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Care Home: Keneydon House

  • 2 Delph Street Whittlesey Cambridgeshire PE7 1QQ
  • Tel: 01733203444
  • Fax: 01733202648

Keneydon House is a care home registered to provide care and support for 21 people over the age of 65 years, some of whom have dementia. The home is situated in the town of Whittlesey, near Peterborough and is close to local amenities. The home is an older property built approximately in 1890. The accommodation is on two floors accessible by stairs or a chair lift to the first floor. There are 13 single and 4 double rooms and a large garden to the rear of the building. Fees range between £354 per week and £550 per week depending on assessed needs. Additional costs include those for hairdressing and private chiropody. Further information about fees can be obtained 0 7 0 4 2 0 0 9 0 0 21 via the home. A copy of our inspection reports are available, on request, from the home and can also be accessed on our website at www.cqc.org.uk

  • Latitude: 52.560001373291
    Longitude: -0.12800000607967
  • Manager: Mrs Elaine Huggins
  • Price p/w: £452
  • UK
  • Total Capacity: 21
  • Type: Care home only
  • Provider: ADR Care Homes Ltd
  • Ownership: Private
  • Care Home ID: 9037
Residents Needs:
Dementia, Old age, not falling within any other category

Previous Inspections

This may not be the latest inspection for this service as we are having techinical problems updating from CQC - please check directly on the regulators website for the most recent report; bestcarehome hopes to be back to regular updates shortly.

For extracts, read the latest CQC inspection for Keneydon House.

