CARE HOMES FOR OLDER PEOPLE
The Kingfisher Care Home 10 Crossways Cleveleys Lancashire FY5 1LA Lead Inspector
Mrs Marie Cordingley Unannounced Inspection 17th March 2008 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 Kingfisher Care Home DS0000070643.V351605.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 Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service The Kingfisher Care Home Address 10 Crossways Cleveleys Lancashire FY5 1LA 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) 01253 853136 wylie@thorntoncare.com Mrs Lindsay Margaret Wylie Mrs Julia Lesley Tilley Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places The Kingfisher Care Home DS0000070643.V351605.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 people of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of people who can be accommodated is 20 Date of last inspection N/A Brief Description of the Service: The Kingfisher Care Home is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 20 older people. The home is located in a residential area of Cleveleys, within easy reach of local transport services, a variety of shops and leisure facilities and the sea front. It is a detached property with pleasant gardens that are accessible to residents. Accommodation is provided in fourteen single bedrooms and three double bedrooms. Three of the single rooms have en-suite facilities. The bedrooms are situated on the ground and first floors. First floor bedrooms are accessed by two stair lifts. There are two lounges, a conservatory and a dining room. Care is provided on a 24 hour basis including waking watch care throughout the night. The current range of fees are from £320.50 to £360.00 per week. All the above information and more can be obtained on request from the home. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The quality rating of this service is 1 star. This means that people using this service experience adequate quality outcomes.
The inspection of this home included a site visit which was carried out over one day. This visit was unannounced meaning that the manager, staff and residents did not know it would be taking place until the inspector arrived. During the visit we spent time talking with residents, staff, the registered manager and the owner of the home. In addition, we viewed a variety of paperwork including a selection of residents’ care plans and staff training records. We also carried out a tour of the home viewing residents’ bedrooms and communal areas. As part of the inspection we carried out a case tracking exercise, which involved us looking closely at the care provided to selected residents from the point of their admission to the home. Prior to our visit, we wrote to the registered manager and asked her to fill in a very detailed self assessment questionnaire. This questionnaire provided us with a lot of information about the home and its management, and was returned to us within agreed timescales. We also wrote to a selection of residents, their relatives and staff members and asked them to take part in a written survey. As part of the survey, people were asked to share their opinions about various aspects of the service provided. We received a number of completed surveys. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 6 What the service does well:
We received a good response to our written survey and a number of people returned completed questionnaires to us. Everyone who took part in our survey expressed satisfaction with the service and some people made very positive comments. These included; ‘The people here are very kind to me.’ ‘Staff are very helpful, kindly and supportive.’ ‘I am very pleased with the standard of care and the kindness and efficiency of staff.’ We consulted a number of people during our visit and again received very positive feedback about the home, its manager and staff. One relative told us ‘’I feel very confident in the staff here, they are all lovely with the residents.’’ We observed carers throughout the day and noted that they went about their duties in a cheerful manner. Carers and residents clearly got along well together and their interaction was pleasant and lively. Residents appeared comfortable and relaxed in their surroundings. The home ensures that people expressing interest in moving there are provided with enough information to help them make their decision. This information is made available in a number of formats to ensure that everyone has equal access to it. In addition, we were able to confirm that people are encouraged to visit the home prior to making their decision, so that they can meet staff, residents and have a look around. People living at the Kingfisher are provided with a number of opportunities to take part in activities both inside and outside the home. Activities coordinators are employed solely for this purpose and a generous budget is provided to facilitate activities. Efforts are made to support people to maintain contact with their friends and families and the owner of the home attempts to create a number of opportunities for residents’ families to be involved in their loved ones’ care (where appropriate) and the general running of the home. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 7 We received very positive feedback from residents and their relatives about the standard of food at the home. Everyone who talked about meal provision expressed their satisfaction in this area. One relative told us ‘’My mother often talks about how good the meals are.’’ We were also able to confirm that every effort is made to meet residents’ individual preferences when planning meals and snacks. One resident writes a list out every week for the manager, of things she would like adding to the home’s grocery shopping list. We spoke with several staff members who demonstrated a good understanding of their role and clearly had the best interests of residents at heart. Staff told us that they felt well supported by the manager and the owner of the home and also felt that they received a good standard of training to help them carry out their roles. The level of qualified staff at the Kingfisher exceeds national targets, with 11 out of 16 staff members holding National Vocational Qualifications in care at level 2 or above. There are a number of processes in place within the home to help the management assess quality and identify areas for improvement. Many of these processes involve residents and their representatives, such as group meetings and regular satisfaction surveys. It was apparent in discussion with the owner and the manager of the home that plans are in place to develop the service and ensure that it continues to meet the changing needs and wishes of residents. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 8 What has improved since the last inspection? What they could do better:
Whilst there is a good format in place for planning residents’ care we found that the system was not always used to its full potential. A number of care plans we viewed had large sections that were not completed or contained out of date information. Whilst staff did demonstrate an understanding of residents needs, it was apparent that the majority of information about residents is passed on verbally. Gaps in written care planning information may lead to gaps in care provision and as such, care plans need to be fully completed, accurate and regularly updated. We have made a requirement and some recommendations in respect of this matter. Processes are in place for assessing risk to residents in a number of areas such as falling or developing pressure sores. However these assessments had not been carried out in all cases. In addition, we became aware that one resident had a bed rail in place, but that no risk assessment had been completed in respect of this. It is important to assess all areas of risk and keep these assessments under regular review to help ensure residents’ safety and wellbeing. We have made a requirement in respect of this matter. There are procedures in place for the safe storage, administration and disposal of residents’ medicines but we found evidence that staff are not always working in accordance with them. We found evidence that staff do not always check medication administration records at the point of administering tablets to residents. This is bad practice and could result in residents being given incorrect medication or not receiving a medicine prescribed for them. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 9 Information on residents’ medication administration records is not always accurate or fully completed. In particular, there is very little information about PRN (as required) medicines in most cases. This information is important as staff need to know when it is appropriate to administer PRN medication. Without this information, residents are in danger of receiving unnecessary doses or not receiving their medicine when they need it. We discussed the issues surrounding medication during our visit and made some requirements in respect of these matters. In most cases we found that careful recruitment procedures had been followed when employing new staff and suitable background checks had been made before people were offered employment. However, in one case we found that a staff member had commenced work within the home without all the checks being completed. We discussed this issue during our visit and have made a requirement in respect of this matter 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 Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 10 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 Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 11 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. Standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers have a good understanding of people’s needs before they move into the home. This means that people can be assured they will receive the help they need straight away. EVIDENCE: People we consulted were satisfied that they had received enough information about the home before they moved in. One person we spoke to confirmed that she had been able to visit the home prior to her move, to have a look around and meet staff and other residents. A Service User Guide is provided to people at the point that they express an interest in moving to the home. This document includes a variety of information, for example details of facilities and services available within the
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 12 home, as well as information about staffing and daily routines such as meal times and activities. The owner of the home advised us that the Service User Guide is available in a number of formats including large print and audio. During our case tracking exercise we viewed pre-admission assessments for a number of residents. The assessment format covered all areas of daily living including mobility, personal care and nutrition. We were able to confirm that the assessments had been carried out prior to the people moving into the home. This means that staff would have the information they need to provide the right level of care straight away. The assessments we viewed also contained social histories. These cover areas such as previous employment, relationships and significant life events. Social histories are important as they help carers to recognise and value the uniqueness of each resident and plan their care in a person centred manner. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 13 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 adequate. This judgement has been made using available evidence including a visit to this service. People living at the home are satisfied with the way their care is provided. However, their care plans don’t consistently reflect the support they need which could result in gaps in their care. Carers don’t always follow correct procedures when dealing with medication which could compromise residents’ health, safety and well being. EVIDENCE: We viewed a number of residents’ care plans during our case tracking exercise. We found that residents’ care plans didn’t always provide an accurate picture of their care needs. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 14 Whilst the format used for care planning was comprehensive and covered all areas of daily life such as personal care, mobility and social activities, we found that some sections were not completed in the plans we viewed. As a result, important areas of need had not need addressed and there was no written guidance for staff about the support people required in some areas. However, despite the gaps in written information, carers we spoke with demonstrated a good understanding of individual resident’s care needs and preferences, but confirmed that the majority of information was shared verbally. There were risk assessments in place for some residents in relation to areas such as pressure sores and falling. However, these had not been completed in every case. In addition, during our case tracking exercise we became aware that one resident had a bed rail but could not locate a risk assessment in relation to this. These issues were discussed with the manager and owner at the time of our visit. One of the residents we case tracked had some complex behavioural needs. These were briefly addressed in her pre-admission assessment but there was no further guidance for staff in relation to this area. Such guidance is important to enable staff to eliminate possible triggers and approach challenging situations confidently and consistently. We viewed the home’s medication store and found that medicines were stored in a safe and well organised manner. However, we viewed medication administration records, which provided evidence that staff do not always follow correct procedures when administering people’s medicines. At the time of our visit we found that some medicines not due to be given until later on that day had already been signed as being given by one staff member. This is very poor practice and demonstrates that carers are not always checking records at the point they are administering medication. Further evidence of carers’ failure to check records at the point of administration was found on one resident’s mar, where staff had for several days, signed for an incorrect number of tablets. Failure to check records at the point of administering could lead to residents being given incorrect doses of medicines, which in turn could put their health and wellbeing at risk. We found that there was not always ample information about medicines on medication records and on some occasions information that was included was not accurate. A number of residents were prescribed certain medicines on a PRN (as and when required) basis. However, in some cases there was little or no information about what the medicines were actually for. This information is essential to ensure that residents are given the medicines when they actually need them.
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 15 We discussed our concerns in relation to medication with the manager and owner during our visit. In addition, several requirements have been made in relation to this area. We received very positive feedback from residents and some of their family members about the approach and attitude of staff and the manager at the home. People we consulted during our visit and those who completed our written survey told us that they were treated with dignity and respect and that their care was provided in a sensitive manner. We talked to a number of carers who showed they had an understanding of good principles of care and were able to give examples of how they ensured residents’ privacy and dignity was maintained whilst providing care. We viewed the home’s general communication book which is used to relay messages between staff and found that on occasions, personal information had been recorded in there. We advised the manager that this practice should cease and that personal information should only be recorded in people’s individual care records. The Kingfisher Care Home DS0000070643.V351605.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 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at this home are supported to maintain contact with family and friends and enabled to take part in meaningful daytime activities. EVIDENCE: People we consulted both in writing and during our visit told us that there was a good variety of activities organised on a regular basis. One relative commented that there always seemed to be something going on when she visited. A staff member is employed at the home to ensure that residents are provided with regular opportunities to enjoy activities of their own choosing. We spoke with the activities coordinator who explained that she always attempted to arrange activities in line with people’s individual interests and hobbies. In addition, she spoke of the importance of supporting residents to maintain links with their local community and said that she was provided with a generous budget to facilitate this.
