Care Home: Kempsfield

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What the care home does well The manager and her staff try to find out what people living in the home like to do and try to arrange for them do it and they find out what they like to eat and try to make sure that is what they get for their meals. If a someone is ill they make sure that they get the right treatment. If someone needs medicines or creams they will make sure they get them. If a someone doesn`t like something they can complain to the manager or the staff who will look at the problem for them. The home is clean and well decorated. Each person can keep their own belongings safely in their room and those rooms can be decorated how they would like them to be. The home has a pleasant and secure garden for people to sit and walk in. The staff are cheerful, friendly and helpful and encourage people to enjoy themselves but also try to make sure that they are safe and well looked after. The manager is also cheerful, friendly and helpful and does most of the things that help the staff to do their job. What has improved since the last inspection? Since the last inspection more staff have been made available to give more help to the people living in the home. What the care home could do better: No requirements or recommendations have been made as a result of this inspection. Key inspection report Care homes for adults (18-65 years) Name: Address: Kempsfield Primrose Drive Sutton Park SHREWSBURY Shropshire SY3 7TP     The quality rating for this care home is:   two star good 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: Michael Moloney     Date: 0 8 0 7 2 0 0 9 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 Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) 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) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Kempsfield Primrose Drive Sutton Park SHREWSBURY Shropshire SY3 7TP 01743246033 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Shropshire County Council care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 19 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 19 Date of last inspection Brief description of the care home Kempsfield is registered with the Commission for Social Care Inspection to provide accommodation and personal care for up to nineteen adults with a learning disability, to include two people who are over the age of 65. The home is owned and managed by Shropshire County Council. The Responsible Individual is Mr Adrian Johnson, Operations Manager, and the Registered Manager is Ms Debora Mowl. The home is located on the edge of Sutton Park, a private residential estate situated on the outskirts of Shrewsbury and is within an easy distance of local amenities such Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 19 Brief description of the care home as shops, a church, cinema, college, pubs and medical facilities. The home is a twostorey building and has been converted into three long-term `flat? type units known as Sabrina, Kingfisher and Primrose. Within each unit the home seeks to provide a positive homely environment for service users affording the appropriate levels of support required to meet their individual needs. Consultation with people who live at the home takes the form of regular meetings, discussions and involvement in the development of care plans. Advocacy services are promoted and family members are also consulted in how they feel the home is run. Fees charged per person were unavailable at the time of the inspection. Care Homes for Adults (18-65 years) Page 5 of 26 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: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, tour of the premises, previous inspection reports and talking with as well as observing the care experienced by people using the service. A number of the people who live in this home have difficulty expressing themselves clearly. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: 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 Adults (18-65 years) Page 7 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may want to live in this home and their representatives have the information needed to choose a home and have their needs assessed so that the home can say whether or not they can meet them. Evidence: The home was seen to have a Service User Guide that contained the information that people may want if they are thinking about arranging for someone to live there. The records of a person who had come to live at the home since the last inspection was looked at and these showed that a full assessment of her needs had been carried out before the home manager had decided that it would be a suitable place for her to live. This assessment had identified such things as problems with eating, how well she walks and what her likes and dislikes were. Although the person concerned had difficulties communicating, observing her at various points during the day as well as chatting to her and listening to staff chat to her as they passed showed that she had settled and was happy to be in the home. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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. Looking at the records of two of the people who live in this home showed that their care plans were reviewed by the staff on a regular basis. Talking to the manager and the staff on duty at the time of the inspection confirmed this. The care plans were seen to cover a number of areas of need from self help skills to interests. The manager and the staff said that the information had been obtained by watching the reactions of those concerned as well as talking with them and their families. Talking with a number of the people who live in the home confirmed this. The staff were seen and heard talking with the people who live in the home in a clear, friendly and professional manner throughout the inspection. Looking at the way that bedrooms had been decorated showed that some of the interests had been identified and recorded correctly. One room contained a lot of football related items and one of the people who live in the home said that her bedroom had been decorated in the way that she had chosen . Risk assessments and reactive management programmes were seen to have been Care Homes for Adults (18-65 years) Page 10 of 26 Judgement: developed for a number of the activities so that people could take part in them in as safe a manner as possible. Evidence: Looking at the records of two of the people who live in this home showed that their care plans were reviewed by the staff on a regular basis. Talking to the manager and the staff on duty at the time of the inspection confirmed this. The care plans were seen to cover a number of areas of need from self help skills to interests. The manager and the staff said that the information had been obtained by watching the reactions of those concerned as well as talking with them and their families. Talking with a number of the people who live in the home confirmed this. The staff were seen and heard talking with the people who live in the home in a clear, friendly and professional manner throughout the inspection. Looking at the way that bedrooms had been decorated showed that some of the interests had been identified and recorded correctly. One room contained a lot of football related items and one of the people who live in the home said that her bedroom had been decorated in the way that she had chosen . Risk assessments and reactive management programmes were seen to have been developed for a number of the activities so that people could take part in them in as safe a manner as possible. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The records of two of the people who live at the home were looked at. Both were seen to have detailed care plans which had been developed with the individual in a way that puts their needs first. Talking to the people who live in the home confirmed that these had been developed by talking with them. The manager and the staff also said that they had watched which activities the person liked or disliked and had asked other people such as friends or relatives for their views. A variety of activities were seen to have been arranged for people with some attending local authority day services. Other activities included a fancy dress party, Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: reflex night club and cricket at Edgebaston. Talking with the people who lived in the home confirmed that other activities that had been identified in the information provided by the home prior to this inspection had included a visit to Crufts, the barge trips, going to the German market in Birmingham, various sea-side trips and going out to restaurants. One lady said, Oh yes, I have a wonderful time; we do lots of things, and one man said I like it - go to the pub and he smiled as he said it. The manager confirmed that the home had access to a vehicle that had been converted for use by people who use wheel-chairs and a number of the staff were authorized to drive it. During the inspection one of the staff was seen using her own car to take someone to an appointment. All of the bedrooms had locks and talking to the occupants of some of them confirmed that they could have keys and could lock their doors if they wanted to. Files were seen to contain guidance for staff about swallowing issues for one person. Talking with to the staff confirmed they were aware of this as was the cook. The cook was also aware of the various special dietary needs that people had and had list of peoples likes and dislikes to hand but was aware of them off the cuff. She said that menus were discussed at residents meetings. People who live in the home confirmed this. The menus were seen to be varied and popular with people spoken to. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Listening to staff talking with the people who live in the home it was found that the staff talk and behave in a friendly but professional manner. Talking with the staff showed that they used discretion when discussing issues that were personal to an individual person. Plans of how an individuals healthcare needs should be met were seen to have been developed. The records looked at showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was. These professionals included GPs, psychiatrists, psychologists, community psychiatric nurses, dentists and chiropodists. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: The arrangements for the storage and administration of peoples medication were looked at. Storage was seen to be appropriate and records correctly maintained. Controlled drugs were found to be stored and recorded correctly. Staff said that they receive training in the safe handling of medication before they are allowed to give them to people and their records confirmed this. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. People who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: The manager confirmed that the home has received three complaints and looking at the complaints records showed how they had been investigated and how the results of the investigation had been communicated to and discussed with the people who had raised the issues. A copy of the homes complaints procedure was seen as was the homes service user guide which was available in an easy read version and these contained the information someone would need if they wished to raise a problem with the home. The manager confirmed that no issues had been referred into the local procedures that are designed to protect vulnerable adults. Although the level of some of the disabilities of some of the people living in this home means that they are unlikely to be able to access the formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: The manager also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions and those records are monitored by the homes line manager. Care Homes for Adults (18-65 years) Page 17 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment that encourages independence. Evidence: Kempsfield is divided into three living areas each of which has its own dining room, lounge area and toilet/bathing facilities. Each area was seen to be clean, tidy and with bathing facilities that would meet the needs of the people who live there. A number of the people who live in this home had been identified as having severe mobility issues. Some of the bedrooms were seen to equipped with permanently installed hoists and the bathrooms that the people who live in those rooms use were equipped with similar equipment. A number of the people who live in this home were eager to show their rooms and all indicated that they had been able to decorated them to their own taste. Each room was lockable and some of the people who lived in the home were able to confirm that they could have a key to their room if the wished. The home has a central kitchen in which the main meals for the whole home are Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: prepared and distributed to each flat. However, each flat has a kitchenette in its dining area so that breakfasts and snack meals can be prepared by the people who live there. The grounds to the home are divided into three separate areas. There is a car park for visitors and staff to the front of the building and to the rear that garden is split into to areas so that one area can be used by the people who live in the Kingfisher flat and the other can be used by the people who live in the Primrose and the Sabrina flats. This latter garden has a basic sensory garden in it as well as a summer house that was bought by one of the people who live in the home for his own use. During the inspection some people who live in this home were seen ambling around the garden in the sun-shine. The home also has a central laundry area which is equipped with machines that can deal with heavily soiled items of clothing and bedding as well as the day to day laundry needs of the people living in the home. Staff stated and their records confirmed that they have received training in infection control so that they can deal with such issues whilst reducing the risk of spreading infections. Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service. Evidence: Looking at the staffing rota and talking with the staff established that staffing levels varied according to what support was needed by the people who live in the home. Various members of staff were heard chatting to and engaging with the service users in a positive and supportive manner. Talking with the manager, the shift leaders and the staff during the inspection confirmed that the majority of the staff had achieved at least National Vocational Qualification level two in care which is a qualification that is considered appropriate for people who work in this kind of service. Talking with the staff showed that they have a good knowledge of the type of issues that are faced by people who use services such as this as well as the more specific issues faced by the individuals that live in this particular home enabling them to play their part in meeting any of the needs that had been identified. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: The training records showed and the manager and the staff spoken to confirmed that training in such things as food hygiene and moving and handling were up to date. There had been one new member of staff recruited to this home in the last year and looking at the records held at the providers human resources office for that person as well those for people who started work in other services run by the provider showed that appropriate checks are carried out as part of the routines for making sure that those people wishing to work with vulnerable people are fit to do so. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager although improvements may be necessary to mandatory staff training frequencies. Evidence: The manager confirmed that she has gained the Registered Managers Award which is an appropriate qualification for someone running a facility such as this. She confirmed that she had undertaken training in how to manage situations where it was necessary to deprive people of their liberty. She was also able to confirm that no such situations had been identified within this home and therefore no referrals into the local authority procedures that deal with such issues had been necessary. Part of the support that she should receive is the regular completion of the monthly visits by a provider, that are required by law, which look at a range of issues that may affect how the needs of the service users are met. Records showed and talking to the staff confirmed that such visits take place. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Records were also seen that showed that residents meetings take place on a regular basis and satisfaction questionnaires were also distributed to people who live in this home and their relatives, with assistance being given on filling them in if required, in order to find out whether they thought their needs were being met. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans, equipment and activities. A variety of records were seen that showed that safety issues are constantly monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Accident records were looked at and these showed that such incidents were monitored by the senior management. Hazardous materials were seen to have been stored in a locked cupboard. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene and fire prevention. Staff spoken to confirmed that these records were accurate. Care Homes for Adults (18-65 years) Page 23 of 26 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 Adults (18-65 years) Page 24 of 26 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 Adults (18-65 years) Page 25 of 26 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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