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Inspection on 13/01/06 for Kitnocks House Nursing Home

Also see our care home review for Kitnocks House Nursing Home for more information

This inspection was carried out on 13th January 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The manager and staff carry out an in depth assessment of needs of the individual residents, liaising with other professionals and then writing a plan of care to meet the needs and carrying out any action needed. They communicate well with the residents and understand the limited communication of those who are unable to speak, through this the staff are to meet the emotional needs of residents without being patronising or making individuals dependent on them. The home continues to monitor its services, through reviewing situations that `they could do better`, and looking at policies and procedures regularly. The manager and deputy then make any changes felt needed, to improve the care provided and the manner in which it is given. The home undertakes information sessions with staff having talks and discussions about illnesses and new practices that are specific to the individuals at the home.

What has improved since the last inspection?

There is a proposal to have a dietician visit the home regularly to advise and support staff on individual nutritional needs, it is hoped that this will help promote the dietary needs of the residents at the home and to support the `holistic` care at the service.

What the care home could do better:

There continues to be improvement in all areas the home. The opportunity is for maintenance of standards so far achieved and the review and development of the home.

CARE HOMES FOR OLDER PEOPLE Kitnocks House Nursing Home Wickham Road Curdridge Hampshire SO32 2HG Lead Inspector Val Sevier Unannounced Inspection 13th January 2006 10:00 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 Kitnocks House Nursing Home DS0000012130.V277459.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. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kitnocks House Nursing Home Address Wickham Road Curdridge Hampshire SO32 2HG 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) 01489 798244 01489 799411 kitnocks@zoom.co.uk Kitnocks House Limited Mr Anthony Nicholas Murdoch Care Home 49 Category(ies) of Dementia (49), Dementia - over 65 years of age registration, with number (49), Mental disorder, excluding learning of places disability or dementia (49), Mental Disorder, excluding learning disability or dementia - over 65 years of age (49) Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Dispensation has been given to 4 named service users in the LD category to remain accommodated in the home. 21st July 2005 Date of last inspection Brief Description of the Service: Kitnocks is a care home providing nursing and accommodation for 46 persons with mental health difficulties, from the age of 18 and is situated in the predominantly rural area of Curdridge, between the local villages of Botley, Wickham, and Bishops Waltham. The registered provider is Kitnocks Ltd. Kitnocks is a converted Edwardian building, originally refurbished and opened as a 32-bed nursing home in 1993. It was further extended in 1994, and now offers 49 beds for a number of client groups. In the main house there are 37 single rooms with 31 being ensuite and 6 double rooms with 4 with ensuite facilities. There is a passenger lift. The home is set in large grounds, flexi paving is provided so that the grounds may be accessed and enjoyed with minimal risks to service users. Seven of the 49 beds are in the extension and self-contained bungalow, which is attached to the main home. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place over 5 hours and was the second statutory visit of the inspection year. The inspector looked at the remaining standards not inspected at the last inspection, so the previous report should also be seen. The manager and deputy were available to assist throughout the visit. The inspector was able to speak with staff, some residents and relatives; the inspector viewed four care plans as part of this and a sample of medication administration records. There was some discussion about the planned extension of the home to incorporate 12 new rooms. It is hoped that this will begin at the end of January. What the service does well: What has improved since the last inspection? There is a proposal to have a dietician visit the home regularly to advise and support staff on individual nutritional needs, it is hoped that this will help promote the dietary needs of the residents at the home and to support the ‘holistic’ care at the service. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 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. Kitnocks House Nursing Home DS0000012130.V277459.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 Kitnocks House Nursing Home DS0000012130.V277459.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): 1 and 2 The statement of purpose and service users guide are good providing prospective residents and existing residents with detailed information about the home enabling an informed decision to be made. EVIDENCE: The information contained in the service users guide and statement of purpose gives readable and full information on the home, detailing how it offers it services and support to residents and relatives. It contains a copy of a contract so that prospective persons can see what the home offers and their part of the contractual agreement. The last Commission for Social Care Inspection report is available to assist with the decision making. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 9 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): 11 The arrangements for understanding an individual’s needs in their final weeks give a clear guidance for staff in caring for those who are dying. EVIDENCE: The home has developed guidance for staff in dealing with the final stages of individuals’ life. Discussion are held with the resident where possible and the relatives, and the homes doctor regarding needs and wishes, from these discussions notes are kept and plans made accordingly. The manager advised that family are notified in the event of an illness or change so that ant previous decision can be reviewed with the new information then available. Four care plans were seen as part of another standard and information regarding wishes in this area were seen in them. