Care Home: Kearsney Manor Nursing Home

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What the care home does well People experience good and excellent outcomes in lots of areas. Service users told us, I am looked after in every way, they are meeting all of my needs. You cannot fault the food, lots of choices. Sometimes I cannot finish it all. Beautifully pressed clothes. Clothes come back from the laundry in a pristine condition. We have a quiz every so often, they are great fun. The pat dogs and cats are brought in every fortnight, which is really good. The staff are kind, they are very good. I am very happy here, the staff are very good. I have a lovely room with a lovely view, I feel very lucky. They (staff) are all charming. Everything is great. One staff member said I listen to what people (residents) tell me and I do my best to sort things out. For example if someone says the bread was hard today, I go to the kitchen and talk to the cook and find out why. What has improved since the last inspection? The AQAA shows that there have been lots of improvements since the last inspection. They have implemented the Gold Standards Framework in caring for people. They have link nurses who specialise in different areas including falls and tissue viability. Menus have been reviewed so that service users choices are included. There are plans to improve the ground floor of the home by having an open plan communal area and creating a chapel. Training workbooks have been introduced for staff training covering various topics so staff can work through the books and complete written questions which check they understand. This means that staff can work through the books at their own pace. A refurbishment programme is underway with the redecoration of bedrooms and communal areas continuing. Photographs of the grounds including the wildlife have been commissioned and displayed throughout the home. What the care home could do better: We made no requirements for improvement in this report. Our judgement is that the home continues to provide an excellent service. Key inspection report Care homes for older people Name: Address: Kearsney Manor Nursing Home Alkham Road Kearsney Dover Kent CT16 3EQ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Kim Rogers     Date: 0 1 0 4 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Kearsney Manor Nursing Home Alkham Road Kearsney Dover Kent CT16 3EQ 01304822135 01304829232 kmnh@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Sisters of the Christian Retreat care home 44 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 44 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Kearsney Manor Nursing Home is a large, detached, traditional stone building, which has been extended in previous years. It is set back from one of the roads leading into Dover, and situated within extensive landscaped gardens. There are two other buildings within the complex, one of which is a convent for several nuns, who take part in the life of the home. The grounds include a large lake, established trees, and accompanying wildlife. There is also a well tended vegetable garden, that provides fresh seasonal vegetables for the homes kitchen. Care Homes for Older People Page 4 of 25 Over 65 44 0 Brief description of the care home Accommodation is provided for 44 older people. Most bedrooms are for single use, and many have en-suite facilities. Most bedrooms have beautiful views across the grounds. The management and staff put a high priority on providing a good quality of care, and service users feel that they succeed in this. The home is easily accessed by public services, as it is close to Kearsney train station, and buses run along the main road. There is a bus stop situated close to the home. The home is also easily accessible by car, and there is ample parking within the grounds. Fees range from £460 per week for residential care and from £735 to £760 for nursing care. This depends on the level of nursing care required. For more information please contact the Provider. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was a key inspection of the service and included an unannounced site visit by one inspector. We went to the home on a Thursday morning, 01/04/10 and spoke 10 service users in private, the manager and 6 staff and observed what was going on. We sampled records and had a look around parts of the home. We looked at the Annual Quality Assurance Assessment or AQAA that the manager completed. This is very well completed and gives detailed information about what the home does well, what could be better and how they intend to improve. We looked at other information we have received about the home including any concerns, complaints and notifications about incidents or accidents. The Key minimum standards were assessed. The previous key inspection was carried out on 10/04/07. This inspection was positive with no requirements for improvement made. We have carried out two Annual Service Reviews since the last inspection. This Care Homes for Older People Page 6 of 25 is how we monitor services. The home is rated as excellent and we found that the home continues to provide an excellent service to the people who live there. Previous reports can be viewed on our website. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: We made no requirements for improvement in this report. Our judgement is that the Care Homes for Older People Page 8 of 25 home continues to provide an excellent service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their needs will be fully assessed before they move in. Evidence: Detailed assessments are carried out before a person moves in. A range of information is gathered with the full involvement of the person and their family and friends. The AQAA says that they are trying to encourage more relatives and next of kin to be involved in the assessment and care planning process. Other assessments are sought, if available, from care management and health professionals so that there is as much information about a person as possible. This ensures that the manager can make a judgement about whether the home can meet a persons needs. Each person is issued with a contract outlining the terms and conditions of their stay. There is other information available about the service if people want it and trial stays and visits are supported. Care Homes for Older People Page 11 of 25 Evidence: One person told us that after coming for a respite stay they decided to stay as they felt safe and well cared for. They have implemented the Gold Standards Framework in caring for people who are terminally ill. This means that staff have the skills and competencies to care for people who are dying. The home does not have a dedicated rehabilitation unit, so standard 6 does not apply. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their needs will be supported and any risks will be managed. People are treated with kindness and respect. Medication is safe protecting service users. Evidence: Each person has a service user plan or care plan. This details a persons needs including health needs and what staff should do to meet those needs. Service users and their relatives are involved in developing individual plans. For example some people have written about their life history so that staff have a better understanding of the person. Any potential risks to a person are identified and assessed. There are strategies in place to reduce potential risks to people. Plans are reviewed every month with monitoring reports completed daily to ensure that any change in need is picked up and acted on. We noticed some sensitive personal information about service users is not stored in line with the Data Protection Act. The manager said she will address this at once. Staff have training in areas related to service users needs. Some staff specialise in certain areas including the prevention of falls, nutrition and tissue viability. This Care Homes for Older People Page 13 of 25 Evidence: means that staff have a person they can ask for advice and support at hand. People we spoke to said their needs are being met and that staff are kind and respectful. People said that staff knock on their bedroom door before entering and that staff respect their dignity. There are systems in place to ensure that medication practice is safe. Two staff check medication into the home. We observed medication being administered by staff to each person. Medication is administered in a safe individual way. Every one we spoke to said that staff give them the support they need with medication. People said that staff support them with health appointments and health checks. