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Inspection on 10/10/06 for The Kings Court Nursing Home

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

This inspection was carried out on 10th October 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.

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

There is a consistent and committed Manager and staff team in place who provide support to residents in a way, which residents told the Inspector makes them feel valued and respected.

What has improved since the last inspection?

The Manager has taken advice from the local Fire Safety Office has completed a fire risk assessment for the home to ensure the safety of all residents is protected.

What the care home could do better:

The home would benefit from a full environmental audit in order to produce a structured maintenance programme, which identifies and addresses all the environmental needs of the home. Staff and residents would benefit from specialist-training opportunities to ensure that they can meet the existing, and changing needs of all the people they care for.

CARE HOMES FOR OLDER PEOPLE The Kings Court Nursing Home Church Street Grantham Lincs NG31 6RR Lead Inspector Roger Harrison Key Unannounced Inspection 10th October 2006 09:30 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 Kings Court Nursing Home DS0000002590.V300449.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 Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Kings Court Nursing Home Address Church Street Grantham Lincs NG31 6RR 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) 01476 576928 e_a_barton@yahoo.com Barnsdale Bros. Limited Mr Phillip Edward Barton Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29), Physical disability (29) of places The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category of PD should be 40 years of age and over. 7th February 2006 Date of last inspection Brief Description of the Service: Kings Court Care Home is a purpose built privately owned care home providing nursing and personal care for up to 29 service users. The homes registration enables the home to accommodate service users within the category ‘Older People’ and ‘Physical Disability 40 Years and above’. Mr and Mrs Barnsdale (Barnsdale Bros. Ltd) are the registered providers and are actively involved in the running of the home. The registered manager is Mr Phillip Barton, is a first level registered nurse. The home is located in Grantham Town Centre. This enables service users easy access to the local amenities. The accommodation is a purpose built and consists of mainly single rooms with 3 twin bedded rooms available. The home has limited parking within the grounds but additional car parking space for visitors is available in an adjacent car park belonging to the home. The home has a small garden with a patio area to one side of the building. Access to the building is wheelchair friendly and the registered providers have also purchased a wheelchair friendly car that enables service users to go out on trips and to attend appointments when they need to. Charges made by the home for residential care and nursing care on 10/10/06 range from: £419.00 - £550.00 pw. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was undertaken using a review of all the information available to the Inspector regarding about Kings Court, and through undertaking a visit to the home, with the inspector using a method of inspection called “case tracking”. This involved identifying individual residents who currently live at the home and tracking the experience of the care and support they have received during the time they have lived there. This key inspection visit was achieved over a five-hour period by the inspector talking to the manager, touring the home, looking at information on care plans and files, talking to residents and care staff, and observing day-to-day care practice within the home. 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 Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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 Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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): 3 [Standard 6 N/A]. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager and senior staff assess residents’ needs before any new admission takes place, which helps to ensure that needs identified can be met safely. EVIDENCE: Residents sent written comments to the inspector before the inspection visit saying that they had received enough information about the home before moving in, which helped them to decide it was the right place for them. Information provided during the inspection visit showed that that the Manager has a statement of purpose and a service users’ guide alongside terms and conditions, which residents said are provided on admission to the home. The registered manager confirmed that he arranges, and carries out assessments with all new residents prior to them moving into the home. Risk assessments are also completed, which are reviewed regularly and all residents are offered a trial visit. Kings Court does not provide an intermediate care service. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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): 7,8,9and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care and nursing plans are provided for residents, and used by staff to ensure that residents’ health and personal care needs are met in a way, which residents wish them to be. Systems are in place to ensure the safe storage, recording and administration of medications. EVIDENCE: Residents and family carers said they know about information contained in their care plans, which included physical, medical, nursing and social needs. The manager said that he is planning to improve the information on care plans by offering residents the opportunity to include more details about their life history so that it gives more information about the interests and needs of residents so that these can be fully met. Care staff said that they use care plans to support each resident in the way they wished and residents said they felt supported and respected by the staff team. One resident and family carer commented that, “I am completely happy here and have made many good friends among the management and staff at The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 9 all levels”. Care plans also showed that reviews are carried out each month by senior care staff and the manager to make sure that residents changing needs can be met in the right way. The manager said that the staff team always encourages residents to self mediacte wherever possible. When help is needed a senior nurse confirmed that only trained and qualified staff provide help with giving medicines. Two senior staff members showed how residents receive support in order to take their medication and were observed giving medicines and keeping records of each activity carried out. Medicines are kept in a locked cabinet and controlled drugs are stored and recorded separately. Residents said they feel confident that their medication needs are met in a safe way and one resident said. “The staff always make sure I get my tablets at the right time”. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff to take part in activities of their choice, maintain control over their lives and receive a balanced and varied diet which is provided in the way residents wish. EVIDENCE: Residents said that they are able to take part in activities of their choice either inside or outside the home. The manager and staff team said that they use the homes own vehicle to escort residents out to places of their choice and to attend appointments when needed. Transport was seen being used during the Inspection to take residents out for local appointments. The manager does not currently use specific staff time for activities but residents said they enjoy either arranging their own activities with their families, going out with support and that a range of entertainment is organised in the home by the manager. Care plans include some information about social needs and interests. Most residents have chosen to have a photograph album in their rooms, which includes a record of their lives before and since admission. The manager said he is in the process of updating this information for all residents where they choose to take part. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 11 Menus at the home are produced by the cook, who keeps a record of each resident’s dietary needs so that these can be met in a safe way. The record used showing residents likes and dislikes was not on full display but the cook said she is producing a new one, which would be, used all the staff team for reference. Kitchen staff knew about residents individual needs and menus showed a variety of food, which residents said they liked to eat, is available throughout the day. Comments about the food at the home were made by residents, which ranged from “The food here is excellent” to “They make sure my husbands food is cooked well and made safe to eat for him” The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they arise. The Care team know how to act in order to protect residents from abuse. EVIDENCE: There is a complaints log in the reception area of the home, which tells residents and visitors how to raise any concerns they may have. Information is also available with the log, which informs residents and visitors that they can always raise concerns or make a complaint confidentially with the manager if they wish. The home has a procedure for dealing with any concerns or complaints, which is maintained by the Manager. There were no recorded complaints made since the last inspection. The home has a copy of the Lincolnshire Adult Protection Committee Procedures. The manager described the action he has taken to protect residents from abuse during the last year, and during this inspection three staff members gave clear examples of action they would take in order to protect the safety of residents. Staff said they have received some training on abuse as part of their overall induction and demonstrated a good working knowledge of the Adult Protection procedures in place at the home and the manager said that he would be arranging for specific training on the prevention of abuse for all the staff team as part of the overall training plan. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well maintained but would benefit from an environmental audit to identify how bathrooms and other areas of the home could be updated to meet all the needs of residents. EVIDENCE: Since the last inspection the manager has consulted with the fire safety officer and taken action to enable residents to have safety catches fitted to their doors so that they can close them quickly in the event of a fire. The manager has also reviewed the evacuation procedure currently in place at the home alongside each resident’s individual needs. During a tour of the building residents made positive comments about their rooms. One resident said, “They are decorating my room, I like the colour pink and they are painting it in the colour I’ve chosen” and another resident said “It feels like my home and I have all the things I need in my own room” The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 14 Three residents showed the Inspector their rooms and all were made personal to meet individual tastes. The inspector talked to the manager about the overall maintenance of the building and it was confirmed that the kitchen area has been improved and that the manager said that some decorative work is currently being undertaken. However there is currently no structured maintenance programme in place to ensure the ongoing improvement of the home environment. Both the manager and a senior staff member confirmed that bathrooms remain safe and that equipment used by the staff team is serviced regularly. However the manager did recognise that parts of the home are in need of a decorative update and that bathrooms in the home are now in need of upgrading in order to provide shower facilities for residents. The manager said he would complete an internal environmental audit of the care home in order to develop a clear action plan with timescales, which fully identify and address all the environmental needs of the home. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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): 27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are currently sufficient numbers of care staff available at the home with enough training and skills to meet the needs of residents safely. The manager makes sure that all staff are recruited safely. EVIDENCE: Information available on staff records showed that the manager carries out proper checks before any new staff member starts work at the home. Staff rotas in place show that the home currently has sufficient staff to meet the needs of the current group of residents safely. Comment cards provided by residents before the Inspection visit said that residents felt there are usually enough staff available to meet their needs. One resident said, “The staff are very good, they take time to know me and about the needs Ive got”. Residents said that they felt they receive good support from staff and that they felt safe when receiving care and support. The manager encourages staff members to develop skills through NVQ qualifications and staff members said they received an induction and had been given training to help them to support residents in the right way. The training plan in place was discussed with the manager who confirmed that he is reviewing it to arrange more specialist training in order to give the staff team more knowledge and understanding The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 16 when providing support for people with physical disabilities and to ensure specific adult protection training is provided for all staff. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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): 31,33,35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a consistent way. The manager protects resident’s financial interests. Resident’s views are listened to, and acted upon by the manager. Systems are in place to protect the health and safety of residents. EVIDENCE: A senior staff team member provided details during the Inspection visit to confirm that all residents are encouraged to manage their own finances wherever possible. When support is needed residents’ monies are kept securely with all transactions being recorded and receipts retained. A sample checked was found to be correct. Residents said they felt the Manager offered a good service and staff members said the Manager is respected. The manager confirmed that since the last The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 18 inspection he has complted the registered managers award and has developed a system of supervision to enable all staff members to receive support in a structured way using observation of practice and recorded supervision sessions. These are used to identify the training and development needs of the overall team. One staff member said “It’s a really good place to work, much better than where I was before and the manager is really supportive, we can always get hold of him if we need to discuss any issues”. The Manager said he always has an open door to discuss any issues with staff, residents and visitors. Residents said that they felt the manager runs the home in the way they wish and that he listens to their views about how the service could be developed. During the inspection one resident told the inspector he would like a shower saying, “I don’t mind having a bath but it takes too long and I get cold. The staff are great but I would love to have access to a shower, if they had a shower room I would be able to have a shower everyday”. The manager agreed to carry out a full written audit as part of the environmental audit planned to identify the work needed to upgrade one of the bathrooms to include a shower facility. The manager also said he would talk further with residents in order to identify any other areas, which need to be improved with timescales for action recorded. The manager said he regards residents and carers comments and contributions to the development of services as important and would be taking action to repeat a service user survey which was carried out last year to encourage views to be expressed about how the home could be improved. The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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 X 3 X X X N/A 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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. 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 OP19 Good Practice Recommendations It is strongly recommended that the registered provider completes an internal environmental audit of the care home with the registered manager in order to develop a clear action plan with timescales, which fully identify and address all the environmental needs of the home. It is strongly recommended that staff be provided with appropriate specialist training for the work they perform; for example; Physical disability and adult protection. 2. OP30 The Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Kings Court Nursing Home DS0000002590.V300449.R01.S.doc Version 5.2 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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