Inspection on 23/01/06 for The Kensington Nursing Home

This inspection was carried out on 23rd January 2006.

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

The Kensington Nursing Home 05/09/08

The Kensington Nursing Home 02/02/07

The Kensington Nursing Home 14/11/05

The Kensington Nursing Home 08/11/04

The Kensington Nursing Home 11/08/04

The Kensington Nursing Home 03/02/04

Similar services:

Ashlong House

Spring Lane Care Home

Avenues (The) (Neave Crescent)

Barrington Lodge Nursing Home

Beacon House Nursing Home

St Mary`s Convent & Nursing Home

1-3 Frederick Gardens

The Royal Star and Garter Home

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

CARE HOMES FOR OLDER PEOPLE The Kensington Nursing Home 40-42 Ladbroke Road London W11 3PH Lead Inspector Sheila Lycholit Unannounced Inspection 23rd January 2006 10:40 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.V274196.R01.S.doc Version 5.1 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.V274196.R01.S.doc Version 5.1 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 Goldsborough Limited 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.V274196.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th November 2005 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, each managed by a senior Nurse. There are attractive, well maintained gardens to the rear of the building. The home, which is operated by BUPA, is located in Notting Hill, close to the tube, shops and services. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place from 10.40AM until 3.40PM on Monday 23rd January 2006. The Manager and Deputy Manager were on duty and made themselves available throughout the day. The Inspector met with the Manager, Deputy Manager and Training Co-ordinator and with 4 residents. There were 51 residents, with 1 resident away for a few days and one vacant place. The visit included a tour of the building with the Deputy Manager. What the service does well: 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 contacting your local CSCI office. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 6 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.V274196.R01.S.doc Version 5.1 Page 7 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): 1, 2, 3, 5. The Statement of Purpose and Service User’s Guide are well-written and provide comprehensive information about the home and the services available. There is a well-established assessment and admissions procedure. EVIDENCE: The Statement of Purpose and Service User’s Guide are comprehensive and clearly written. All residents are provided with a contract, which includes a breakdown of the fees. All prospective residents are visited at home or in hospital by a senior member of staff – normally the Deputy Manager, who undertakes an assessment. In discussion the Deputy Manager explained that where there is any delay between her assessment visit and the person’s admission, she undertakes a second visit to ensure that the home is still able to meet the person’s needs. As the majority of residents are self-funding a needs assessment by a Care Manager is not usually available. The home’s preadmission assessment is recorded using a pro-forma. Completed copies were seen on individual files. Visits to the home by prospective residents and their families are encouraged. One family was looking around the home on the day of the inspection. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 8 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 10 There are comprehensive care planning systems in place. Steps need to be taken to ensure that all staff adopt a consistent approach. Good relationships with health care and other professional colleagues have been established. An ethos of treating residents with respect, listening to their views and respecting their privacy is well-established. EVIDENCE: Six individual files were looked at. All were in good order and included copies of assessments, care plans and risk assessments, as well as daily notes. Some care plans were of a high standard and had been regularly reviewed and updated. Other care plans and risk assessments seen had not been updated or consistently implemented. For example one resident who had been initially identified as being at risk of falling and had suffered a number of falls had not been re-assessed nor had the risk assessment in relation to falls been updated or reviewed. Two residents whose care plan stated that their weight was to be checked weekly were weighed infrequently. Not all care plans had been signed by the resident or next of kin. The Deputy Manager undertook to monitor care planning on the unit where an inconsistent approach was identified. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 9 Records show that health care is given a high priority, with prompt referrals made to GPs, Speech and Language Therapists and other health care professionals. Staff were observed to treat residents with courtesy and respect. Although the home has a policy of staff not using their mobile phones on duty, one member of staff was using a mobile phone in a resident’s room. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Steps are taken to support service users to maintain their interests, including a varied programme of regular activities. Good links have been established with the local community and the number of visitors to service users is high. The home provides an excellent standard of catering. EVIDENCE: Two Activities Co-ordinators are employed to offer a varied programme. Staff ratios are sufficiently high to allow residents to be accompanied on outings and to support individual interests. A record of activities attended was available in each of the individual files seen, showing that each person had taken part in a number of sessions. Photos of activities and events are displayed in the home and in an album. People in the local community are invited to events such as the summer garden parties. The home has a number of volunteers who visit regularly. ‘Patting dogs’ visit weekly and are enjoyed by a number of residents. The visitors’ book, observation and discussion with residents shows that the number of visitors, in particular family and friends is high. Routines in the home are flexible, with residents choosing when to get up and when to go to bed. As far as possible, with 53 people to be served, mealtimes are also flexible and menus offer an excellent choice. Staff were seen to be assisting residents in the conservatory at lunchtime, sitting next to people who needed support to eat. Residents confirmed that The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 11 they can choose where to have their meals, including in their rooms. Cereals and snacks are available in the pantries in each unit. One resident mentioned that she particularly enjoyed having her meal in one of the smaller dining areas with a fellow resident whose company she enjoyed. ‘Soft’ food was seen to be well presented. Staff were observed to encourage residents to maintain their fluid intake by regularly supplying drinks, including fruit juice and water. Files indicate that action is taken if a resident has problems in eating solid food, including prompt referral to the Speech and Language Therapy Team. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 12 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 and 18 The home has an established complaints procedure. Complaints receive a prompt response from the Manager and her Operations Manager. A high priority is given to adult protection, with staff receiving regular training. EVIDENCE: Information about making a complaint is provided in the Service User’s Guide. One complaint has been received since the last inspection in November 2005. The complaint’s file and discussion with the Manager showed that the complaint had been dealt with straightaway and as far as possible, given the nature of the complaint, issues had been resolved. There have been no adult protection concerns since the last inspection. A monthly protection of vulnerable adults workshop is held for staff. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 The building is well maintained and attractively furnished and decorated. The gardens are accessible and designed for residents to enjoy, with raised flowerbeds and a sensory garden. Residents have a choice of communal areas, including a newly established library. Residents’ bedrooms are individualised with a wide range of personal possessions. Standards of hygiene and cleanliness are high. EVIDENCE: The building, which is over 3 floors, has been well adapted and extended to provide an attractive and accessible environment. All bedrooms are single with an en suite lavatory and washbasin. The standard of décor and maintenance is high. The handyman was decorating 2 of the bedrooms at the time of the inspection. One of the rooms being re-decorated was used by a resident who smokes. The Inspector had raised concerns about other residents being affected by cigarette smoke at the previous inspection. While no extractor fan had been installed, there was no smell of cigarette smoke at all. The Deputy The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 14 Manager said that the resident was complying with requests to ensure that her door was kept closed. Each floor has a number of communal areas, including a dining room and sitting room. Sitting rooms are comfortably furnished and two have tropical fish in tanks. A library/reading room has been created on the ground floor, which contains a variety of books, including some with large print. Good lighting has been provided for readers. Individual bedrooms showed that residents bring a number of their personal possessions with them and rooms are personalised with family photos, paintings, books, CDs and a variety of memorabilia. General risks assessments are in place. A new system of risk assessments has recently been introduced. On the day of the unannounced visit all areas of the home seen were clean, tidy and in good order. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 and 30 The home’s staffing levels are good, allowing for personalised care. All staff have access to an excellent training programme, related to the changing needs of residents and to planned developments in the service. EVIDENCE: Each unit has 2 registered nurses and 4 care staff on each shift. In addition there are housekeeping, catering and administrative staff. The home has a good record of retaining staff and turnover is low, particularly for central London. The home recruits its own staff, with interviews normally carried out by the Manager and Deputy Manager. All recruitment checks are undertaken by the home. Personnel files were not checked at this visit. There is a high commitment to achieving a trained workforce, with all staff having access to accredited training. Discussion with the Manager and Training Co-ordinator shows that 90 of non-nursing staff have achieved or are enrolled on NVQ2 or 3. Domestic staff undertake a NVQ2 in housekeeping. Staff who have achieved or are undertaking NVQ3 attend a medication course, so that they are more informed when assisting nursing staff with medication. New staff complete the home’s own induction and the Skills for Care Induction and Foundation modules. Each new member of staff, including nursing staff, has a mentor until induction is complete. The Manager signs off the induction record. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 16 Staff undertaking training have the support of the Training Co-ordinator and access to learning resources including the internet. Links have been made with other services to provide training. For example Nurses and Senior Carers have attended a 5 day course in palliative care at a London hospice and staff attend workshops at the City University, which has student nursing placements at the home. One member of the nursing staff is completing a degree in dementia studies. The course is sponsored by BUPA and the Alzheimer’s Society. The Training Co-ordinator receives information on training needs identified in supervision and appraisal and in day to day practice from the senior staff and at the Heads of Department meetings which she attends. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 17 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): 31, 32, 33, 37 and 38 The Manager and Deputy Manager seek to ensure that the home is well run. An ethos of continuous improvement and service development has been established. EVIDENCE: The Manager is a Registered Nurse, who has a NVQ4 in Care Management. Both the Manager and Deputy Manager ensure that they are accessible to residents and to staff. A weekly Heads of Department meeting takes place, which is attended by the Training Co-ordinator. Discussion with senior staff shows that they seek ways to improve the service to residents, for example the purchase of serving dishes to move away from food being plated up and to give more choice is planned, together with further changes to the dining room/conservatory. Regular surveys of residents’ views are carried out. Generally records seen were up to date and in good order. All staff receive regular training in health and safety, including fire safety. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 18 The premises are kept secure, with access via an entry phone. CCTV monitors the entrance area. Cleaning materials are kept in a locked cupboard or a locked box on the cleaning trolley. Fire safety records showed that 2 fire drills had been held in November 2005, one of which was for night staff. The home’s policy is to hold 4 drills a year. A record of only one other drill, which took place in February, could be found. The home has since changed to a different recording system with all fire records kept in one book. Records show that the fire detection system and firefighting equipment are regularly serviced and maintained. Accidents are carefully recorded. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 19 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 3 3 x 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x x 3 3 The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 20 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 7 Regulation 15 Requirement Steps must be taken to ensure a consistent approach to care planning on all units. Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 7 Good Practice Recommendations Staff should be reminded of the home’s policy regarding mobile phones. The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hammersmith Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 The Kensington Nursing Home DS0000026016.V274196.R01.S.doc Version 5.1 Page 22 - 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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