Inspection on 01/10/07 for Kynaston Care(80)

This inspection was carried out on 1st October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kynaston Care(80) 04/08/09

Kynaston Care(80) 30/01/07

Kynaston Care(80) 15/12/05

Kynaston Care(80) 29/07/05

Kynaston Care(80) 13/01/05

Kynaston Care(80) 05/07/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Kynaston Care(80) 80 Kynaston Avenue Thornton Heath Croydon Surrey CR7 7BW Lead Inspector James Pitts Key Unannounced Inspection 1st October 2007 11:35 Kynaston Care(80) DS0000025805.V351308.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 Kynaston Care(80) DS0000025805.V351308.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. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kynaston Care(80) Address 80 Kynaston Avenue Thornton Heath Croydon Surrey CR7 7BW 0208 665 4798 F/P 0208 665 4798 farisean@yahoo.co.uk 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) Mrs Efilidah Smith ****Post Vacant**** Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. A variation has been granted to allow one specified service user over the age of 65 years to be accommodated subject to: (1) A minimum annual review of the service user’s health needs (2) All staff having the necessary skills and training to meet the service user’s needs (3) Should the service user become too physically or mentally frail and/or require nursing care, they will need to move to alternative accommodation. Date of last inspection Brief Description of the Service: 80 Kynaston Avenue is registered to provide support to three young adults with learning disabilities with a variation granted to allow one person over the age of 65years to live there. The home is owned and managed by Mr and Mrs Smith and is run as a small family type service. Located in a quiet residential area in Thornton Heath, there are accessible transport links within easy reach, including buses and trains. There is a ground floor bedroom and two bedrooms on the first floor with a staff sleep in room situated in a loft extension. Communal areas include a lounge, kitchen / dining area, bathroom / toilet and a good size garden available to the service users. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a Monday, starting late morning. Two people who use the service were present and both seemed to be content and interacted without any hesitation with the people who care for them. A number of standard records were examined, including the care plans for all but one of the people who live here. The proprietor, who has also taken over day to day management of the home was also present. Questionnaires were left for the people who use this service to complete at a later date if they wish too. Aspects of professional management of the home show significant improvement. The previous manager had been required to improve on a number of staff and home management areas and clearly had significant difficulty in doing so. The proprietor of the home, who is also this person spouse, took over management of the service earlier this year and her own knowledge and skills have clearly helped these improvements to be made. Eleven of the previous 13 requirements have been achieved and the remaining two are showing signs that these are also being addressed. What the service does well: What has improved since the last inspection? Records now evidence what food is provided for service users and show how their choices are respected. All staff involved with food preparation are also now trained in essential health & safety courses i.e. food hygiene practices. The registered provider now ensures that the home obtains an up to date CRB and POVA check for all new staff before they commence employment. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 6 The registered provider has ensured that all staff attend accredited medication training and that the person who actually administers the medication is the person who initials the medication chart to confirm that the medication has been given. More care staff are in the process of obtaining the NVQ2 qualification to meet the required standard of 50 of care staff trained in the home. Duty rotas now accurately show not only who is on duty but also the hours that they work. A quality assurance system and an annual development plan have also been developed. 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. Kynaston Care(80) DS0000025805.V351308.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 Kynaston Care(80) DS0000025805.V351308.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 This judgement has been made using available evidence including a visit to this service. Standard 2 was assessed at this inspection. The people who use this service and other people are told what the home does and how it will do it. The service user guide is written in a clear way to maximise each person’s ability to understand it. The people who use the service can feel confident that the home will only care for people that the staff are trained and able to care for. EVIDENCE: The people who use this service, and others, are told what the home does and how it will do it, and the guide for service users is presented in a clear way. The people who live here can feel confident that the home will only care for people that the staff are trained and able to care for. The home has had one new service user come to live here and the necessary pre –placement and assessment documentation was completed. These indicate that this person is appropriately placed at the home. Kynaston Care(80) DS0000025805.V351308.