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Inspection on 04/10/05 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 4th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

What the care home does well

The home provides a welcoming setting for residents, who were observed being supported to retain control and choice over their lives. The manager and staff team are committed and caring. Feedback from residents and their carers on the day of inspection confirmed that their needs are seen as central to the service and that they are met in the way they want them to be.

What has improved since the last inspection?

There were no requirements made at the last inspection. The care team continue to provide a consistently positive approach to meeting the needs of residents.

What the care home could do better:

There is a need to provide formal supervision for staff, which is recorded and stored appropriately. Residents care plans would benefit from updated, formal reviews and risk assessments. There is a need for a fire safety inspection.

CARE HOMES FOR OLDER PEOPLE The Kings Court Nursing Home Church Street Grantham Lincs NG31 6RR Lead Inspector Roger Harrison Unannounced Inspection 4th October 2005 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.V255240.R01.S.doc Version 5.0 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.V255240.R01.S.doc Version 5.0 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.V255240.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category of PD should be 40 years of age and over. 21st March 2005 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 on a one to one basis to utilise for outings, appointments etc. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken over a four and a half-hour period, with the inspector using a method of inspection called “case tracking”. This involved selecting four residents who currently live at the home and tracking their experience of the care and support they have received during the time they have lived at the home. This was achieved 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? There were no requirements made at the last inspection. The care team continue to provide a consistently positive approach to meeting the needs of residents. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 6 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.V255240.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4 and 5. The home has a statement of purpose and residents guide. Information is available for residents to make choices about where they wish to live. Residents are assured that their needs can be met through pre-assessment procedures. EVIDENCE: The home has a Statement of Purpose, which was seen at the entrance of the home and Service User Guide is given to each service user as part of the admission procedure. The inspector found from discussions with service users, relatives and staff as well as general observation of care practice, that the care home clearly evidenced they are able to meet the current needs of residents currently living at Kings Court. The Manager confirmed that pre-admission assessments are undertaken for all new admissions to the home and that a trial period of care is used to determine whether the home is appropriate for the resident, their carer and the care team. Visits to the home are encouraged to provide individuals and their families with the opportunity to view rooms and talk to the care team about their needs in advance of a move. During the inspection a family carer told the inspector that, “We came to look around The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 9 before my husband came here, they look after him really well and cannot do enough”. The home does not provide an intermediate care service. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9, and 10. The staff team have a caring approach toward residents, and their dignity and privacy is respected. Care plans are in place which ensure need is met in the right way but these are in need of updating to include formal reviews. Systems are in place, which ensure the safe storage, recording and administration of medicines. EVIDENCE: All residents have an individual care plan. Each individual has a named key worker highlighted who is responsible, with the manager for updating and reviewing the care plan. Individual choice is discussed as part of the care giving. Care plans showed that needs are met in the way residents want them to be and that each care episode was recorded. However, plans are in need of updating and formally reviewing each month to ensure any changes in need are met. This was discussed with the manager who agreed to undertake the task of carrying out formal reviews regularly, and recording outcomes as appropriate. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 11 All residents are encouraged wherever possible to self medicate. On the day of inspection all residents required support with medication. Trained, senior staff administers medicines. Controlled drugs were seen to be in a locked cupboard within a secure medication room. Medicine records were up to date which included wider medical needs, for example dressings, and the inspector observed medicines being administered safely as part of a residents care plan. The care team were seen to provide sensitive and caring support to residents at all times during the inspection. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15. The care team regard the rights and choices of each individual resident as central to their work. Staff have a good knowledge of individual social, and cultural need, which ensures that control, and choice about how residents live their lives is supported. Food in the home is of high quality, providing a varied and nutritious diet for residents. EVIDENCE: The inspector was able to talk to several service users about daily life at Kings Court. Many said that they were able to do what they wanted to do; many choose to stay in their rooms and entertain themselves by watching television, listening to music or reading. Individual cultural and religious needs are supported through the care planning process as part of a social care assessment and residents were able to confirm that they are supported to take part in local community activities as they wish. The home employs a carer for one day a week to develop activities with residents and residents told the inspector about a variety of activities in the home and wider community which they chose to do. The home has its own vehicle, which is used to transport residents and their carers to places of their choice. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 13 Residents were seen to have personalised their own rooms and several residents confirmed that their visitors are made welcome by the staff team. The inspector observed and talked with family and friends coming and going throughout the inspection and was told that they were always made to feel welcome. The inspector spoke to one resident, with a family friend who said, “They are brilliant here”. All residents have the option of having a phone in their room. Where this is not a preference a radiotelephone is available for residents to ensure access to private calls when needed. A payphone is also available in the home. The inspector was able to observe residents enjoying lunch in a variety of settings around the home. Residents told the inspector they were very happy with the food provided. Menus are planned on a weekly basis through consultation with residents and offer a range of alternatives for all meals including cooked breakfasts and a vegetarian option. Friends and relatives can choose to take meals with residents if they wish to. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. The manager and care team take complaints seriously and wherever possible involve residents and carers in resolving issues as soon as they are evident. The manager and staff team protect residents from abuse. EVIDENCE: There is a complaints log in the reception area of the home. Information is also available which encourages residents and visitors to raise concerns confidentially with the manager if they wish. The home has a procedure for dealing with any concerns or complaints. There were no recorded complaints made since the last inspection. The home has a copy of the Lincolnshire Adult Protection Committee Procedures. The organisation has not needed to invoke the adult protection procedure over the last twelve months. The manager and staff demonstrated a good working knowledge of the Adult Protection procedures in place and were aware of necessary protocols to invoke the procedure. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 15 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): 19,22 and 26. Residents live in a clean, comfortable environment. There is appropriate equipment in place to meet the moving and handling needs of residents. With regard to fire safety, there is a need to ensure the home complies with standards as appropriate EVIDENCE: The home is clean and appropriately maintained. The staff were seen to be following the homes health and safety policy to ensure any risk of cross contamination was minimised through the use of aprons and gloves when care giving and following correct procedures when providing both personal and domestic support. Residents told the inspector that there are sufficient bathrooms and toilets to meet their needs and the inspector observed that the care team uses an appropriate variety of equipment to ensure safety and support when mobilising for residents. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 16 Staff were seen to encourage residents to be independent and on the day of inspection the inspector observed safe practice from the care team. On the day of inspection some of the doors to residents rooms were wedged open. Concerns were raised in relation to fire safety and the manager agreed to remove wedges from doors. The manager also agreed to arrange a fire safety inspection visit to ensure that any outstanding issues relating to fire safety can be addressed appropriately. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 17 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): 27,29 and 30. The home has a recruitment policy, which helps to support staff in their practice whilst safely meeting resident’s needs. There is an appropriate mix of skilled trained staff in adequate numbers to meet the needs of residents. The manager ensures that staff are recruited safely and that all checks are made to ensure the safety and protection of residents. EVIDENCE: During the inspection the inspector observed that the home has many service users with high dependency care needs. There was adequate staff on duty with the required mix for the number and category of service users. The recruitment policy and terms and conditions of employment in place ensures that all appropriate checks are made before starting any new staff member and staff files looked at confirmed that procedures are followed. There is an induction programme and a pack is given to all new staff members, which includes safe moving and handling training along with other key competencies that support staff development. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 18 The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 19 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 and 36 Resident’s social and health care needs are safeguarded by a manager who regards resident’s needs as central to service provision. Daily consultation and communication is undertaken with residents and carers to ensure that the home is run in the resident’s best interests. Staff receive informal supervision but this is not done formally and recorded as appropriate. EVIDENCE: The home has a registered manager who takes a full working role within the home. This “hands on” approach gives the manager a good understanding of resident and staff needs. Staff are supervised by the manager and their views are sought about improvements to the services provided. However there was The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 20 no evidence available to confirm that formal supervision is undertaken with staff. This was discussed with the manager who confirmed that he has started to re-organise staff files, and is developing a formal system of supervision which would be in place soon. The home has a range of policies and procedures for staff to follow, which are kept with staff files in an appropriate way. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 21 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 3 x x x 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x 2 x x The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 22 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 OP36.2 Regulation 18(2) Requirement Timescale for action 30/11/05 2. OP7 13(4) 14(2) 15 (1)(2) 3. OP19.5 23.4 The registered person must implement a formal supervision structure to enable supervision to be carried out at least six times a year. A comprehensive care plan must 30/11/05 be completed for each service user, which must clearly identify each service users needs and demonstrate how these are met. The plan for every service user must be reviewed each month and updated on a regular basis. Service users and their representatives (where appropriate) must be involved in the devising of care plans where possible. The registered person shall, after 04/11/05 consultation with the fire authority take appropriate action to protect residents from the risk of fire. The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Kings Court Nursing Home DS0000002590.V255240.R01.S.doc Version 5.0 Page 24 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. 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