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are able to pursue leisure and social activities according to their wishes, and visitors are welcome at any time. Service users benefit from well prepared meals, providing a varied and nutritious diet. Evidence: People are asked about their social preferences and this is recorded. This means that any activities are planned around what people like to do. Every one we spoke to said there is enough to do and that there are enough activities on offer. One person said that they especially like the fortnightly visits from the pat dogs and cats. One to one activities like manicures are offered for people who are restricted to their roons. There is also a hairdresser who visits on a weekly basis. The hairdresser said she loves coming to Kearsney Manor and that she would highly recommend the home to anyone including her own family. The daily routines are flexible and visitors are welcome at reasonable times. People told us that they enjoy having visitors who are made to feel welcome. All ten service users we spoke to said good things about the food. People said that there is plenty of food and that it is served hot. People said that they have plenty of Care Homes for Older People Page 15 of 25 Evidence: choices and milky drinks and biscuits between meals. One person said you cannot fault the food. Food and drink intake is monitored by staff, when necessary, and extra support given if and when needed. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a complaints procedure and people know how to make a complaint. People are safeguarded from harm and abuse. Evidence: There is a complaints procedure that is displayed in the home. The AQAA shows that there have been three complaints in the last twelve months. All complaints were investigated and recorded with one complaint being upheld. For more information please contact the manager. There is a comments and suggestions book available for service users and visitors to use. Everyone we spoke to said that they know who to talk to if they have a complaint and are confident that it would be listened to and acted on. There are systems in place to safeguard service users from harm and abuse. Staff have training in how to recognise and respond to abuse. A bursar looks after service users money, if necessary, keeping records of expenditure with receipts. One person said if I need any money I ask Pam (the bursar) and she sorts it out for me. Service users said that they feel safe. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is clean and well maintained. People have lovely views from their bedrooms. Evidence: The home is set in seven acres of grounds. People said they have lovely views from their bedrooms of the lake and the wildlife. There are seating areas and paths so people can access the garden when they wish. They have brought the garden into the home by having photographs of the grounds and wildlife there commissioned and displayed around the home. There are maintenance and ground staff employed as well as domestic staff, kitchen staff and laundry assistants. The home is clean and well maintained with plans to continue with a refurbishment programme including plans to improve the ground floor of the home. Service users told us that their rooms are kept clean and smell fresh. One person said that their clothes come back from the laundry in a pristine condition, pressed beautifully. People we spoke to said that they are happy with their bedrooms. One person said they asked to move to a spare room which is bigger and has a better view. They said the manager agreed straight away and the room is being prepared for the person to move into. There are assisted bathrooms and wet rooms with specialist equipment that enable people to continue enjoying a bath or shower. Other equipment is also available that people may need like hoists and wheelchairs. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough trained staff to meet peoples needs. Recruitment checks are robust protecting service users Evidence: There are always at least two trained nurses on duty, one on each floor with a team of care assistants. A range of housekeeping staff are employed including groundsmen, domestic and kitchen staff so carers and nurses can concentrate solely on care and support. People told us that there are enough staff to meet their needs. People said staff generally come promptly when they call for assistance. More than half of the staff have a National Vocational Qualification in care at level 2 or above. The manager ensures that staff are up to date with mandatory training including first aid, fire safety and manual handling. More specific courses are also offered either by way of attending a day course or completing a work book on a given subject. This means that staff can study at their own pace and the written questions check that staff have understood the topic. The home supports placements of student nurses from Canterbury College. The AQAA shows that recruitment checks are carried out before a person starts working at the home. Staff confirmed this saying they had a Criminal Records Bureau check and had to give references. Everyone we spoke had good things to say about Care Homes for Older People Page 19 of 25 Evidence: the staff. Service users said The staff are very good, they are all charming and the girls (staff) are all lovely. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and managed in service users best interests. People know that their health and safety is protected. Sound quality assurance systems ensure that people can air their views about the service. Evidence: The same manager is in post as at the last inspection. The manager has been in charge of the home for seven years and the skills and experience needed. The manager is registered with us so she has passed the fit person process. The manager spoke with knowledge and understanding of peoples needs. The manager attends local and national provider group meetings to keep abreast of best practice. The manager completed the Annual Quality Assurance Assessment or AQAA. This must be completed and sent to us every year. The AQAA is well completed and has lots of information about what the home does well and how they intend to improve in the future. The AQAA shows an understanding of issues relating to equality and diversity and gives evidence of how the home is good value for money. The manager has identified in the AQAA some barriers to improvement and has ideas about overcoming Care Homes for Older People Page 21 of 25 Evidence: these barriers so that the service continues to improve. There are quality assurance systems in place that monitor and audit the service. People are asked for their views about the service by way of annual surveys and questionnaires. There is a comments book where people can record their views and the manager makes sure she is accessible so that people can speak to her about any issues. The AQAA shows that checks are carried out on the building and equipment to make sure that they are safe. Staff are trained in areas relating to health and safety. Staff said that they have plenty of personal protective equipment like aprons and gloves. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). 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