Inspection on 06/01/09 for The Kenrick Centre

This inspection was carried out on 6th January 2009.

CSCI found this care home to be providing an Adequate service.

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

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Maple Lodge

Polesworth Group 32 Station Road

Heathlands

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

CARE HOMES FOR OLDER PEOPLE The Kenrick Centre Mill Farm Road Harborne Birmingham B17 0QT Lead Inspector Brenda O’Neill Key Unannounced Inspection 6th January 2009 09:10 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 The Kenrick Centre DS0000072114.V373633.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 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. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Kenrick Centre Address Mill Farm Road Harborne Birmingham B17 0QT 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) 0121 675 0900 0121 675 0901 The.Kenrick.Centre@birmingham.gov.uk www.birmingham.gov.uk/kenrickcentre Social Care and Health Ms Tina Walstrom Mr Delroy Gladstone Bonnitto Care Home 64 Category(ies) of Dementia (64), Learning disability (64), Mental registration, with number disorder, excluding learning disability or of places dementia (64), Old age, not falling within any other category (64), Physical disability (64), Sensory impairment (64) The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) 64 Old age not falling within any other category (OP) 64 Mental Disorder (MD) 64 Sensory Impairment (SI) 64 Learning Disability (LD) 64 Physical Disability (PD) 64 The maximum number of service users to be accommodated is 64. 2. Date of last inspection New Registration. Brief Description of the Service: The Kenrick Centre is a newly built, multi purpose care centre that incorporates 64 beds registered to provide residential care. It is located in a residential area of Harborne next to Harborne Park. The centre is easily accessed by public transport and is within easy reach of the local facilities in Harborne including shops, public houses, banks and restaurants. The centre has been built to a high standard with input from Sterling university regarding the suitability for people with dementia. The residential units are all open plan, accessed through a security door and exited by a push button system. The residential units have their own reception area, manager’s office and staff stations. The accommodation consists of sixty four single bedrooms all with en-suite facilities which include a walk in shower. Bedrooms are large enough for all the required furniture and are wheel chair accessible. Bedrooms are well equipped and include an emergency call system which allows staff to talk to the people living in the home and vice versa. The system can be extended to include other The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 5 assistive technologies. The accommodation is divided into units of eight which each have their own lounge and dining areas. Furnishings and fittings are of a very good standard. Corridors are wide with hand rails fitted allowing people to move around easily if they have mobility difficulties or use walking aids. As well as the en-suite showering facilities there are also fully assisted bathrooms and additional toilets throughout the home available for people to use. The home has extensive landscaped gardens with seating areas and a water feature. The majority of the accommodation overlooks the garden and the park. The garden can be accessed directly from all the ground floor communal areas. There is a designated car park at the front of the centre which allows for several vehicles. The fees charged at the home are assessed by the placing social workers and are based on the assets of the people being admitted. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 Star. This means the people who use this service experience adequate quality outcomes. This was the first inspection of the Kenrick Centre since its registration in July 2008. It was carried out by two inspectors over one day in January 2009. Before the inspection the manager had completed and returned an Annual Quality Assurance Assessment (AQAA) to us. This provided us with some information about how the home was operating. We sent satisfaction surveys to 10 of the people living in the home and 15 staff to get their views on the home. We received completed surveys from 5 of the people living in the home and 7 staff. During the course of the inspection we looked at the care for two of the people living in the home which included speaking with them, looking at their care files and medication records. We also looked at other documentation related to such things as health and safety, accidents, complaints, money management and quality monitoring. We spoke with the registered manager, the general manager, five staff members, one visitor and five of the people living in the home. No complaints or adult protection issues had been raised with us since the home opened. There had been two complaints raised with the manager by the people living in the home both about the temperatures in their bedrooms as they felt it was cold. These had been managed appropriately. What the service does well: The needs of the people moving into the home had been assessed before they moved in to ensure the home was appropriate for them. People could visit the home before moving in to see if they liked it. The staff spoken with during the inspection were able to tell us about the needs of the people living in the home and how they managed any risks. There was ample evidence that the people living in the home had access to health care professionals such as G.Ps, district nurses, continence advisors and more specialist health care professionals such as occupational therapists. The people living in the home were able to make some choices in their day to day lives. Activities were available for them to take part in if they wished. