Inspection on 14/02/06 for Kynance

This inspection was carried out on 14th 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 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

Kynance 01/10/08

Kynance 22/02/07

Kynance 14/09/05

Kynance 01/02/05

Kynance 11/06/04

Kynance 04/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Kynance 97 York Avenue East Cowes Isle Of Wight PO32 6BP Lead Inspector Richard Slimm Unannounced Inspection 14th February 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 Kynance DS0000012505.V260078.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. Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Kynance Address 97 York Avenue East Cowes Isle Of Wight PO32 6BP 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) 01983 297885 01983 297885 Mentfade Limited Corinne Rachel Lovejoy Care Home 24 Category(ies) of Dementia - over 65 years of age (6), Old age, registration, with number not falling within any other category (24), of places Physical disability over 65 years of age (1) Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user in category DE may be accommodated over the age of 60 years 14th September 2005 Date of last inspection Brief Description of the Service: Kynance is a registered care home, which is registered to provide care/support and accommodation for 24 older people, six who may have dementia over the age of sixty five years. One resident may be accommodated by reason of age related physical disability over 65 years. The home is situated in a residential area of East Cowes, on the main road leading to the centre of the town. There are plans to develop the home further which will involve building works. Upkeep and maintenance of the home and an ongoing refurbishment plan is in place in oder to provide a valuing and safe physical environment. Accommodation is organised over 2 floors with access via the shaft lift. There are gardens to the rear of the home, which are enclosed and fully accessible to residents. The ground floor has some bedrooms, but also provides communal space, including a lounge and a dining area, office, communal bath/toilet facilities. A further lounge diner, bedrooms and facilities are provided on the 1st floor. The kitchen a utility/laundry area, storage areas and staff facilities are sited in the basement. All bedrooms are single and 13, are slightly below 10 square metres, however, 23 bedrooms have been provided with en suite facilities. There are plans to develop 8 additional single bedrooms with ensuite facilities. Each floor has access to communal bathing/shower and WC facilities. The home pays particular attention to the provision of good quality activities and outings, with a dedicated staff member to organise activities, and a mini bus to provide regular outings. Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between the hours of 10.30 am and 4 pm on the 14/2/06. The day was spent visiting service users in their own rooms, and communal areas of the home and interviewing them in order to establish their views of the quality of service provided by the home, the inspector also joined the residents for lunch and met other visitors to the home. The inspector undertook a tour of the premises, checked records and other relevant documentation, interviewing care, management staff/owner. Residents, staff and visitors spoken to, made positive comments about the home. This report will make no requirements and 1 best practice recommendation. What the service does well: What has improved since the last inspection? Action had been taken to provide a number of privacy locks to residents who have requested these facilities; there is also an ongoing commitment to provide all bedroom doors with suitable privacy locks as required. Risk assessments have been carried out in respect of hot water and surface temperatures, and weekly checks are carried out and recorded, to promote and protect the safety of residents. Action is being taken to ensure that the floor of the laundry area has an impermeable surface, to reduce risk of cross infection. Monthly reviews of care arrangements are now taking place and are fully recorded. National Vocational Qualification targets have been met, and plans regarding an extension to the home will be forwarded to the CSCI once they are cleared through the local planning department. Kynance DS0000012505.V260078.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. Kynance DS0000012505.V260078.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 Kynance DS0000012505.V260078.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): 3 Residents have their needs assessed prior to admission by a qualified staff member. Residents’ are assured that their needs will be met at the home. EVIDENCE: The home does not provide intermediate care services. Consequently standard 6 was not assessed. Samples of case records were inspected. The provision of personal profiles as part of assessment enhances the quality of information about residents’ lives prior to entering the home, and takes account of individual likes and dislikes. Care assessments provided quality information needed to develop clear plans of care. Where necessary the home will seek additional input from social workers, CPNs’, residents’ advocates/relatives, wherever possible with the consent of the resident. Residents were found to be happy and contented, but given the degree of confusion of some residents they were not all fully aware of care records held about them. Staff members were able to demonstrate an awareness of residents’ needs and the importance of care planning systems in regard to promoting consistency and accountability. Daily care records used terms such as “agitated” and “confused”, with little information to assess what these judgements are based on. There was evidence in one case where a resident is sometimes restricted from using the Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 9 telephone, with no mention of this in the plan of care. This matter will need to be reviewed with further written clarification provided in case records. Staff still may benefit from some training input and consultation about the ongoing development and completion of the daily care records at the home. Kynance DS0000012505.V260078.