Inspection on 08/08/06 for The New Close

This inspection was carried out on 8th August 2006.

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

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

Other inspections for this house

The New Close 17/01/06

The New Close 07/09/05

The New Close 29/11/04

The New Close 21/04/04

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

CARE HOMES FOR OLDER PEOPLE The New Close Conyngham Lane Bridge Canterbury Kent CT4 5JX Lead Inspector Wendy Mills Unannounced Inspection 09:30 8 August 2006 th 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 New Close DS0000023607.V299424.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 New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The New Close Address Conyngham Lane Bridge Canterbury Kent CT4 5JX 01227 780070 01227 830710 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) Kent Community Housing Trust Mrs Susan Keiper Care Home 63 Category(ies) of Dementia - over 65 years of age (63) registration, with number of places The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The residents shall be 60 years of age and over Date of last inspection 17th January 2006 Brief Description of the Service: The New Close is a residential care home providing care for up to 63 people, aged 60 and over, with dementia. The home is situated in a cul-de-sac in the village of Bridge, near Canterbury. The village has a number of shops, including a post office, pharmacy and small supermarket. The New Close is owned by Kent Community Housing Trust, which manages 22 residential care homes for older people in Kent. The Trust also provides a range of home care services. All accommodation is on the ground floor. The home is surrounded by extensive gardens and there is a large parking area to the front of the property. The home has been divided into two by a coded door entry system, with separate staff teams for each wing. This enables staff to have free access to all areas of the home and limits the access for residents, to ensure their safety. Each wing has a dining room, a number of small lounges and a visitors room. Residents rooms are accessed from the lounge areas. There are 55 single rooms, of which 23 are en-suite and 4 double rooms. The home contains a large number of toilets and 7 bathrooms with disabled facilities. The fees for this home range between £388 and £477 per week The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit lasted approximately six hours. A pre-inspection questionnaire and provider’s assessment form completed by the manager were received prior to the inspection. Four relatives and three members of staff were spoken in private. Several of the residents were spoken to during the tour of the home. In depth discussion was held with the registered manager of the home, Ms Susan Keiper. Documentation, including care plans, was examined. The views of visiting professionals were sought by telephone. A tour of the home was made and both direct and indirect observation was used throughout the visit. Feedback from both relatives and staff on the day of inspection was very positive. Care managers and other health and social care professionals also said that they were very happy with the way the home is run and said that good working relationships are maintained. What the service does well: What has improved since the last inspection? Since the last inspection staffing levels have improved and rosters changed to ensure that there are more staff on duty at busy times. More activity coordinator time has been supplied and the way activities are provided has been changed. There are now individually tailored activities based on a comprehensive assessment. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 6 There has been some change of use of rooms to make the running of the home more efficient. The administrative office is now adjacent to the front entrance of the building, the lounge area has been divided into smaller sections to make it more homely, the manager’s office is now more accessible and large clinical room has been provided in the centre of the building to provide greater security and accessibility. 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 New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home provides the residents, their relatives and supporters, with the information they need in order to make a decision about moving into the home. The home assesses prospective residents well. This ensures that only those residents appropriate to the home are admitted. EVIDENCE: The home has a statement of purpose and service user guide that give good information for residents and their supporters. These documents were on display in the front entrance hall along the certificates of registration and insurance and the last CSCI inspection report. There were also a number of other documents and leaflet in this area that provided further information. Inspection of care plans showed that good pre-admission assessments have been made on all residents prior to their admission to the home. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 9 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 & 10 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The health and the emotional well being of the residents is generally promoted in a kind and sensitive manner but all staff must ensure their conversation is inclusive at all times. EVIDENCE: Inspection of care plans confirmed that the health and care needs of the residents have been documented. Staff were observed to give care and prompt the residents in a kind and sensitive way. Staff are well aware of the need for confidentiality. Relatives said that they are very happy with the care the home gives and said that they staff are always kind and helpful. However, both staff and relatives expressed concern that some staff whose first language is not English sometimes held conversations in their own language whilst assisting the residents with their meals. The home is aware of these concerns and the manager said that she has taken action to ensure this does not happen again. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 10 It is important that all staff ensure their conversation is inclusive when on duty in the home. Since the last inspection the clinical room has been move to a more central position in the building. This gives better access for staff and is a more secure area for the storage of mediation. Storage of medicines is well organised and there are separate locked cupboards for each wing of the home. Medication in the home is well managed. There are two members of staff who take responsibility of monitoring medicines to ensure there are adequate supplies and that unused medicines are disposed of properly. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 11 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 & 15 The quality in this outcome area is excellent. This judgement is based on evidence gained both before and during this visit. The home supports the residents to maintain as much independence as possible and to make appropriate choices. This means that they can live their lives as comfortable as possible within the limitations of their mental capacity. EVIDENCE: There is a wide range of activities that takes place in the home. More activity coordinator time has now been provided. There is a significant improvement in the way residents are assessed for activities. This ensures that activities re tailored to individual needs. The activity coordinator talks to residents and their supporters to find out about previous interests, likes and dislikes, family history and other relevant details. Where choices can no longer be made the home then bases its decisions on behalf of the residents on this information. On the day of inspection one resident talked enthusiastically about the garden and the vegetables he is growing. Other residents were taking part in arts and crafts work. Photographs of recent activities are on display in the home. Hand and foot massages are provided for the less able residents. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 12 Relatives said that they are always made welcome. They are supported to help care for their relatives and take part in activities if they wish. They said that staff always offer help but are sensitive to their wishes to be involved with care. There is a relatives support group. Relatives said that this had been a great help to them. The home makes room for them to meet if they wish but sometimes they also meet away from the home. They give each other support and take part in fund raising events to provide specialist equipment for the home. The importance of ensuring that visitors act appropriately whilst in the home was discussed with the manager. Examination of the home’s visitor policy suggested that this policy could be more robust. The home should review this policy and procedure. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 13 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 & 18 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home deals well with comments, concerns, and complaints well. There are sound policies and procedures for the Protection of Vulnerable Adults that staff understand. This protects the residents from harm. EVIDENCE: Comprehensive policies and procedures for dealing with concerns, complaints and protection of vulnerable adults. Staff demonstrated a good understanding of these policies and procedures and said that they would always report any concerns. There is a clear organisational structure and reporting procedure for anyone who may suspect any form of abuse. The one complaint made by both staff and relatives was that cited under Standard 10. This complaint was made because staff whose first language is not English were heard to speak in their own language whilst assisting residents. The manager of the home has addressed this issue and instigated closer monitoring of staff in order to prevent a further occurrence. Staff have been made aware that any non-inclusive conversation is unacceptable and could lead to disciplinary action. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The environment is well maintained, clean and comfortable. This gives the residents a pleasant and homely place in which to live. EVIDENCE: A tour of the home was made in the company of the manager. All areas were clean, free from offensive odours and comfortably furnished. New furniture is on order to replace some chairs that have become shabby. The home is large and all accommodation is on the ground floor. The lounge areas have been divided to make the area more homely. There are extensive gardens that surround the home and these are also divided to give smaller areas. One garden is completely enclosed whilst another has lovely views over the local playing fields and countryside and there are further garden areas where residents are supported to grow their own plants. The New Close DS0000023607.V299424.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 & 30 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. Staffing levels, staff training and staff morale are all good. This means that well-informed and cheerful staff cares for the residents. EVIDENCE: Since the last inspection additional staff hours have been made available and staffing rosters have been changed to ensure that there are more staff on duty at busy times. There is now a good staff to resident ratio. Staff said that they felt staffing levels are sufficient to meet the needs of the residents. There is a good level of staff training and staff said that they were pleased that the manager attends some training sessions with them. Statutory training is up-to-date and several staff have also attended specialist training. Significant progress has been made in dementia training. The home has worked in partnership with the Development Service Development Centre at the University of Kent, to provide high quality specialist training in dementia for the staff. Inspection of staff files shows that appropriate checks are made on new staff before offering them a position at the home. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 The quality in this outcome area is good. This judgement is based on evidence gained both before and during this visit. The home is well managed and there are good procedures in place for quality monitoring. This ensures that the home is run in the best interests of the residents. EVIDENCE: There is a good organisational structure for both the home and the Kent Community Housing Trust. This allows for regular supervision to take place at all levels. Ms Susan Keiper, the registered manager, assisted throughout this visit. In depth discussion took place with her. She demonstrates a clear understanding of good care practice. She is very knowledgeable about dementia care and shows a dedication to her work in this field. Ms Keiper holds the NVQIV in The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 17 management and is currently undertaking the care modules of this qualification. She has managed the home for three years with a six-month secondment to another home within the Trust. She returned from this secondment on the day before the last inspection. Since then she has ensured that all the recommendations made at the last inspection have been met. She took immediate action when the two health and safety issues were noted during the tour of the home. There are established quality monitoring systems in place. Regular staff meetings and one-to-one staff supervision take place. Relatives said that they can “always talk to Sue and she deals with any concerns right away. Observation of her interaction with the residents showed that she is kind and caring and clearly understands the communication needs of people with dementia. Staff said that they respect Sue and particularly appreciate her management style and that she operates an “open door” policy for all staff and relatives. Relatives said that she listens to their views and ideas and acts upon them when necessary. Whilst there is generally a good level of maintenance and health and safety, two hazards were noted during the tour of the home: - Two differently colour coded cloths were found on the draining board of the sluice room - this presented an infection control risk; and a wheelchair in a poor state of repair was found in an alcove near the residents dining room – this presented a trip hazard to the residents. The manager dealt with both issues immediately. The home should pay more attention to detail when making health and safety checks. The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 2 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 2 The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 19 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. 2 Standard OP10 OP38 Regulation 12 23 Requirement Timescale for action The registered person must ensure that staff are inclusive in 08/08/06 their conversations at all times. The registered person must ensure that attention is given to 08/08/06 detail in health and safety checks on the premises. 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 OP13 Good Practice Recommendations The home should review the Visitor Policy to ensure it is more comprehensive The New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 New Close DS0000023607.V299424.R01.S.doc Version 5.2 Page 21 - 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. 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