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 7 There were no restrictions on visitors to the home unless individuals requested this. One visitor was spoken with during the inspection and he stated he was ‘always made welcome and staff are very friendly.’ He was very satisfied with the service received by his relative and stated the home was like a ‘five star hotel’. The menus in the home offered the people living there several choices at each meal. People could choose to have their main meal at lunchtime or teatime or both if they wished. Cultural and medical diets were catered for. The people living in the home that were spoken with indicated that they were satisfied with the meals served to them. The people living in the home were listened to and their views acted on. Staffing levels were appropriate for the needs of the people living in the home at the time. Some very positive comments were received about the staff team and the service offered at the home. These included: ‘The care and friendliness shown throughout his 3 week stay were excellent.’ ‘Lovely place and where else can you get such lovely people.’ ‘Could not ask for a better place.’ ‘I feel happy to talk to staff about any issues and comfortable.’ ‘I like it here and happy I came.’ The home provided the people living there with a high standard of accommodation. The manager of the home was very experienced in the running of a residential home and ensured the home was run in the best interests of the people living there. What has improved since the last inspection? What they could do better: To ensure the people living in the home received person centred care they needed to have care plans in place that detailed all their needs and how these were to be met by staff. Care plans from previous homes needed to be reviewed to ensure they reflected the current needs of the people living in the home. There needed to be risk assessments and management plans in place for all the identified risks in relation to the people living in the home. Risk assessments from previous homes needed to be reviewed to ensure they were still appropriate. This will ensure the people living in the home are safeguarded. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 8 Tissue viability and nutritional assessments needed to be undertaken for all the people living in the home. This will ensure any issues that need to be followed up or monitored are identified at an early stage and the people living in the home are safeguarded. When any of the people living in the home refused antibiotic medication the manager needed to ensure this was reported to the G.P. This will ensure the people living in the home are receiving the appropriate medical care. 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. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 9 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 The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There was adequate information available for people wanting to move into the home to help them decide if the home was suitable for them. The assessment procedure ensured the staff were aware of the needs of the people being admitted to the home. People could visit the home before admission to see if they liked it. EVIDENCE: There was a comprehensive service user guide for the home that was given to people who were considering whether the home was suitable for them. The document was available in a well laid out folder or in a more compact version. It included all the necessary information about the home and the facilities available to help people make a decision as to whether the home would be able to meet their needs. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 11 At the time of the inspection there were only eight people living in the home and all had been transferred from other Local Authority homes that were closing. The care for two of the people living in the home was looked at during this inspection and this included the pre admission assessment process. Both of the individuals’ files included evidence that extensive assessments had been undertaken prior to them moving into the home. These detailed all their needs and what they had said about how they wanted to be cared for. Social worker care plans were also evident on the files sampled. Staff at the home had access to all this information to ensure they were aware of the needs of the people living in the home. People were able to visit the home before moving in to see if they liked it. One of the files sampled included the details of two pre admission visits made by the individual who had moved into the home. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The care plans for the people living in the home were in the process of being fully developed to ensure they received person centred care. The people living in the home had management plans in place for the majority of their identified risks. The management of medicines in the home was generally good ensuring the people living in the home received their medicines as prescribed. EVIDENCE: The care files for two people that had been living in the home for six weeks were sampled. Clearly both were still being fully developed and were at different stages. Care plans at the home were entitled Individual Service Statements (ISS). Both of the individuals whose care was being looked at did have an ISS. One ISS had been only partially completed as staff were trying to involve the individual in the process and this was taking some time. The ISS included some detail of the person’s background, family contacts, leisure pursuits, likes, The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 13 dislikes and preferences. The person’s needs in relation to such things as hearing, sight, oral health, washing, dressing and communication were included and it did include some detail of how needs were to be met, for example, ‘I am able to hear if you are close.’ The ISS for this person identified that they were prone to falls and that staff should ensure they had their walking aid. Clearly from the amount of completed accident forms the individual was having numerous falls. A system had been put in place to monitor and oversee the frequency of the falls but this was not referred to in the ISS. All the falls sustained by the individual were being documented by the staff on a falls register with details of the time and the activity being undertaken, staff were also noting what had been done on each occasion to reduce the risk, for example, position of bed changed. We were told the individual had also been referred to the falls clinic and a review meeting was to be held to discuss the issue of the falls and other issues in relation to this person. We did not see any documentation in relation to this. Not all the information on the pre admission assessment had been collated onto the ISS but clearly some of the things that were important to the individual were being followed through. For example, the assessment stated that the newspapers that the individual carried around were very important to them and the person was seen with these during the inspection. The second care file included quite a comprehensive ISS but this had been completed at the previous residential home. It detailed the needs of the individual and was clear that the person had dementia and how this affected them. The ISS included the abilities and preferences of the person, for example, ‘will wash her own face hands and face, will choose her own clothes she wants to wear’ and ‘Staff should be aware she likes to wear full under slip she does like tights or stocking’. The ISS also detailed the needs in relation to such things as oral care and dietary needs. Although the ISS was quite comprehensive it had been drawn up in August 2008 and needed to be reviewed in light of the move to the current home to ensure it did not need updating. Both files sampled included some risk assessments however the majority of these had been undertaken at the previous home they had transferred from. Only one file included tissue viability and nutritional screenings. These needed to be in place for all the people living in the home to ensure they were not at risk in either of these areas. The manual handling risk assessments were quite comprehensive and included the details of any equipment to be used where necessary. Personal risk assessments were in place but again these had been put in place at the previous home. These included management plans for mobility and medication refusals. Both the people whose care was being looked at could have some challenging behaviours and could be verbally abusive. One of the pre admission assessments stated ‘can be resistant to care intervention and tell staff that he does not want to do the task. Staff need to The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 14 be patient with him and use humour.’ This was not included in the risk assessments or the ISS. Staff told us they were completing an incident log for the other individual when there was any challenging behaviour. Again there was no mention of this in the risk assessments or the ISS. The staff spoken with during the inspection were able to tell us about the needs of the people living in the home and how they managed any risks. However with new staff joining the team all the time and further people being admitted to the home it is important that the manager ensures that any existing ISSs and risk assessments are reviewed and updated as necessary. Any risks identified since moving to the home or not already detailed need to be documented with corresponding management plans. There was ample evidence that the people living in the home had access to health care professionals such as G.Ps, district nurses, continence advisors and more specialist health care professionals such as occupational therapists. Records also showed that where recommendations had been made these had been followed through. For example, the occupational therapist had recommended a toilet frame for one of the people living in the home and this had been fitted. The daily records for the people living in the home gave an overview of the care they received and how they spent their time. Staff were using a system of numbering certain personal care issues in the daily records and these could be cross referenced to a list that identified what the numbers meant. The manager explained this was to try and protect the dignity of the people involved when writing about very personal tasks. The medication system in the home was generally well managed. The people living in the home had individual secure cabinets in their bedrooms for their medication. Senior staff administered medication directly from these cabinets. It was recommended that the individual MAR (medication administration records) were kept in the cabinets with the medicines for ease of access for staff. At the time of the inspection they were all kept together in one folder. When the home has more people living there this system of every one having individual medication cabinets will need to be monitored to ensure it does not prolong the medication administration round too much. The medication for three of the people living in the home was audited. All medication was acknowledged when