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 This judgement has been made using available evidence including a visit to this service. Standards 6, 7 & 9 were assessed at this inspection. The people who use this service can feel confident that staff generally know what they need. The home has a keyworker system to further support this work. The people living here can be assured that the staff will try their best to make sure that each person who lives at the home is allowed to live the sort of life that they choose. EVIDENCE: A keyworker system is in operation at the home. A keyworker is a member of staff who especially makes sure that individual service users are being supported in the right way. Keyworkers have the primary responsibility for keeping care plans and risk assessments up to date and at this inspection it was seen that this continues to occur. Three service user’s care plans were Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 10 looked at in detail and these show that the preferences and needs of each person are given the proper consideration. One previous recommendation that was made for improvement was that for two service users who are not able to read, their care plans should be presented in a more accessible way. This would allow these people to have a more in depth knowledge of their care plan should they wish to see what it contains. This recommendation has yet to be addressed. The home compiles a risk assessment for each of the people who live here. A risk assessment tells the staff how to make sure that each of the service users is kept safe from anything that might harm them. The staff are still very good at doing this about very particular needs for each of the people who live here. Each of the people who live here has an updated risk assessment that was written in the last year. These are then reviewed every two months although rarely are changes required to be made. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 12, 13, 15, 16 & 17 were assessed at this inspection. The people who use this service can feel confident that the staff team supports the opportunity for each to develop and maintain their preferred lifestyle as well as personal and family relationships. EVIDENCE: The service users are supported by the staff to be as independent as possible and to make as many choices as they can. All of the service users are engaged in activities of their choosing each week and, due in part to the ages of the people who live here, they each have a very settled routine and chosen lifestyle. All of the people who live here are very independent and all more than able to make meaningful choices about how each wishes to live their life. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 12 The staff encourage continuing contact with families and friends. All of the people who live here are allowed to use the entire house, except other people’s bedrooms or the office. The menus, backed up by comments that have been made in previous inspections, now more properly reflect the meals that people have. The menu is a weekly rotation that does now provide an accurate picture of the meals that are offered and chosen each week. All staff involved with food preparation have now been trained in essential health & safety courses i.e. food hygiene practices. Food stocks were looked at and there was a plentiful and varied amount of fresh, refrigerated and frozen food available. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 18, 19 & 20 were assessed at this inspection. The people who use this service can feel confident that they will get the right support to take care of their physical and healthcare needs. Anyone who needs to take medicine regularly to help them stay well will get the proper support from staff to make sure that this happens. EVIDENCE: Each of the people who live here has a care plan that tells the staff about the way that each person wants to be cared for and supported and about what each person likes or does not like. The care plans do indicate the particular degree and type of support that each person needs to manage their personal care. All of the people who live at the home usually go to see a local GP if they are not feeling well. They can see any local GP but most see the same one that the staff know very well and get along with. The staff are good at writing down Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 14 anything that happens if anyone becomes unwell. If anyone has an illness or something else is wrong with them then the staff do know what this is and how to help them to get the treatment that they need. Three of the people who live here need to take medicine every day and the staff are very good at making sure that this happens so that they can stay well. The fact that staff have to control these medicines has been previously agreed with the service users placing authorities. The staff are also good at making sure that no one can get hold of any medicine that they should not have and so they keep medicines locked away. Medication training for staff has now been updated and verified, as was required at the previous inspection. Another area of concern at the previous inspection was that the medication records had the initials of the member of staff who is expected to be on duty pre written onto the medication charts. A tick was then placed next to the initials once the medication is given. It is noted that this is no longer happening and that medication charts are only filled in each day once the medication has actually been given. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 22 & 23 were assessed at this inspection. The people who use this service can feel confident that the staff team at the home know what to do if there are complaints or concerns about abuse. The home has clear guidance for staff about the procedures to be followed in either of these circumstances. EVIDENCE: The people who live here, and others, are given clear information about how to complain and what happens when they make a complaint. No complaints have been made to the home or to the Commission since the previous inspection. The staff team are effective at making sure that all of the people who live here are protected from abuse (this means that the staff at the home do everything that they can to stop any of the service users from being hurt by someone else). None of the people who use this service have said that they are being hurt by anyone else. No concerns have been raised by anyone else who has contact with the home with either the placing authority, the geographical authority or the Commission. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standards 24 & 30 were assessed at this inspection. The people who use this service can feel confident that they are living in a well maintained and clean home. EVIDENCE: None of the fire doors in the home were seen to be wedged open, which had been the case at the time of the inspection in 2005. Staff continue to record hot water temperature checks and there is sufficient hot water throughout the house. The house is kept very clean, is a warm and comfortable environment and is free of any unpleasant odours. Some small areas of redecoration were seen to be needed, although the proprietor is aware of this and said that it would be attended to shortly. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Standards 32, 33, 34, 35 & 36 were assessed at this inspection. The people who use this service can feel more confidant that there is an increasingly well trained staff team and that they are managed in an appropriate way. EVIDENCE: The law says that half of the staff must have a proper qualification to work with adults who need support in a care home. The name of this qualification is NVQ 2. It could not be confirmed at the previous inspection whether any progress has been made with ensuring that at least 50 of the staff team have this qualification. The deputy manager is completing their NVQ 4 later this month, two support workers are currently studying NVQ level 2 or 3 and two other staff are new and have yet to start the NVQ qualification. This is a significant improvement on what had previously been the case. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 18 There have been two new staff come to work at the home since the previous inspection. As this is the case the previous requirements regarding CRB checks for new staff being taken up prior to their starting work at the home could now be verified and this did occur for both of these people. The two recommendations that were also previously made in respect of staff references and induction were also now seen to have been achieved. The staff names appear on a rota, however, this had clearly not been accurate at the time of the previous inspection as the two staff on duty on the day of that inspection were actually supposed to be off duty. The rota was seen to be accurate at the time of this visit and now also shows the hours of the day that staff are actually on duty. Staff training / development plans were still not in evidence although an appraisal system has now been established as was previously required. Staff performance, once assessed, must then lead to appropriate ongoing training and development programmes in order to enhance their skills. The home employs only five people, aside from the manager, one being the deputy manager and four care staff (one of these is bank staff used to fill any gaps in the rota as needed). Staff supervision (this is a time that each member of staff spends talking about how they are getting along in their work) is done by the deputy, who is then supposed to be supervised by the manager. Staff are supposed to meet with their direct line manager at least 6 times a year by law. The home still cannot show that this is happening although improvements have been made since the previous key standards inspection earlier this year. Staff must be supervised at appropriate intervals to support the professional nature of the work that they are required to undertake with the service users. The requirement that was previously made about this matter will remain in this report, although it should be noted that if current improvements continue then the home should be able to demonstrate full compliance by the time of the next key inspection. Kynaston Care(80) DS0000025805.V351308.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Standards 37, 39 & 42 were assessed at this inspection. The people who use the service can feel confident that they are living in a home that has improved the standard of internal management and that they are safe from hazards in the house in which they live. EVIDENCE: There were previously a number of concerns over Mr Smith’s ability to run the home as he had limited experience in the care profession and of working with people who have learning disabilities. In order to meet the needs of the people who use this service users and the home’s stated purpose, Mr Smith was required to develop his skills and knowledge further to demonstrate competency to manage this home. Since then, Mrs Smith (the spouse of Mr Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 20 Smith) has taken over the management of the home. Mrs Smith, who is also the proprietor, has extensive knowledge and working background of care services of this kind. She is also qualified to NVQ level 4 management qualification to comply with current National Minimum Standards and Regulations. The people who use this service and relatives have been asked about their views of the home, this has then lead to an annual development plan. This plan is dated January to December 2007 and although basic is does meet the minimum standard in this regard. The homes fire and other safety certificates were examined at this inspection and all were found to be up to date. Kynaston Care(80) DS0000025805.V351308.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 X 2 3 3 X 4 X 5 X 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 X 32 3 33 3 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 3 3 X 3 X X 3 x Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 22 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. 1. Standard YA35 Regulation 18 (1) ( c ) (i) & (ii) Requirement Staff training / development plans were not in evidence. Staff performance, once assessed, must then lead to appropriate ongoing training and development of their skills. (Previous timescale of 30/04/07 has not been fully complied with) Staff must be supervised at appropriate intervals to support the professional nature of the work that they are required to undertake with the people who use the service. (Previous timescale of 30/04/07 has not been fully complied with) Timescale for action 08/10/07 2. YA36 18 (2) 08/10/07 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 Good Practice Recommendations DS0000025805.V351308.R01.S.doc Version 5.2 Page 23 Kynaston Care(80) 1. Standard YA6 For two service users who are not able to read, their care plans should be presented in a more accessible way. Kynaston Care(80) DS0000025805.V351308.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Croydon, Sutton & Kingston Office 8th Floor Grosvenor House 125 High Street Croydon CR0 9XP 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. 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