Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 02/02/07 for The Kensington Nursing Home

Also see our care home review for The Kensington Nursing Home for more information

This inspection was carried out on 2nd February 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a very good person centred service that meets residents` needs in a friendly, caring and professional way through the dedicated work of the staff team.

What has improved since the last inspection?

The requirement made at the previous inspection was met.

What the care home could do better:

The home may consider changing some of the ensuite facilities from baths to showers to further meet residents wishes and needs more efficiently.

CARE HOMES FOR OLDER PEOPLE The Kensington Nursing Home 40-42 Ladbroke Road London W11 3PH Lead Inspector Wynne Price-Rees Unannounced Inspection 2nd February 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Kensington Nursing Home DS0000026016.V329569.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 Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Kensington Nursing Home Address 40-42 Ladbroke Road London W11 3PH 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 7727 8033 020 7727 9712 smallcupa.com www.bupa.co.uk BUPA Care Homes (GL) Ltd Mrs Christine Small Care Home 53 Category(ies) of Dementia (16), Physical disability (34), registration, with number Terminally ill (3) of places The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: The Kensington Nursing home provides 53 places for people needing residential and nursing care, including 3 places for people needing palliative care. The building comprises of 3 stories, to which there is lift access. All bedrooms are single rooms with en suite facilities. There are various communal rooms, including a pleasant dining room and conservatory on the ground floor, a newly established library and smaller dining and sitting rooms on each floor. The home operates as 3 units, on separate floors, each managed by a senior Nurse. The home has attractive, well-maintained gardens to the rear of the building. It is owned and operated by BUPA and located in Notting Hill, close to the tube, shops and services. There are currently fifty-two residents. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over three days, during which twelve residents’, two visitors and a number of staff and relatives were spoken with. The Care Manager was on leave during the inspection and the home was found to function very efficiently during their absence. What the service does well: What has improved since the last inspection? What they could do better: The home may consider changing some of the ensuite facilities from baths to showers to further meet residents wishes and needs more efficiently. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 6 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 Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of nine resident’ files were case tracked, that received heavy, medium and light care and it was found each contained a thorough assessment that followed the written assessment policy and procedure. These met the criteria of the standard and were carried out prior to a resident entering the home. The Head of Care or duty nurse has responsibility for completing the assessments during home or hospital visits, as appropriate and are qualified to do so. The visits are also used to discuss needs and wishes with prospective clients to further ascertain if they can be met and provide information about the home. Written service-user handbooks are also provided. Where appropriate relatives are also invited to participate in the assessment process The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 9 and this further provides background information and history in respect of the prospective client. Full handover information is given to staff if it is identified that needs can be met and the resident wishes to move to the home. The home tries to balance dependency level on each floor to provide good service continuity and workload levels for staff. There is a three-month trial period and the home gives one month’s notice of placement termination whilst residents’ are required to give two weeks. The home does not provide an emergency respite service; admissions take place before 7.00pm to reduce disruption levels for the other residents and respite care is subject to the same assessment process as long-term care. Many of the respite care residents are repeat visitors and therefore familiar with the staff team and daily home routines. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were checked as part of the tracking process and it was found that those in place were underpinned by the assessment information and enabled by risk assessments. These are written by the named nurse and checked by the Head of Care. They contain problem, aim, intervention and evaluation when needs change. There are monthly written reviews that are fed by daily notes. A named nurse at the end of each shift signs them off. Whilst meeting the standards some of the daily entries were prescriptive of a resident’s day rather than needs identified within the numbered care plans and monthly reviews one line that didn’t give much clear information. The home is aware of this and a new person centred care plan system becomes operational in March 2007. The format was shown to the Inspector and has identified and targeted the areas that could be improved on. “Problems” are replaced by “needs” and the new system has a far more positive emphasis and balances health care and The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 11 provision for good quality of life through pursuit of individual interests. Having said this, the residents interviewed stated that they enjoyed living at the home due to interest shown and friendly, approachable and caring attitude of staff. The residents’ health care needs were fully documented within the care plans and records and observation of care practice showed they were fully met. A GP is retained for thirty residents’ whilst twenty-three have opted to keep their own or use two other associated practices. There is a medication administration policy and procedure that staff confirmed they are aware of and are trained in. The records for all residents were checked and standard met although the recording clarity varied depending on the floor. The Head of Care was made aware of this, on the first inspection day and this was appropriately addressed when the records were revisited on the last inspection day. The home has a policy and procedure regarding a resident’s right to privacy and dignity that is updated annually, included as part of core induction training, re-visited two monthly during staff meetings and as part of supervision. It is also included in the resident and staff handbook and residents’ also have the facility to install private phone lines. The residents’ felt their privacy and dignity was upheld, recognised and this was confirmed by care practices observed. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents spoken with felt there was a good level of varied activities available to them that they can participate in if they wish. There were a number of notice boards that detailed the weekly changing activities available that are run by the activities co-ordinator. The co-ordinator has one to one conversations with residents’ where individual preference is identified and offered if possible. Relatives are also asked. The activities included theatre and cinema visits to Notting Hill Gate where the home has an agreement and up to eight residents can be accommodated at a time if one week’s notice is given. Shopping trips are available as required and the Whiteleys Centre is quite popular. Visits take place from the Children’s Ballet, Fulham Big Band and a three-piece wind ensemble. Major days such as Valentines and St George’s Day are celebrated and preparation for Valentines Day was taking place during the inspection. Pat a dog visits take place and there are a number of regular The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 13 in-house activities such as light exercise, coffee mornings, what the papers say and poetry readings. There are photographs of staff members on each floor for easier resident identification. Two volunteer visitors attend the home who have been CRB cleared. The home has a written visitors policy and a number of relatives visited residents, at different times, during the inspection. Right to choice and autonomy are contained in the organisational mission statement included in core induction training and the resident and staff handbooks. The residents’ spoken with confirmed they choose what they want to do particularly within the context of activities and are free to come and go as they wish. Wherever practicable residents bring their own possessions to make rooms more homely. The home provides two main meals per day with alternative options available and residents are asked their preference the evening before. The meals observed were well presented and hot with ample portion sizes. One resident said that they were actually too big. The residents felt the food was generally very good, although some felt it can be a little bland sometimes and unadventurous. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a written complaints policy and procedure that is available in the residents’ handbook and sited around the building including the entrance hall. Complaints are part of staff induction training included in the handbook and contain a whistle-blowing procedure. Complaints are responded to within seven days and logged and recorded with outcomes. They are monitored monthly by the Operations Manager to identify any emerging themes and patterns as part of quality assurance. Five complaints were logged over the previous twelve months all of which were resolved. Residents spoken too said they knew how to complain, who to and would feel comfortable doing so. Generally they felt most difficulties are resolved by staff on duty without necessary reference to the procedure. There is a policy and procedure regarding protection from abuse that staff confirmed they were aware of, trained in and operate if necessary. They were fully aware of what constitutes different forms of abuse. In-house POVA training takes place bi-monthly. There were eleven entries documented in the accident and incident book for the previous twelve months. The home does not currently hold appointeeship for any residents and this responsibility is maintained by relatives or legal guardians. Personal allowances are held in a bank account, on behalf of residents and they receive interest. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 15 Any transactions are fully documented including deposit, withdrawal, balance and receipts. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 16 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 & 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is suitable for stated purpose. Each bedroom is equipped with an ensuite. It was noted that all ensuites had a bath rather than shower and depending on individual needs and preference the organisation may wish to consider replacing some of the baths with showers as they are not being fully utilised. The home was secure, safe and well decorated throughout. There is a CCTV camera sighted at the front door with monitors on each floor so that staff are aware who is there. Each floor has a lounge and quiet area where residents can relax and two very well maintained garden areas one of which has a sensory area. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 17 The building complies with local fire service requirements and the fire fighting equipment is checked and serviced annually. Staff have received fire training, the alarm system is tested weekly and records kept. The last visit from the fire brigade took place in July 2006 and they were happy with the arrangements in place. Hot water temperatures are also regularly tested and comply with the standards. There is also a rolling maintenance programme in place. The home was clean, tidy, well maintained and odour free. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 18 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 & 30.Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota runs monthly and currently 80 of care staff have attained NVQ level 2 and one NVQ level 3 care worker works on each morning. The rota showed that there were suitable numbers of trained staff, on duty, at all times to meet residents’ needs. This was confirmed by residents’ interviewed. Currently there is one vacancy of 30 hours for a care assistant and interviews have taken place to fill the post. There are separate rotas for each floor as well as for housekeeping and kitchen staff. The care staff to resident ratio is approximately one to five. There is a thorough recruitment policy and procedure that meets the standard and a sample of records showed is followed. New staff receive induction training and a rolling training programme is in operation that is co-ordinated by an onsite trainer. English lessons are also available for those whose first language is not English. Training needs are identified as part of one to one supervision sessions, staff meetings and issues arising from staff handovers. Annual appraisals also take place. The residents spoken with had a lot of praise for the staff team who they found friendly, approachable and obliging whilst remaining competent and professional. This The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 19 was confirmed by the care practices observed by the Inspector during the inspection. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 20 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 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Although the Care Manager was on leave during the inspection; records, care practice observation and conversations with residents’ demonstrated that the home ran very well in their absence due to the competence of the staff team and Head of Care. The Care Manager has been in post for two years and met the CSCI registration criteria. They have NVQ level 4 in management and care. There are external lines of accountability that are contained in the organisation’s quality assurance system and underpinned by scrutiny visits carried out monthly by external managers. These are forwarded to the local CSCI office. The QA system contains performance indicators and trigger levels The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 21 that are frequently reviewed. The organisation reviews policies and procedures annually. Resident and relative feedback is obtained through two monthly resident meetings that take place on the last Tuesday in the cycle and Bi-annual surveys and questionnaires. The home is not an appointee or have power or enduring power of attorney for any residents. These rolls are carried out by relatives or legal representatives. Home representatives are not permitted to sign wills. One resident has a living will. The home has four health and safety representatives with one lead and one is always on duty during the day. Regular health and safety meetings take place with the next one due the Monday after the inspection. Observation showed that safe working practices are followed and any accidents or injuries are recorded. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 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 X 3 The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP21 Good Practice Recommendations The organisation may wish to consider replacing some of the ensuite baths with showers. The Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Kensington Nursing Home DS0000026016.V329569.R01.S.doc Version 5.2 Page 25 - 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!