received into the home and signed for when administered. It was recommended that any hand written entries on Mar charts were verified and signed by two staff as being correct. One of the people living in the home often refused to take their medication and the G.P. had been consulted about this. Records showed that the G.P. had visited and spoken to the person concerned about the importance of taking medication but that they still often refused. A meeting was due to be held about this issue. It was noted that this person had been prescribed some antibiotics for an The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 15 infection. The individual had taken very few of these. The G.P. had not been contacted about this, which was important as the infection could have worsened, or there could have been an alternative treatment. There were no controlled drugs being administered in the home at the time of the inspection. There was a controlled drug register on site should this be needed in the future. No issues were raised in relation to the privacy of the people living in the home. All bedrooms were singly occupied and all had en-suite facilities that included a floor level shower. Staff told us the en-suite facilities made it much easier to promote the privacy and dignity of the people living in the home. All bedrooms were lockable and all had a lockable piece of furniture for keeping personal effects. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were able to make some choices in their day to day lives. Activities were available for them to take part in if they wished. There were extensive menus in the home with several choices available at each meal and medical and cultural diets could be catered for. The people living in the home indicated they were happy with the food served to them. EVIDENCE: Some of the staff surveys received prior to the inspection indicated there was little time to undertake activities with the people living in the home due to low staffing levels and the amount of paperwork they had to do. This view was not reflected on the day of the inspection. Staff spent a considerable amount of time with the people living in the home throughout the course of the inspection. Staff were seen undertaking one to one activities such as darts, card and board games as well as sitting talking to individuals. The staff spoken with thought staffing levels were appropriate for the needs of the people living in the home and were able to tell us about the activities they facilitated. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 17 Activity records were being completed by staff and these indicated that activities were available on a daily basis. These included such things as reminiscence, charades, playing cards, newspapers, sing a longs, sitting have 1 to 1 chats, dominoes and Christmas celebrations. Records did allow for staff comments as to how people had reacted to the activity. Most days more than one sheet was completed. Staff were not always including the names of the people taking part in the activity. It was strongly recommended this was done as not all activities were recorded on daily records and staff needed to monitor that it was not always the same people taking part and that everyone received staff time. We were told and the AQAA and service user guide detailed that all the people living in the home could use the facilities within the care centre which included a multi faith room, hairdressing room, gym and internet area. Daily records showed people had visitors at varying times. The service user guide for the home details that people living in the home will be supported to maintain contacts with families and friends and that there will be no restrictions on visitors unless individuals request this. One visitor was spoken with and he stated he was ‘always made welcome and staff are very friendly.’ He was very satisfied with the service received by his relative and stated the home was like a ‘five star hotel’. People living in the home were encouraged to make decisions and choices about their daily lives. For example, when to go to bed and get up, what to wear, what to eat and how they spent their time. The ISSs detailed where people were able to make choices for themselves, for example, ‘is able to choose her own clothes’. Where people were not able to specify this on an ongoing basis their likes, dislikes and preferences were generally detailed in their ISSs. There was a four weekly menu in the home. There were extensive choices on the menus and the staff were seen going around and asking people to choose what they would like to eat. The people living in the home that were spoken with indicated that they were satisfied with the meals served to them. The menu indicated that cultural diets could be catered for. The records of food eaten by the people living in the home indicated that they did choose different items from the menu and that diabetic diets were catered for. Staff spoken with told us there were no issues with food and that the meals were of good quality and there were ample amounts. We were also told that as dishes were cooked photographs were being taken so that these could be used to help people to make choices. The staffing arrangements in the kitchen allowed for the people living in the home to have a cooked meal at lunchtime or in the evening or both if they wished. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living in the home were listened to and their views acted on. There were appropriate systems and procedures in place to ensure the people living in the home were safeguarded. EVIDENCE: The AQAA for the home detailed ‘service users and customers are given information about their rights to complain, service user guide clearly outlines this process and information of how to contact CSCI or other relevant agencies.’ The service user guide, which was available in large print, was seen and clearly detailed how the people living in the home or their representatives could raise any issues both at an informal and formal level. Staff spoken with during the inspection told us how important is was to always listen to what the people living in the home say. Staff surveys clearly indicated that they knew what to do should one of the people living in the home raise any concerns. Comments included: ‘The Kenrick Centre has time and will always listen to what is being said and offer support to those in need where it is possible.’ ‘Listen carefully try and alleviate the situation and guide them about and on complaint procedures and assist them if necessary on the complaint forms or refer them to senior members of staff.’ ‘Any concerns are dealt with immediately.’ The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 19 The home were logging any complaints made to them. There had been two complaints raised by the people living in the home about the temperatures in their bedrooms as they felt it was cold. The manager stated this had been resolved by increasing the heating. The complaint records did not allow for the outcome of any complaint to be entered. This was to be addressed by adding another column to the form. It was known that the Local Authority has robust procedures for the safeguarding of vulnerable adults therefore these were not inspected at this visit. The home had not had any safeguarding issues raised with them. The AQAA stated ‘we ensure the safeguarding of vulnerable adults by a robust knowledge of all relevant legislation and ensuring staff awareness through supervision and training.’ As the training matrix had not been drawn up for the home it was not possible to ascertain how many staff had undertaken training in issues related to adult protection. We were given the list of planned training for the year and adult protection was not one of the topics covered. It was strongly recommended that the manager checks to ensure all staff have received the appropriate training in this topic. The recruitment procedure in the home is that of the Local Authority and this is known to be robust. There were appropriate systems in place in the home for the safekeeping of money deposited by the people living in the home or their representatives. No complaints or adult protection issues had been raised with us since the home opened. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the people living there with a high standard of accommodation. Further improvements could be made to ensure the environment is more homely. EVIDENCE: The care home was registered in July 2008. It is a new building and therefore meets all the requirements of the National Minimum Standards. At the time of this inspection only the ground floor was toured as this was the only part of the home occupied. The residential accommodation was divided into four units of eight bedrooms. Each of the units had their own dining areas and there were four lounge areas. One of the lounge areas was the designated smoking area for the people living The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 21 in the home. Furnishings and fittings were of a good standard however the home lacked such things as pictures and ornaments to give it a more homely feel. This was discussed with the registered manager and centre manager and they were in the process of purchasing some pictures for the home. One of the people living in the home who was spoken with was waiting to have pictures put on the walls in their bedroom but there had been some issues with the walls not being very strong and with the location of wiring. The manager was addressing this. The Home had its own reception area which also had some comfortable seating. One of the people living in the home chose to sit here most of the time. They told us they like to sit away from the other people and watch what is going on. The people living in the home had access to very well laid out landscaped gardens. The garden included seating areas and a water feature. All communal areas and bedrooms looked out onto the garden and several also looked out over the park located to the rear and side of the home. All the bedrooms had en-suite facilities of toilet, wash hand basin and floor level showers. The home also had fully assisted bathrooms for those who preferred to have a bath. The assisted bathrooms were fully equipped however this made them quite clinical and efforts should be made to make them more homely and domestic in appearance. The home had a variety of aids and adaptations including, hand and grab rails, assisted bathing facilities, free standing hoists and corridors were wide and accessible to people in wheelchairs. It was recommended that additional signage indicating where facilities are may be beneficial for the people living in the home who have dementia. There was an emergency call system in the home. The system allowed staff to speak to the people living in the home and vice versa. There had been some issues with the call system and it had broken down for a period of time. It was pleasing to note that when this happened individual risk assessments had been undertaken for each of the people living in the home. The risk assessments indicated to staff how often the whereabouts of individuals were to be checked during the day and night. Checks were recorded throughout the period the call system was not functioning and were dependent on the vulnerability of the individuals. It was noted that the call points in the bedrooms were static meaning that if someone’s bed was moved they did not have access to the call system. This was discussed with the manager. Extension cords were available but these were sometimes not accessible. The manager stated that if this was the case a risk assessment had been undertaken to ensure the individual was safe. The centre manager informed us that there were wristbands that incorporated a call button that could be purchased for the system in place. It was strongly recommended that some of these were made available. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 22 Several bedrooms were seen during the inspection. All were large enough to accommodate some personal furnishings if the occupants wanted some of their personal effects. One of the people living in the home had taken some of her furniture into the home. She told us she liked her room ‘very much’. As stated all bedrooms had en-suite facilities that included a floor level shower. Furniture provided by the home were a good quality and included a wardrobe with see through panels, dressing table with drawers that could be sat at and a bedside cupboard. All bedrooms included a lockable facility. The people living in the home could lock their bedrooms doors if they wished. The home was warm and the lighting was appropriate for the needs of the people living in the home. All areas were clean and odour free. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs of the people living in the home were known by the staff and were met by sufficient numbers of staff who had the relevant training. EVIDENCE: Some of the staff surveys indicated staffing levels were low. This was not reflected on the day of the inspection or the staffing rotas that were seen. There were only 8 people living in the home and staffing levels throughout the day varied between 3 and 6 with at least one senior member of staff in addition to this. During the night there were 3 staff members on duty one of whom was senior. There were also catering, domestic and laundry staff employed at the home. Staff spoken with during the course of the inspection indicated that staffing levels were adequate and that they had time to facilitate activities or just sit and have a chat with the people living in the home. There were good relationships evident between the people living in the home and the staff and manager. Some of the compliments received by the home and comments received by us showed that people thought the service offered by the staff was good. These included: ‘The care and friendliness shown throughout his 3 week stay were excellent.’ The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 24 ‘Lovely place and where else can you get such lovely people.’ ‘Could not ask for a better place.’ ‘I feel happy to talk to staff about any issues and comfortable.’ ‘I like it here and happy I came.’ The responses on the staff surveys also varied considerably in relation to staff training. Some saying they had plenty of training others saying they felt they needed more training. Comments included: ‘Did various training, in house training and team development e.g. dementia, person centred care.’ ‘Need more training for staff, training on confidentiality.’ ‘Did not get the full training programme.’ Staff told us they worked well together as a team. Staff spoken with during the inspection were very satisfied with the training they had received and told us about their induction training before the centre opened. This included team building, dementia care, manual handling and health and safety. The manager also told us the induction training had included such topics as equality and diversity, understanding the role of the direct care worker and managing change. It could not be ascertained what staff had undertaken what training as the manager had not drawn up a training matrix for the home but from the discussions throughout the inspection it appeared staff had the relevant training to care for the people living in the home. We were given a list of the training planned for the next year which indicated there would be some training every month. Topics included diabetes, dealing with aggression, social activities, person centred care, fire training and understanding learning difficulties. The AQAA sent to us prior to the inspection indicated that the home had twenty one staff and fourteen of these had NVQ 2 or the equivalent which is above the required fifty percent. Staff spoken with were able to tell us about the needs of the people living in the home and how these were met. They told us to find about the people living in the home when being admitted they read the information on their files and talked to them. All the staff employed at the home had transferred from other Local Authority homes. We were told they had been interviewed for their posts and references had been obtained. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 25 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and in the best interests of the people living there. EVIDENCE: The home has two registered managers however only one of these was carrying out the manager’s role at the time of the inspection. The other registered manager had been employed to manage an interim care unit on the first floor of the centre but this had not been set up. At the time of the inspection she was undertaking some project work. We were told that it is anticipated that the PCT will eventually occupy the first floor. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 26 We spoke with the registered manager and the centre manager, who supports the registered manager. Both are very experienced in the running of residential homes and appropriately qualified. During discussions with the registered manager it was evident he had a good knowledge of the people living in the home. Staff spoken with described the manager as ‘very good’ and ‘approachable.’ There was a quality monitoring system in the home which was quite extensive and audited the service over seven outcome areas that looked at all the National Minimum Standards. As the home had only been open for a short time and occupancy being low this was very much in the early stages. The manager told us that the system involved satisfaction surveys being sent out every three months and that by the end of the year a development plan would be drawn up to further improve the service. There was a system in place for the safekeeping of money on behalf of the people living in the home if they wished to use it. The records for this were sampled and found to be appropriate. All income and expenditure were recorded and receipts were available for all purchases. It was evident from the records that the system was regularly audited. At the time of this inspection there was no safe in the manager’s office on the residential unit but one was on order. Staff did have the use of a safe in the general office in the care centre. The health and safety of the people living in the home were well managed. There were records of a variety of health and safety checks including fire alarms, fire extinguishers, emergency exits and water temperatures. There were no records of any checks on the emergency lighting in the home. We were told this was a computerised system but they did not know how to get a printed record off the system. The system could be checked by checking all the bulbs and the home had its own generator therefore this should not be an issue. The manager needed to pursue this to ensure there were some records for the checking of the emergency lighting system as this is required by the fire service. Fire drills were being undertaken regularly and we were told all staff had up to date fire training. Accident and incident records were sampled and found to be appropriate. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 27 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 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 3 3 3 2 3 3 3 3 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 3 X 3 X 3 X 3 3 The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 28 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 OP7 Regulation 15(1) Requirement All the people living in the home must have care plans that detail all their needs and how these are to be met by staff. Care plans from previous placements must be reviewed to ensure they reflect the current needs of the people living in the home. This will ensure the people living in the home receive person centred care. There must be risk assessments and management plans in place for all identified risks in relation to the people living in the home. Risk assessments from previous placements must be reviewed. This will ensure the people living in the home and the staff are safeguarded. Tissue viability and nutritional assessments must be undertaken for all the people living in the home. DS0000072114.V373633.R01.S.doc Timescale for action 28/02/09 2. OP8 13(4)(c) 28/02/09 3. OP8 13(4)(c) 28/02/09 The Kenrick Centre Version 5.2 Page 29 4. OP9 13(2) This will ensure any issues that need to be followed up or monitored are identified at an early stage and the people living in the home are safeguarded. When any of the people living in the home refuse antibiotic medication this must be reported to the G.P. This will ensure the people living in the home are receiving the appropriate medical care. 06/02/09 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. 3. 4. Refer to Standard OP9 OP9 OP9 OP12 Good Practice Recommendations It is recommended that the individual MAR charts are kept with the medication in the bedrooms of the people living in the home. The system of every one having individual medication cabinets will need to be monitored to ensure it does not prolong the medication administration round too much. It is recommended that any hand written entries on MAR charts are verified and signed by two staff as being correct. It is strongly recommended the names of the people taking part in activities are recorded on activity sheets. This will ensure staff are able to monitor that if the same people are always taking part and that everyone receives staff time. Complaint records should include details of the outcome of the complaint so that it can be evidenced that complaints have been managed appropriately. The environment could be further improved and made more homely with the addition of some pictures and redecoration of the bathrooms. It is strongly recommended that some wristbands that incorporate a call button are made available so that all the people living in the home have access to the emergency DS0000072114.V373633.R01.S.doc Version 5.2 Page 30 5. 6. 7. OP16 OP19 OP22 The Kenrick Centre 8. 9. OP22 OP30 10. OP38 call system when in bed. It is recommended that additional signage indicating where facilities are is considered as this may be beneficial for the people living in the home who have dementia. A staff training matrix should be drawn up showing what training staff have had and when this is due to be updated. A copy of this should be forwarded to the Commission. This will show that staff have had all the required training to fulfil their roles. Records should be kept of the checks made to ensure the emergency lighting in the home is functioning efficiently. The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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. Extracts may not be used or reproduced without the express permission of CSCI The Kenrick Centre DS0000072114.V373633.R01.S.doc Version 5.2 Page 32 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!