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): 7-8-9-10 Residents had individual plans of care. Care plan records were specific. Daily monitoring care records may benefit from increased detail. All monthly care reviews were up to date. Care plans, and management systems, ensured residents health care needs were identified, monitored and met. Arrangements for the administration of medications were found to be appropriate to the needs of the residents who needed support. EVIDENCE: Each Resident has an individual plan of care. Daily monitoring notes of care plans were being maintained as a clear chronology of the care provided, however, more specific detail of behaviours and manifestations of mental health issues are needed. Care plan systems appeared to cover both practical aspects of daily living, and insight into the mental health/psychological needs of residents. More confused and frail residents needs and wishes appeared to be met on a daily basis, with a staff team that appeared to be well managed and organised to the benefit of residents. There will be a recommendation made in order to ensure residents’ daily notes are fully recorded and where terms such as “agitated” or “confused” are used there is sufficient detail to enable monthly reviews to vary, or plan different interventions when needed. Consequently, some staff members training needs were identified in the area Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 11 of maintaining daily records. Residents spoken to confirmed that they had access to community health care support as required, and said that they could see their GP on request. Some residents were under specialist health services, including consultants and community psychiatric nurses. Residents spoken to confirmed that the staff members treat them with dignity and respect, and this was also observed throughout the visit. Care plans not only took account of residents’ interests, but action was being taken on a daily basis to provide meaningful occupation, including 2 outings each week in the homes’ mini-bus, external activity providers and a specific staff member who organised regular activities at the home in line with the needs and wishes of the resident group. The home has a monitored dosage system for the administration of medication, drugs and medicines. Medications were kept safely and securely, and records of medications are maintained. The inspector was advised that the local pharmacist visits the home to monitor practices in this area, and all new staff receive medication training as part of the home’s induction. Kynance DS0000012505.V260078.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): 12-13-14-15 Residents are provided with support to lead their own lives as far as possible. Contact from outside of the home is encouraged and supported. Residents are encouraged and supported to exercise choice and control. One area where a restriction was being applied was not fully recorded in the care plan and being kept under review with all concerned. The home provides a balanced diet with options to main menus based on the wishes/ needs of residents. The recreational needs of residents’ are recognised and met to a high standard. EVIDENCE: A number of the resident group needed some element of supervision in aspects of daily living. However, more able residents are free to journey out as they wish, and many residents are enabled to take part in outings provided by the home, and/or their relatives. Mini-bus trips are arranged twice a week however, the current bus is unable to take people who are wheelchair dependent. The owner employs a specific staff member who organises activities and outings on a daily basis. External activity providers are also used. Residents said that they enjoyed the activities at the home, and the regular trips out in the mini-bus. The needs, interests and wishes of residents are known, and action is taken to meet those needs, by a committed staff team. Residents confirmed that there were enough things going on at the home to meet their needs. Some residents have family support in the area of outings. Visitors to the home are welcomed and encouraged. Residents confirmed that Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 13 they had visitors, and visiting arrangements were flexible. There appeared to be few restrictions in the home, with residents having full freedom of movement around communal areas and choice in such areas as where they sit, this was observed during the visit. However, one resident had access to the ‘phone restricted due the request of the family, this needs to be recorded clearly in the care plan and kept under regular review. Residents spoke highly of the staff and good relations were evident. Routines appeared to be kept to a minimum, with the residents placed at the centre of the running of the home. Residents choose where they eat their meals, and support is provided to maintain dignity and independence to more dependent residents. Residents spoken to were found to be happy with the quality and choice of food provided, and options are provided to main menus. Special diets are catered for where necessary. Kynance DS0000012505.V260078.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): Not inspected on this occasion – see last report dated 14/9/05. EVIDENCE: Kynance DS0000012505.V260078.