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 17 Activities regularly on offer within the home include music sessions, arts and crafts, chairobics and quizzes. In addition, residents have the opportunity to take part in trips out to places such as garden centres, local pubs and the theatre. Residents confirmed that they were able to have visitors at any time. We spoke to one visitor who told us that she was always made to feel welcome by staff and always able to see her relative in private. Since the home’s registration in September 2007 the owner has taken the time to meet with every resident and where appropriate, their family to introduce herself and ensure that people are satisfied with the service. The owner has also organised meetings for residents and their families which take place outside of the home and include people from sister care homes. People told us that routines within the home are flexible and that they are able to make every day decisions such as when to get up, or when to eat their meals. One resident told us ‘‘It’s all about what I want, I just please myself but the girls (carers) are there if I need them.’’ Everyone who responded to our written survey and people we spoke with during our visit expressed satisfaction with the quality and variety of meals provided at the home. One resident said ‘’It’s always very good and there’s plenty of it.’’ People also confirmed that there was always a choice of main meal avalailable. One resident who completed a written survey wrote ‘There are always plenty of choices if I don’t want what’s on the menu.’ The manager advised us that every effort was made to ensure that people’s individual preferences are taken into account when planning meals. One resident gives the manager a list every week of food items she would like to be purchased and these are added to the main shopping list. We were also able to confirm that meal times are flexible. During our visit a number of residents ate their lunch at various times as they had been busy during the home’s main lunch time serving. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 18 The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 19 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. Residents and their representatives feel confident that any concerns or complaints they raise will be taken seriously and promptly dealt with. There are systems in place to protect residents from harm. EVIDENCE: The home has a complaints procedure in place which is clearly written and easy to understand. This document gives guidance in how to raise a complaint and outlines the steps that will be taken by the home in this event. The procedure also provides contact details of other agencies the complainant can contact if they are not satisfied with the action taken within the home. The complaint procedure is posted in various areas around the home and is included in the home’s Service User Guide, which is provided to all residents. In discussion the owner of the home confirmed that the complaints procedure is available in a variety of formats for example, large print and audio. We were advised by the registered manager that there had been no complaints made at the home since their registration in September 2007. In addition, the Commission for Social Care Inspection have not received any complaints or concerns about the home.
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 20 The registered manager confirmed that there are safeguarding adults and whistle-blowing procedures in place. Staff spoken with were aware of these procedures and confirmed that if they had any concerns they would first ensure the resident’s safety and then speak with the registered manager or owner. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 21 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. Residents are provided with safe, homely and comfortable accommodation. EVIDENCE: The home is a detached property located within easy reach of Cleveleys town centre and sea front. There are a variety of communal areas within the home including two lounges a dining room and conservatory. There are also safe, well maintained gardens which are accessible to residents. The majority of rooms are single but there are two bedrooms that are currently shared. The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 22 We carried out a tour of the home and found that all areas were clean, warm and comfortable. Since the current owner acquired the home in September 2007, a number of improvements have been made including the refurbishment of two communal lounges and several residents’ bedrooms. There are plans in place to make further improvements including the refurbishment of the kitchen, and the relocation of the laundry (which is currently located outside) to inside the home. It is recommended that a wash hand basin be provided in the laundry to assist staff in following good hygiene practice. Due to the current layout of the home there is an access issue for some residents wishing to get to the manager’s office or kitchen, as these areas can only be accessed via some steps. The owner is planning to address this and at the time of our visit was discussing the problem with a professional builder. The registered manager confirmed that the home has an infection control policy and procedures in place which provide guidance to staff in good practice in this area. We recommended that the manager familiarise herself with the Department of Health guidance ‘Essential Steps’ for further guidance. The Kingfisher Care Home DS0000070643.V351605.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 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has an adequate level of staff who are motivated and competent to meet the residents’ needs. Failure to carry out necessary background checks prior to people’s employment could result in unnecessary risk to residents’ safety and wellbeing. EVIDENCE: We examined personnel files for the most recently appointed staff members. In all cases it was found that a full employment history had been provided and that formal interviews had been carried out prior to offers of employment being made. We were also able to confirm that a number of background checks had been made in respect of the staff members including a Criminal Records Bureau check and written references. However, in one case we noted that a staff member had commenced employment at the home prior to all the checks being completed. This was discussed with the manager and owner who stated this was not usual practice and had occurred as a result of human error. We have made a requirement in respect of this matter.
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 24 We viewed a selection of staffing rotas and spoke to people about staffing levels. Residents, relatives and carers all told us that they felt there were always enough staff on duty to meet residents’ needs. No one we consulted expressed any concerns about staffing levels in the home. The owner of the home advised us that staffing levels are constantly kept under review to ensure that they are in line with residents’ needs. We consulted a number of staff members during our visit and observed them going about their duties. Carers appeared well motivated and well organised and went about their duties in a cheerful manner. In discussion, carers told us that they feel well supported by the manager and owner and confirmed that they were provided with regular opportunities to meet, both in a group and on a one to one basis. One carer said ‘’Julia’s (the manager) door is always open and she is very approachable. I wouldn’t ever be worried about going to talk to her if I needed to.’’ Staff were also very complimentary about the training provided. All the staff we consulted confirmed that they had completed their mandatory health and safety training in areas such as moving and handling and fire safety. In addition, figures provided by the home confirmed that 11 out of 16 carers hold National Vocational Qualifications in care at level 2 or above. This is a good achievement and exceeds the national target that 50 of carers of a home should hold this qualification. The Kingfisher Care Home DS0000070643.V351605.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 & 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 run in the best interests of residents. EVIDENCE: This home was acquired in September 2007 by the current providers who own a number of care homes in the area. One of the owners who was present throughout our visit, works closely with the registered manager on a day to day basis. It is clear in discussion that she has a genuine commitment to providing a high standard of care and since the home’s registration has identified a number of areas she plans to develop.
