Inspection on 14/09/05 for Kynance

This inspection was carried out on 14th September 2005.

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 14/02/06

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 September 2005 09:30 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.V249859.R01.S.doc Version 5.0 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.V249859.R01.S.doc Version 5.0 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.V249859.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user in category DE may be accommodated over the age of 60 years 1st February 2005 Date of last inspection Brief Description of the Service: Kynance is a registered care home, which provides 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 devlop 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 large lounge/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 improve the size of a number of bedrooms. Each floor has access to communal bathing/shower and WC facilities. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between the hours of 9.30 am and 4 pm on the 14/9/05. 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. The content of the pre-inspection questionnaire forwarded to the CSCI was also taken into account as an evidence source for this inspection. This report will make one requirement of several parts and 3 recommendations. What the service does well: What has improved since the last inspection? What they could do better: Privacy locks need to be provided to all bedroom doors, of a type that meet the needs and wishes of the residents and the standards. A programme of risk assessment is needed to hot water to sinks throughout the home. The laundry floor needs attention to ensure that the floor surface is impermeable. Monthly reviews of all care plans need to be carried out. 50 of care staff are to be Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 6 trained to NVQ level 2 by 31/12/2005. (nb. The pre-inspection questionnaire indicates an intention to train all care staff to this level). When plans for the changes to the physical environment are finalised, new layout plans will need to be forwarded to the CSCI. Monthly care reviews need to be carried out and fully recorded. 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.V249859.R01.S.doc Version 5.0 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.V249859.R01.S.doc Version 5.0 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. A sample of care assessments, planning and review systems 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 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. Staff may benefit from some training in the ongoing development and completion of the monthly review of care records at the home. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 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): 7-8-9-10 Residents had individual plans of care. Care plan records were specific. Daily monitoring care records are kept appropriately. All monthly care reviews were not up to date. Care plans, and management systems, did ensure residents health care needs were identified 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 on an individual basis, or providing a clear chronology of the care provided or issues arising. 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’ monthly reviews are fully recorded on an individual basis. Consequently, some staff members training needs were identified in the area of maintaining review records. Residents were able to confirm that they had access to community health care support as required, and confirmed that they could see their GP on request. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 10 Some residents were under specialist health services, including consultants and community psychiatric nurses. The inspector spoke to visitors who confirmed that they visited the home on a regular basis and always found the home to be welcoming, clean, and with a staff group who were interested in the residents. 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. One resident and visitor indicated that it would be good if a mini-bus could be provided that could transport residents who are wheelchair dependent. The home has a monitored dosage system for the administration of medication, drugs and medicines 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. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 11 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, and the home provides a balanced diet with options to main menus based on the wishes/ needs of residents. Religious and recreational needs of residents’ are recognised and met. EVIDENCE: Some of the resident group need 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. Currently the mini-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, Mondays to Fridays. 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 and several residents were observed going out for a drive with their relatives. Visitors to the home are welcomed and encouraged. Residents confirmed that they had visitors, and visiting arrangements were flexible. The inspector spoke to Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 12 visitors and they confirmed that they were always made welcome at the home. There are 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. Residents spoke highly of the staff and good relations were evident. Residents confirmed that their religious needs are catered for at the home, and one resident receives visits from a local pastor. 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.V249859.R01.S.doc Version 5.0 Page 13 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): 16-18 Systems are in place to ensure any concerns or complaints are listened to, taken seriously and acted on. This includes information and systems to protect residents from potential abuse. EVIDENCE: The home has a clear and accessible complaint procedures, information regarding complaints is displayed, and is made available to residents and/or their representatives. Residents’ confirmed that they knew how to make any concerns known, and who to speak to. The manager has the role of investigating any concerns and full records would be maintained. There had been no complaints since the last inspection visit. There is an adult protection policy and procedure in place and this is available to staff members. A number of staff members have received adult protection training via their NVQ courses. The home reports all incidents affecting the wellbeing of residents to the CSCI as required. Residents confirmed that they felt safe living at Kynance. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 14 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): 19-24-26 The home was clean and well maintained, providing a valuing environment to residents. The home provides only single bedrooms. Bedrooms are not 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. The floor to the laundry area did not meet the standards. All hot water outlets where residents access hot water are not temperature controlled. 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 garden. The home has only single bedrooms, and 23 have been provided with Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 15 en suite facilities. Some bedrooms do not have appropriate locking arrangements, however, existing residents were not concerned with this matter. The owners have agreed that they will 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. The laundry floor needs to be provided with an impervious floor covering. There are plans to change the layout and location of the dining area, and also convert the upper lounge diner so as to provide three of the undersized bedrooms with additional space. This work will also provide a new communal bath area to the upper floor and an en suite to the bedroom that currently does not have this facility. The owner has agreed to forward new floor plans for the premises when these have been finalised with Building Control. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 16 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): 27-28-29-30 Staffing levels were maintained to a good standard. Staff recruitment, selection, supervision and retention met the standards. Staff members may benefit from further training in care review record maintenance. Records of checks on staff are maintained. New staff members receive appropriate induction. The home needs to train more staff to NVQ 2 level, 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 owner Mr Davies, one senior carer and three care assistants were on duty, in addition to 2 domestic workers and one cook. The home provides 2 waking night staff. Consequently, staffing levels were maintained to a good standard. 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’ care review record systems. 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. The home uses a recruitment and selection system that meets the legal requirements and provides safeguards for residents, by ensuring staff receive appropriate checks. There is a clear commitment to the ongoing training and development of the staff team to NVQ levels 2 and 3, however, currently less than 50 of the staff team had these qualifications. There are a number of Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 17 highly dependent residents, however, staffing levels were sufficient to ensure their care needs did not detract staff time from other residents accommodated. 29.4 of the staff team had been provided with training to NVQ 2 or above. Staff 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.V249859.R01.S.doc Version 5.0 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33-38 The home is run in the best interests of residents. The Health and safety of residents in the area of hot water temperature control, and staff, in the area of providing a laundry floor that is impermeable and easily cleaned should be further promoted. EVIDENCE: A sample of policies and procedures were inspected. Systems of quality assurance continue to develop at the home. The homes’ owner employs a manager, and is keen to work with the CSCI in the ongoing development of the service. Residents spoken to confirmed that they could have access to money if they needed it. 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. Staff members confirmed that fire training and drills were provided regularly in line with the recommendations of the chief fire officer. Residents confirmed that the fire alarms are tested regularly. Service contracts Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 19 are in place for the maintenance of the central heating, shaft lifts, and electrical items/systems and bath hoists/chair. The floor to the laundry area needs attention, and action is needed to risk assess hot water temperature controls as identified above. Residents confirmed that they felt safe living at the home. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 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 2 8 x 9 3 10 x 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 2 x x x x 2 x 2 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 x x 3 x x x x 2 Kynance DS0000012505.V249859.R01.S.doc Version 5.0 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. 1 Standard 24-26-38 Regulation 12-13-1623 Requirement The registered persons must forward a clear time limited plan to cover – the provision of suitable privacy locks to bedroom doors where existing residents request this. Bedroom door locks will be provided to any new resident admitted to the home. The provision of clear risk assessments of safe hot water controls to all hot water outlets where residents have access. The provision of an impermeable floor covering to the laundry area. New floor plans for the premises when finalised. Timescale for action 30/10/05 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 7 Good Practice Recommendations It is recommended that staff receive training in the maintenance of records of care reviews, in line with the DS0000012505.V249859.R01.S.doc Version 5.0 Page 22 Kynance 2 3 30 19 system used in the home for these purposes. Monthly reviews should be fully recorded on all care plans. It is recommended that additional staff members are trained to NVQ 2. Post 2005 this will be a requirement. When floor plans for the alterations proposed at the home are finalised the registered person will forward copies of these plans to update CSCI records, as agreed. Kynance DS0000012505.V249859.R01.S.doc Version 5.0 Page 23 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.V249859.R01.S.doc Version 5.0 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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