Inspection on 06/12/05 for Prince George Duke Of Kent Court

This inspection was carried out on 6th December 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

Prince George Duke Of Kent Court 13/06/07

Prince George Duke Of Kent Court 22/06/06

Prince George Duke Of Kent Court 28/06/05

Prince George Duke Of Kent Court 08/12/04

Prince George Duke Of Kent Court 17/05/04

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

Queen Elizabeth House

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

CARE HOMES FOR OLDER PEOPLE Prince George Duke Of Kent Court Shepherds Green Chislehurst Kent BR7 6PA Lead Inspector Sue Meaker Unannounced Inspection 6th December 2005 13:00 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 Prince George Duke Of Kent Court DS0000010152.V268846.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. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Prince George Duke Of Kent Court Address Shepherds Green Chislehurst Kent BR7 6PA 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) 020 8467 0081 020 8295 3526 www.rmbi.org.uk Royal Masonic Benevolent Institution Mrs Gillian Khalighi-Motamed Care Home 78 Category(ies) of Old age, not falling within any other category registration, with number (78) of places Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 24 Beds for Nursing Care Staffing Notice issued 21 January 2000 Date of last inspection 28th June 2005 Brief Description of the Service: Prince George Duke of Kent is a purpose built care home situated in Chislehurst in Kent. The care home is operated by the Royal Masonic Benevolent Institution who provide a range of services to meet the needs of older Freemasons and their dependents; as well as offering practical support to people who prefer to remain in their own homes; care is also offered in homes and sheltered accommodation throughout England and Wales. Prince George Duke of Kent offers residential care to a wide range of older people, some simply choose this lifestyle for their later years, others may be unable to manage in their own home due to failing health or a need for help with some day to day activities. The home also offers nursing care for older people with specific medical conditions requiring treatment that needs to be provided under the direction of a Registered Nurse. Prince George Duke of Kent was built in 1968 and is surrounded by gardens containing a large collection of rose bushes as well as many shrubs. A concrete path borders the garden, allowing residents with frames or wheelchairs to have uninhibited access. Part of the lawn is laid out for putting, which is enjoyed by the residents and their families and friends. The home provides accommodation for fifty residents in single bed sitting rooms and four double rooms (for couples) in the residential part of the home; and there are twenty- four beds for residents who require nursing care in the specialist nursing wing of the home. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second statutory inspection for Prince George Duke of Kent; the inspection focussed on the Nursing Unit in the home; and was conducted over a period of four hours. This unit offers nursing care to twenty- four elderly residents all of whom have single bedrooms, their own toilets, bathrooms, lounge and dining rooms as well as an office and treatment room. The inspection focussed on the care plans particularly those around pressure area care, the recording by staff on the care plans and training relating to pressure and wound care. Three care plans of residents requiring pressure area care were looked at in detail; looking at new and revised documentation. A tour of the nursing unit was undertaken looking at pressure relieving equipment, the layout and furniture in individual bedrooms and the revised layout of the lounge and dining areas. The home manager, deputy manager and the manager of the nursing unit were spoken to and the various improvements made in the nursing unit were discussed in detail. Conversations were held with two of the qualified nurses and four members of the care staff, who commented on the training they had received relating to pressure and wound care and continence and nutrition. He homes’ GP, who was visiting the home at the time of the inspection, talked about the improvements made to protocols relating to nutrition and dehydration and said that these protocols were having a positive impact on these specific areas of care. Personnel files were inspected in respect of supervision and appraisal documentation. The activities programme was looked at and a discussion relating to the provision of activities and entertainment was discussed with the home manager and the activities co-ordinator; a concert given by local schoolchildren was also observed. Residents and relatives spoken to during the inspection were positive and appreciative of the quality of care provided by a committed staff team. What the service does well: The home has a comprehensive programme of activities and entertainment; this is planned on a monthly basis with input from residents, their family and friends as well as staff and management. The activities co-ordinator is to be congratulated on her commitment to implementing a varied and creative programme. The home is decorated, furnished, equipped and maintained to a high standard, there is an ongoing programme of redecoration and refurbishment. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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 Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 7 contacting your local CSCI office. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 8 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 Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 9 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): None EVIDENCE: Standards one to five were comprehensively assessed in the previous inspection report of 28th June 2005, and were met. Standard six is not applicable to this home. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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 and 11 The care plans now reflect the individual needs of the residents in the nursing wing of the home; they are more detailed regarding pressure care and give detailed instructions relating to the management of pressure care ensuring that residents health care needs are fully met. EVIDENCE: Three care plans, on the nursing wing, were looked at in detail, there has been significant improvements in the documentation and in the recording on these plans. Pressure care for residents were looked at in detail; and it was noted that this documentation was very detailed and gave specific instructions, the tissue viability nurse had been involved and had drawn up a dressings protocol, thereby matching the appropriate dressing to individual wounds this information was clearly documented on the care plans seen. There had been concerns raised relating to the refusal of fluids by some residents; this issue has now been addressed, and a protocol for dealing with this issue was formulated and implemented with input from the homes’ GP. The GP was visiting the home on the day of the inspection and was able to give details of the improvements to documentation made by the home manager and the nursing manager, both qualified nurses. The fluid chart used has been Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 11 reviewed and relevant changes made to improve recording. A digital camera has now been purchased and is used, with the residents permission, to aid with the recording of the treatment of pressure sores, this has been used to great effect and has helped considerably in monitoring the progress of treatment. Care staff have received training relating to the application of dressings and around pressure care, continence, nutrition and dehydration; this training is to be updated regularly, and appropriate training has been accessed by the unit manager; staff spoken to at the time of the inspection confirmed that they had attended training and had found it useful. In house training has been implemented for the qualified nursing staff and this has proved successful in improving care planning and recording relating to pressure care. The nursing unit is well equipped with height adjustable specialist nursing beds and appropriate pressure relieving aids, all residents have pressure relieving mattresses and cushions, the home is awaiting delivery of eight careflex hydro tilt chairs and three recliner chairs to enable residents to sit in the lounge and participate in activities. The unit has three hoists used to assist residents requiring aid to get out of bed and to stand, moving and handling risk assessments are done and reviewed monthly and staff receive regular training as evidenced by documentation in the training files. There are five bathrooms and ten toilets in the nursing unit, all the toilets are equipped with grab rails and raised toilet seats; bathrooms have bath hoists and /or walk in showers. The home has a comprehensive policy and procedure relating to the care of residents who are dying; all specific wishes are recorded on the care plan; residents are assured that at the time of their death, the staff will treat them and their family with care, sensitivity and respect. Prior to the inspection a resident on the nursing unit had passed away, and it was evident from talking to the staff involved that the privacy and dignity of the resident had been maintained, that the resident had family and friends present. The home has a chapel for the use of the residents, relatives and staff of the home. Standard nine was not assessed at this inspection, this standard was met as previously documented at the inspection on the 28th June 2005. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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 The residents are supported and encouraged to participate in social activities enabling them to pursue their chosen lifestyle within the home and the wider community. EVIDENCE: The home employs a full-time activities co-ordinator, who manages the extensive activities programme with considerable input from the residents, their family and friends and the staff and management of the home. The co-ordinator has developed a monthly programme, that is displayed in the home, this details activities available throughout the month, there are a variety of activities and entertainment on offer and residents are encouraged to participate if that is their wish, family and friends are also invited to attend. The programme of events for the month of December includes a Christmas fayre, a tea dance, a carol concert, a Christmas party, a pantomime and numerous musical entertainments, the activities co-ordinator is to be congratulated on the wide range of events organised for the benefit of the residents. During the inspection there was a concert in the lounge with carols and Christmas songs performed by the children from the local school, this event was particularly enjoyed by the residents, their families and friends. The home maintains good community links particularly with local schools and other organisations. Residents and relatives spoken to, during the inspection were Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 13 very appreciative of the effort put in by the activities co-ordinator and staff at the home. The activities co-ordinator has been short listed for an award by the Care Forum for her work in the provision of appropriate activities and entertainment in the home. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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): 16 The home has comprehensive policies and procedures in place ensuring that residents feel safe and protected in their chosen environment. EVIDENCE: Complaints received by the home are investigated by the home manager in accordance with the organisations comprehensive complaints policy and procedure. The service user guide contains a copy of these documents and the residents and relatives can readily access these documents. Currently a complaint relating to the nursing unit is being investigated by the Commission; the complaint was initially investigated by the home manager but the complainants were not satisfied and the complaint was referred to the Commission for resolution. The complaint was investigated by the home in accordance with their policy and procedure and within the set time scale; this complaint is still not resolved and is still being investigated. As a result of this complaint certain measures have been put in place, therefore addressing issues raised by the complainants. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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): 21,22,23 And 25. The residents in the nursing unit are provided with appropriate accommodation and facilities enabling the staff to meet their assessed health, personal and social needs. EVIDENCE: The environment in the nursing unit was assessed at this inspection; the unit comprises of twenty-four single rooms, two of which have en-suite facilities. There is a lounge, dining room, an office, a treatment room, two sluices, ten toilets and five bathrooms all of which were maintained to a high standard. Some redecoration and refurbishment work has been carried out and this work is ongoing. The unit is well- equipped providing specialist height adjustable nursing beds for each resident with appropriate pressure relieving equipment and hoists; new chairs have been purchased for the residents benefit enabling them to sit comfortably in the lounge and dining room. The unit is easily accessible to residents with wheelchairs and walking aids and there are grab rails in the Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 16 corridors, bathrooms and toilets. All bedrooms have a call bell system enabling residents to call for assistance as and when required, this system is well maintained and regularly checked. Bedrooms are well decorated and furnished to a high standard, rooms were personalised with ornaments, pictures, photographs and small items of the residents’ own furniture, reflecting the residents’ personal tastes. Bedrooms are individually ventilated and heated with radiators being covered as required by health and safety legislation; water temperatures are checked and documented as required. Emergency lighting is provided throughout the unit, this being well-maintained and checked by the maintenance person. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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): None EVIDENCE: All the key standards identified in this section of the report were comprehensively assessed in the previous inspection report of 28th June 2005, and were met. Prince George Duke Of Kent Court DS0000010152.V268846.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): 34,36 and 37. The home benefits from comprehensive financial and accounting, supervision and appraisal and record keeping policies and procedures, therefore ensuring that the residents best interests are safeguarded. EVIDENCE: The home has robust financial and accounting systems in place, these systems ensure that the residents’ financial interests are safeguarded; residents’ personal monies are regularly audited by the management of the home and the organisation. A recommendation in the previous report relating to supervision and appraisal of staff has now been addressed; staff receive six supervision sessions each year with an annual appraisal incorporating a personal development plan for each member of staff. This system was implemented fully in June 2005 and is overseen by the organisations’ human resource department; copies of supervision sessions and the yearly appraisal are kept on individual personnel Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 19 files. The management of the home have all received training in how to conduct supervision and appraisals of staff employed at the home. Prince George Duke Of Kent Court DS0000010152.V268846.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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 X 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X X X 3 3 3 X 3 X STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X 3 X 3 3 X Prince George Duke Of Kent Court DS0000010152.V268846.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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP8 OP8 Good Practice Recommendations It is recommended that care continues be taken to complete all documentation relating to pressure care. It is recommended that the home continues to provide, with the permission of the patient, distinct photographic evidence of pressure areas. Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Sidcup Local Office River House 1 Maidstone Road Sidcup DA14 5RH 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 Prince George Duke Of Kent Court DS0000010152.V268846.R01.S.doc Version 5.0 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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