The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 26 The registered manager has over 18 years experience in managing care services and achieved the Registered Managers Award in August 2005. Throughout our visit the registered manager and owner were very cooperative and appeared keen to discuss any areas where improvements could be made. People who responded to our written survey and those we consulted during our visit spoke very highly of the manager and owner, some commenting that they were very approachable. One relative said ‘’I really feel that I could go to them about anything I wasn’t happy with and they would deal with it straight away.’’ There are a number of systems in place to help the management monitor quality at the home. These include regular satisfaction surveys for residents and their relatives. In addition, group meetings for residents and their relatives have been organised where people can express their views and make suggestions about the running of the home. Some of the residents who live at the home need assistance in dealing with small amounts of petty cash, and records are held of any such assistance given. We viewed a selection of these records and found them to be in good order. The home has a health and safety policy in place which is supported by a number of procedures such as fire safety and infection control. Staff we spoke to confirmed that all staff are provided with training in the mandatory health and safety areas such as moving and handling, at the start of their employment. The home confirmed in writing that all the required checks and maintenance of equipment and facilities take place as necessary. The Kingfisher Care Home DS0000070643.V351605.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 x 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 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 2 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 Kingfisher Care Home DS0000070643.V351605.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 Timescale for action 30/04/08 2. OP8 3. OP9 4. OP9 Residents’ care plans must provide a current and accurate account of their needs so that carers know what support they require. 13 (4) (c ) Assessments must be carried out 30/04/08 with regard to risks to the health and safety of residents in relation to falling and developing pressure sores, so that any such risks can be identified, and so far as possible, eliminated. 13 (2) Procedures must be followed to 17/03/08 ensure that residents are given the correct medicines at the correct times, as receiving incorrect medicines could seriously affect residents’ health and wellbeing. 24(1) Regular recorded audits must be 17/04/08 carried out to ensure residents receive their medicines as prescribed. 18(1)(a) All care staff that handle medicines should be assessed as competent and if necessary receive further training to help ensure residents receive their
DS0000070643.V351605.R01.S.doc 5. OP9 17/04/08 The Kingfisher Care Home Version 5.2 Page 29 medicines correctly. 6. OP10 12 (4) (a) Residents personal information must not be recorded in general communication books as this compromises residents’ privacy and dignity. 19 (1) (b) People must not be employed to work at the home until all the necessary background checks have been made so as to protect the safety and wellbeing of residents. 13 (4) (c ) A risk assessment must be carried out before providing any resident with a bed rail, so as to protect their health and safety. 24/03/08 7. OP29 24/03/08 8. OP38 24/03/08 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 OP7 Good Practice Recommendations A positive support plan should be put in place for any resident who has complex behavioural needs. This plan should include any known triggers and approaches/strategies to be used by carers in challenging situations. Medicines prescribed as when required or, as a variable dose should have clear written instructions for care staff to follow to ensure they are administered correctly. Further review of the medicines handling policies is strongly recommended to ensure all best practice is accurately reflected. A wash hand basin should be provided in the laundry to assist staff in carrying out good hygiene practices. It is recommended that the Department of Health guidance ‘Essential Steps’ is obtained and referred to when reviewing the home’s infection control policy and procedures. 2. 3. 4. 5. OP9 OP9 OP26 OP26 The Kingfisher Care Home DS0000070643.V351605.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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
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