kismet House was registered under new ownership. It took place in the presence of the manager Mrs Dolan. Evidence to support this inspection was gained through 1-1 and group discussions with six of the eight residents currently at Kismet House. Written surveys were not obtained in this instance. A review of documentation held in the home was carried out these included care records, personnel, medication and health and safety records. What the service does well: What has improved since the last inspection? Does not apply as this is the first inspection following change of ownership, however residents did comment on the changing environment. Residents stated the redecoration of the lounge was an improvement ‘it makes the room lighter.’ Comments raised during the homes surveys have been acted on. During the inspection a planned smoking room was being decorated and furnished. The garden has been improved and is used more by residents. One resident said it was difficult at the moment to comment on improvements because they were in changing times. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Kismet House Care Home DS0000068845.V346946.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 Kismet House Care Home DS0000068845.V346946.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): Quality in this outcome area is good. 1, 2, 3, 4, and 5 This judgement has been made using available evidence including a visit to this service. Kismet House provides a Statement of Purpose and Service User Guide, which is individual to the home and sets out clearly the objectives and philosophy of the home. Prospective residents are encouraged to visit the home and meet residents before deciding to stay. All resident have a signed contract of terms and conditions, which jargon free and easy to understand. EVIDENCE: Kismet House provides a very supportive approach to enabling prospective residents make their own choice about moving into the home. They have a very clear jargon free Statement of Purpose and Service User Guide. The prospective resident is encouraged to visit the home for a meal. During this time they can meet others who live there and talk to them about their experience of living in the home. They can then stay overnight experiencing the feel of the home for themselves. An initial trial period is agreed which can be extended if the resident is still not sure about the placement. Residents spoken to did not comment on the process. One resident said ‘they do listen to us if we feel someone is not going to fit in.’ The manager could confirm that this had happened in the past when residents felt uncomfortable about a prospective resident. All care records reviewed contained signed and dated contracts of terms and conditions these stated clearly the fee and who was responsible for paying them. Kismet House Care Home DS0000068845.V346946.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): Quality in this outcome area is good 6, 7, 8, 9 and 10 This judgement has been made using available evidence including a visit to this service. Kismet House involves residents in the development of their care plans, identifying potential risks and agreeing limitations. Individuals are encouraged to make their own choices and become involved in the day to day running of the home. All residents are informed of their right to confidentiality. They are also aware that they have a responsibility in respecting other residents right to confidentiality. EVIDENCE: Care plans reviewed all showed that residents had been involved in their development. They contain a comment from the staff point of view then one from the resident with an agreed plan of action. Risk assessments are in place and contain guidelines for enabling residents to take reasonable risks in their lives. Residents spoken to agreed that they have a say in the development of their care plans and took part in the review process. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 10 They did feel that the staff were controlling some areas of risk. This specifically referred to being able to make a cup of tea or coffee. This provision had been suspended due to a resident self-harming with boiling water. Residents agreed that it would be better to have the waking night staff so they could be supervised when making a drink. Staff carry out a monthly review of how residents have managed or progressed. It was recommended that this could be enhanced if it included a statement from the resident on how they viewed the month had gone. The manager agreed that this would be a good idea as they wanted to encourage resident to be more proactive in their care. Resident meetings have been introduced this was following comments by residents that they wanted regular meetings with the owner and manager. Residents stated that they are listened to and that the improvements in the garden and the provision of a smoking area were evidence of that. One resident said that it was a ‘step forward to provide the smoking room.’ They felt this resulted directly from discussions with staff. The management of confidentiality was discussed during a group session. Residents said they were aware that staff respected their confidentiality. They all stated that if the office door is shut they know to knock, as it is usually open. One resident said they also respected each other’s confidentiality and did not discuss other residents with friends or relatives. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 11 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): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Kismet House has a strong commitment to enabling residents to develop their personal skills. They encourage residents to maintain contact with friends, family and the local community. Residents take part in meaningful activities of their own choice and they are fully involved in planning their lifestyle and quality of life. EVIDENCE: Kismet House continues to encourage service users to treat it as their home, staff in turn treat them as a family member. Residents spoken to said that Kismet House was their home and that they were encouraged to treat it as such. They did say there were some limitations but these were all agreed. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 12 These limitations were such things as making sure you inform staff when you are going out and respecting other people’s points of view. They confirmed that they had the freedom to do as they wished within reason, and any restrictions were agreed with them. The natural family atmosphere within the home continues to merit a commendation. Residents continue to be encouraged to belong to local clubs, and to follow educational and developmental courses at the college or local training centres. They have access to a variety of activities that take place outside the home and within the local community. The activities within the home are those usually followed by a family after a day at work or college. Records show that staff supported service uses in maintaining contact with their families or friends. Residents were concerned that they may not be able to continue to visit other parts of the country on holiday. The manager confirmed that home holidays would continue to take place. Mealtimes in the home are flexible; they are based around the activities of the service users who are involved in choosing the menu. Fresh food is used on all occasions and fresh fruit and vegetables are made available. The residents stated that meals were always nice. Lunchtime on the day of inspection consisted of a snack lunch, whilst residents said they would have a full cooked meal that evening. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 13 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, 20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have access to healthcare and remedial services. They are encouraged to be independent and attend regular appointments. Staff are aware of the robust policies and procedures regarding the management of medication. Appropriate support is provided to manage bereavement issues. EVIDENCE: Kismet House does not provide nursing care. They do have access to other agencies to enable residents to access all the healthcare service available. Care records showed that residents attend regular dentist and optician appointments. The manager enables residents to access the Mental Health Team as and when necessary. Staff will go with resident to GP or out patient appointments and support them with all their health care needs. Residents stated that they knew they could get the help they needed if they approached a member of staff. One resident said it was good to have a member of staff go with them to hospital appointments. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 14 Staff manage medication as residents have been assessed as not able to manage their own. Some residents do not feel confident that they could maintain their own medication. Residents can self administer such things as ointments and inhalers. A clear audit trail could be found and there were no errors in recording of medication. Staff have been recording PRN medication on a separate sheet but they do not sign the MAR (Medication Administration Record) chart. This does not indicate on the MAR Chart whether medication has been used or not. Staff need to sign the MAR Chart when PRN medication is administered. Residents spoken to said that staff had been very helpful and supportive in helping them to come to terms with recent deaths that have affected their lives. The manager confirmed that residents had been offered 1-1 sessions and suggestions for coping with bereavement had been followed. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an open culture, which encourages residents to express their views and concerns in a safe and understanding environment. All resident have access to a very clear easy reads complaints procedure. The home understands the local procedures for Safeguarding Adults EVIDENCE: Residents spoken to said they could raise any issues with the manager. They were pleased that they now had resident meetings when they could also talk to the new owner. A very clear easy read complaints procedure is displayed on the notice board. This takes residents through the process of making a complaint step by step. It also informs them of their right to contact other agencies such as CSCI. Staff were aware of the local Safe Guarding Adults policies and procedures and knew what action to take. They were also aware of the homes whistle blowing policy and what it entailed. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Kismet House provides a physical environment that is appropriate to the specific needs of the resident group. EVIDENCE: A tour of the premises was not carried out. Residents at Kismet feel that their rooms are their private area. They were happy to discuss the physical environment of the home. They stated that the lounge had been very nicely decorated and was a lot brighter. One resident stated that they could choose how their room was decorated and that it was exactly what they wanted. All the residents spoken to were glad their comments on smoking in the home had been taken seriously and that staff were decorating and furnishing a smoking area separate to the house. Two residents proudly pointed out that the garden had been improved giving them room to have a BBQ or sit out in pleasant surroundings. The home was clean tidy and no unpleasant odours were present. Staff were aware of infection control issues and the manager was aware they could get advice from outside agencies if the need arose. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 17 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): 31, 32, 33, 34, 35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Kismet House has enough competent and experienced staff to meet the needs of the resident group. Staffing rotas cover the day shift adequately, but are insufficient for night cover. The home has a robust recruitment procedure, which is followed. Staff have a clear understanding of their roles and responsibilities. EVIDENCE: Staffing rotas confirmed that there are adequate numbers of staff on duty to meet the needs of the resident group. Both residents and staff stated that there were adequate numbers of staff on duty at all times. During the registration process the provision of waking night staff had been discussed. The manager confirmed that this was being considered. It was agreed that following comments made by residents who felt restricted regarding getting a hot drink at night or going out for a cigarette, and recent events in the home a waking member of staff during the night was necessary. The manager agreed that it would be arranged as soon as possible. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 18 The manager has introduced a robust recruitment procedure. Personnel records showed that this procedure is being adhered to. All the relevant criminal checks, references and required information were available for inspection. Staff did not commence work until a full CRB had been obtained. They then worked through a comprehensive induction programme. The manager confirmed that training was being accessed for staff. However it was difficult sometimes to arrange for staff to attend outside training. Records confirmed that all mandatory training had been attended. Staff have also attended training in Mental Health issues, and medication. It was difficult to evidence that regular staff supervision had taken place. The manager confirmed that she was now carrying out regular supervision. She agreed supervision had slipped following the recent events in the home and the process of the sale of the home. Progress in this area will be accessed at the next inspection Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 19 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, 38, 39, 40, 41 and 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The manager has the required qualifications and experience to run the home. The ethos is open and inclusive resulting in residents feeling that they do have a say in the day-to-day running of the home. The home has sound policies and procedures and works to a clear health and safety policy. EVIDENCE: The manager is registered with the CSCI and has all the required qualifications and experience to run the home. She has maintained her personal development by attending relevant courses in management techniques. Residents spoken to said they felt they could talk to the manager, they all referred to her by her first name. The manager is aware of the diverse needs of the resident group and acts as an advocate for them supporting them in their progress and development with in the wider world. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 20 Residents stated that the support they had received from the manager following the recent events had helped them come to terms with moving on. Staff confirmed the manager was open and approachable. Residents felt that they have a say in the running of the home and appreciated the introduction of meetings where they could have their say in a safe environment. The response by the home to the survey carried could be seen in the provision of resident meetings, improved garden area and a separate smoking area. The home has sound policies and procedures in place, which the manager has been proactive in reviewing for the recent sale of the business. The manager ensures that staff are aware of the policies and procedures in place. Staff were aware of the policies and procedures in place. Records reviewed showed that all relevant health and safety procedures are being followed and risk assessments carried out. The fire log showed that all the required checks are being carried out. Residents are also involved in regular fire drills. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 21 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 3 2 3 3 3 4 4 5 3 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 3 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 3 3 3 3 X Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation 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 2 3 Refer to Standard YA6 YA20 YA33 Good Practice Recommendations Staff need to ensure the monthly review also includes a paragraph from the residents perspective on how they feel the month has been. Staff need to sign the MAR Chart when PRN medication is administered. The manager needs to implement the plan to have a waking member of staff at night as soon as possible. Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection South West 4th Floor, Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Kismet House Care Home DS0000068845.V346946.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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