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 10 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): 15 The home offers a balanced meal with specialist diets and needs also accounted for. EVIDENCE: The cook at the home has recently reviewed the menus. The meals offered consist of a main choice with alternatives available. Where a pureed diet is needed these were seen to be presented as separate items on the plate. Many of the residents are unable to express a preference and information from relatives is sought on likes and dislikes. Several residents need assistance and support with their meals and approximately a dozen individuals need to receive their nutrition via a tube. The dietician in liaison with the homes GP assesses all individuals who receive their meals in this way. The inspector was able to see correspondence from the dietician proposing a provision of a twice-weekly then monthly support in nutrition and dietary needs at the home. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 11 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): 16, 17 and 18 The manager has established a sense of openness at the home so that relatives and residents can voice their concerns. Staff also feel that they can voice concerns especially regarding the care of the residents. There is an allegation being investigated by social services under the Protection of Vulnerable Adults however, the Commission has not identified at this time, any evidence to support the allegation of abuse with regards to lack of care. EVIDENCE: There have been no complaints made since the last inspection to either the home or to the CSCI. Relatives were aware of how to complain and said they felt comfortable in speaking with the manager or deputy about any issues. The manager advised that the electoral register has been completed and that residents are supported to make their votes at the local voting centre. There has been one allegation regarding adult protection at the home that was being investigated at the time of the inspection. The inspector was able to view information regarding the individual and discuss the events surrounding the allegation, from a regulation point of view. The manager undertakes training the staff in this area, and staff spoken with were aware of the whistle blowing policy and the training. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 12 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): 20, 21, 22, 23, 24, 25 and 26 The standard of the environment is good providing residents with an attractive and homely place to live. EVIDENCE: The inspector walked around the home and sampled some bedrooms and bathrooms. It was seen that specialist equipment such as supportive chairs are provided according to need. There are also specialist beds and moving and handling equipment for staff to use when assisting residents. Risk assessments were seen for those individuals where specialist equipment is needed. Most of the furniture is in a good repair and clean, with some needing repair or replacement the deputy advised the inspector that these chairs were due for repair. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 13 The home is bright, homely and well maintained by the homes maintenance person, who paints rooms as needed. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 14 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 and 29 The home assists staff with an internal training programme in order to meet resident’s needs. The home carries out a recruitment practice that protects the residents of the home. EVIDENCE: The home has assisted staff in applying for an NVQ qualification that is suitable for them and offers support in the home, there has been some difficulty in securing NVQ training with the local college at the moment the home has 48 of its care staff trained to NVQ level 2. The home also has student nurses from the University and several senior staff have just refreshed their mentorship skills to assess these students. Training is planned throughout the year to cover both mandatory and issues related to needs of residents. For example assessment methods of mental health, and writing care plans to meet the needs associated with this. One member of staff has been recruited since the last inspection and the file indicated that references, and other checks have been undertaken. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 15 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): 33, 35, 37 and 38 The manager has a clear vision for the home, which he has effectively communicated with staff. There is clear leadership and staff support and training so that the needs of residents can be met. There was evidence that health and safety is attended to protecting the well being of all at the home. EVIDENCE: It was seen in the sample of policies viewed on this occasion that they had been reviewed in the last three months. The manager stated that policies are reviewed throughout the year and as needed. A relative’s questionnaire is sent out annually and is due in March 2006. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 16 Where necessary the inspector has received regular notification of incidents at the home. The proprietor also carries out a regular monthly visit and sends a report to the commission about that visit. The fire records were seen, and all were in date with checks carried out as regularly. The Environmental Health Officer had visited the home two days before the inspection (11th January 2006) and they were believed to be satisfied. Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 17 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 3 3 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 X 3 3 3 3 3 3 3 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Kitnocks House Nursing Home DS0000012130.V277459.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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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