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): 19-26 The home was clean and well maintained, providing a valuing environment to residents. The home provides only single bedrooms with en suite facilities. Bedrooms are beginning to be provided with appropriate privacy locking arrangements for potential residents needs and wishes, in line with the standards. There is a clear commitment and written plans for the ongoing improvement and development of the home’s environment. There are plans to develop and extend the home further. All hot water outlets where residents access hot water are risk assessed and checked on a weekly basis. The inspector was advised that arrangements for temperature control at the home are safe. EVIDENCE: The home is well presented and maintained, and there was clear evidence of the ongoing investment into the physical environment of the home. The home was cleaned to a good standard throughout at the time of the visit. Residents stated that they were happy living at the home, and confirmed their home was always kept clean and decoration is ongoing, and that they were involved in deciding colour schemes. Residents also confirmed that they could access the Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 16 garden in warmer weather. The home has only single bedrooms, and 23 have been provided with en suite facilities. Some bedrooms do not have appropriate locking arrangements, however, existing residents were not concerned with this matter, and a number of rooms had been provided with these facilities since the last inspection. The owners have agreed that they will continue to consult with all residents about the provision of door locks to individual bedroom doors, and where necessary provide privacy locks. It was agreed that existing residents who choose not to have locks will have their wishes respected, however, as residents move on rooms will need to be provided with locks before new residents are admitted to the home in the future. The owner has agreed to monitor this issue in consultation with the resident group. Communal baths and shower facilities have appropriate safe hot water mechanisms, however, there is a need to extend risk assessment to hot water taps in residents’ bedrooms, and other sinks. There are plans to provide the laundry floor with an impervious floor covering. Plans to change the layout and location of the dining area are now completed, and once the new carpet is fitted this area will be used. There are plans to provide an additional 8 bedrooms to the home. The owner has agreed to forward new floor plans for the premises when these have been finalised with planning and Building Control. Kynance DS0000012505.V260078.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): 27-30 Staffing levels were maintained to a good standard. Staff members may benefit from further training in maintaining daily care records. New staff members receive appropriate induction. The home has trained staff to NVQ level 2, 3 and 4 in order to meet the national 50 target for care staff working in registered homes. EVIDENCE: The home has clear staff rosters. On entering the home the registered manager Mrs. Lovejoy, one senior carer and two care assistants were on duty, in addition to 1 domestic worker, a maintenance worker and one cook. The home provides 2 waking night staff. Consequently, staffing levels were maintained to a good standard. The owner attended the home briefly during the inspection process and showed the inspector the planned building developments. The home employs a specific staff member in order to provide regular, planned activities and resident outings. Residents spoke highly of the staff team, and confirmed that they are always treated with dignity and respect. Staff members were observed interacting well with residents, and providing sensitive, discreet support. Staff may benefit from increased training in the maintenance of the homes’ daily care records, and the home may benefit from staff trained in dementia mapping. There are two waking staff members at night. In addition to the manager and care staff the home employs ancillary staff including cooks, domestics and an admin person 2 days per week, as well as a maintenance person. There is a clear commitment to the ongoing training and development of the staff team to NVQ levels 2 and 3. Currently sufficient members of the staff team have these qualifications. There Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 18 are a number of highly dependent residents, however, staffing levels were sufficient to ensure their care needs did not detract staff time from other residents accommodated. Staff members confirmed that they had also been provided with other specialist training relevant to the care needs of the resident group. There are regular staff meetings, and formal staff supervision is being provided. New staff members receive induction training. Staff spoken to confirmed that they were happy working at the home. Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 19 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): 38 The home is run in the best interests of residents. The Health and safety of residents and staff is promoted. EVIDENCE: A sample of policies and procedures were inspected. Systems of quality assurance continue to develop at the home. The homes’ owner and manager are keen to work with the CSCI in the ongoing development of the service. Residents spoken to confirmed that they are consulted. The resident group were found to be happy and contented with the general quality of service provided. Staff members had received training in core training topics, including manual handling, fire safety, first aid, and food-hygiene and infection control. The manager makes arrangements for the maintenance of health and safety at the home. Service contracts are in place for the maintenance of the central heating, shaft lift, and electrical items/systems and bath hoists/chair. Residents confirmed that the fire alarm system is tested regularly and that they felt safe living at the home. Kynance DS0000012505.V260078.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 X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X X X X 3 Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 21 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. 1 Refer to Standard OP30OP7 Good Practice Recommendations It is recommended that staff training be provided in the following areas – daily care recording – dementia mapping. Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Kynance DS0000012505.V260078.R01.S.doc Version 5.1 Page 23 - 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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