Key inspection report Care homes for older people Name: Address: Keneydon House 2 Delph Street Whittlesey Cambridgeshire PE7 1QQ     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: Elaine Boismier     Date: 3 1 0 3 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 31 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 31 Information about the care home Name of care home: Address: Keneydon House 2 Delph Street Whittlesey Cambridgeshire PE7 1QQ 01733203444 01733202648 adrcare1@btconnect.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): ADR Care Homes Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: care home 21 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: Dementia - over 65 years of age (DE(E) - 21 (both sexes) Old Age not falling into any other category (OP) - 21 (both sexes) Date of last inspection Brief description of the care home Keneydon House is a care home registered to provide care and support for 21 people over the age of 65 years, some of whom have dementia. The home is situated in the town of Whittlesey, near Peterborough and is close to local amenities. The home is an older property built approximately in 1890. The accommodation is on two floors accessible by stairs or a chair lift to the first floor. There are 13 single and 4 double rooms and a large garden to the rear of the building. Fees range between £354 per week and £550 per week depending on assessed needs. Additional costs include those for hairdressing and private chiropody. Further information about fees can be obtained Care Homes for Older People Page 4 of 31 0 7 0 4 2 0 0 9 0 0 Over 65 21 21 Brief description of the care home via the home. A copy of our inspection reports are available, on request, from the home and can also be accessed on our website at www.cqc.org.uk Care Homes for Older People Page 5 of 31 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 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: We, The Care Quality Commission (CQC), carried out this unannounced key inspection (KI), by two Inspectors, between 10:10 and 14:35 taking four hours and twenty- five minutes to complete. Before the inspection we received surveys from five of the residents and ten from the staff. We looked at information that we have received about the home since our last key unannounced inspection. The home sent us, as requested, an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. During this inspection we looked around the premises and looked at some of the documentation. We case tracked two of the fifteen current residents. Case tracking Care Homes for Older People Page 6 of 31 means speaking with some of the residents and visiting their rooms and speaking with some of the staff who were looking after them. We compared what we saw and heard with the peoples individual records. We also spoke with and watched other people who were not part of our case tracking. We spoke also to some of the other staff, including the Manager. For the purpose of this inspection report people who live at the home are referred to as people, person, resident or residents. Care Homes for Older People Page 7 of 31 What the care home does well: What has improved since the last inspection? What they could do better: There must be some amendments to the Statement of Purpose to reflect the change in our name, the Care Quality Commission: the Manager said that she would update this required information. This is so that people will have access to accurate and up to date information. Although we found no physical evidence that people had acquired nail, skin or eye Care Homes for Older People Page 8 of 31 infections, we advised the Manager to assess the practice of how residents manicures are carried out, including the methods of reducing the risk of cross infection and the application of hand creams etc, from communal containers. Accurate information must be entered in records of temperatures, where medication is stored, and within the controlled drug register. This is to ensure that the quality of medication is maintained and that there is a clear audit trail of medication received and administered in the home, respectively. Work in progress needs to be maintained to ascertain peoples End of Life wishes. The home should consider starting to carry out mental capacity assessments to ensure that care is being provided in a consenting or best interest way. Access to the gardens should be made accessible and safe should any person admitted to the home wish to gain entry to this area. The lighting, ventilation and bathing facilities of the home should be re-assessed to determine if they meet the needs of the residents in a safe and comfortable way. The laundry floor should be replaced to reduce the risk of infection occurring. A record of peoples personal allowances must be maintained to ensure that peoples monies are safeguarded. An appropriate record must be used for fire drills that are carried out and completed with the full names of any person attending such fire safety training. The opening and closure of any fire door must comply with the current fire regulations. 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 31 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 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that there is enough information to help them in their decision where to live. They can also be confident that their needs will be assessed to ensure that the home is a suitable place to live. Evidence: Since our last inspection we have received five surveys from residents. Three of these surveys said that the person had received enough information about the home to help them in their decision where to live; another of these surveys said that this was not the case with the remaining survey saying that the person did not know if they had received such information. According to the AQAA, prior to admission ...we issue a copy of our statement of purpose, service user guide, complaints policy and terms and conditions of residence plus a leaflet giving further information about Keynedon House. The Statement of Purpose has been updated to reflect the change in the management arrangements of the home. There must be some amendments to the document to reflect the change in our name, the Care Quality Commission: the Care Homes for Older People Page 11 of 31 Evidence: Manager said that they would update this required information. A copy of our last inspection report was available in the home for any one to read. We also saw a newsletter that provided information of forthcoming events, on display, on the visitors, residents and staff noticeboard, located close to the Managers office. The AQAA said Pre-admission assessments are always carried out prior to residents coming to stay at Keynedon, so that we can build a plan of care around the specific individual. The Manager said that no person is allowed to live at the home unless they have had their needs assessed before they move into the home. The AQAA noted that there have been no placement breakdowns within the last twelve months, indicating that the homes pre-admission assessment procedures are robust. According to the Manager no person is allowed to live at the home unless they have had their needs assessed before they move into the home. As part of our case tracking we saw evidence that, unless there was an emergency admission to the home, the person had had their needs assessed, by the home, before they moved in. Care Homes for Older People Page 12 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be confident that they receive safe and proper care and that they are valued as individual people. People can not be fully confident that some of the current medication records will protect them. Evidence: According to the AQAA ..we try to give in-depth descriptions of communication and behaviour issues. Care plans are completed with the input of residents and families who are integral to the process. As part of our case tracking we found evidence recorded that verified what the AQAA told us. We also found that the care plans were detailed and person centred; they provided information about the peoples life histories and provided the staff the guidance in how to meet the individual and special needs of the person. Care plans and risk assessments were reviewed monthly or sooner. We pointed out some minor deficiencies within the care records that the Manager said would be addressed: this included, for example, how often a person was to have their position changed when in bed and what level their pressure relieving mattress should Care Homes for Older People Page 13 of 31 Evidence: be set at, according to their weight. All of the five residents surveys said the person always or usually received the care, including medical care, and support that they needed. Added comments included (The home) cares for the residents very well and (My relative) and family are very impressed with the care & attention given to everyone with understanding & compassion. The AQAA noted that We monitor constantly the health needs of our service users and seek further professional help from the service users own GPs and relevant health professionals. We offer chiropody, hearing and sight tests in-house. The team at Keneydon House have developed an excellent working relationship with the Older Peoples Specialist Team, which consists of the Modern Matron, Community Psychiatric Nurse, Dietitian (sic) and Speech and Lanuage (sic) Therapist, who are always on hand if advice is needed. We found recorded evidence that peoples weight was recorded each week and that peoples weights were stable. The Manager stated that the home is well supported by a team of health care professionals and we noted that she was actively consulting, on behalf of a resident, with a falls prevention co-ordinator. The Manager provided recorded evidence of when people had received treatments from a chiropodist. We saw some of the people receiving manicures and spoke with a member of the staff about how the risk of cross infection is reduced. We were told that wooden sticks, used to clean peoples finger nails, are washed after each use, and used for any other person after such cleaning. Although we found no physical evidence that people had acquired nail, skin or eye infections, we advised the Manager to assess the practice of how manicures are carried out, including the methods of cleaning any implements used and the application of hand creams etc, to individual residents, from communal containers. We observed the lunchtime medication round and saw that peoples dignity and choice were valued when the member of the staff was administering medication to them. The medication was also administered in an hygienic manner. Medication was stored safely during the medication round and was also stored safely in locked, appropriate cupboards. Temperatures of where medication is stored were recorded each day. Records for the medication cupboard were satisfactory although the records for the temperature of the drug fridge were not always satisfactory. We discussed the discrepancies with staff, including the Manager, who considered that this was a lack of understanding on the part of a member of staff and action would be taken, by the Care Homes for Older People Page 14 of 31 Evidence: Manager, to improve the understanding of recording such temperatures. The temperatures recorded of the drug fridge, for the 30th and 31st March 2010 were satisfactory. Controlled drugs were stored in an approved manner and we looked at the record of one medication currently in use. We, with the Manager, examined the controlled drug register and compared the quantity of medication received with the record: the record stated that there was twice the amount of medication received and there was no balance recorded of any medication left. The Manager confirmed that the amount of medication available was the same as that prescribed. We also found that there was no name and no address of where the medication was dispensed. As a result of these discrepancies of recording, there was no clear audit trail and we have made a requirement to ensure medication records protect people. We looked at some of the medication administration records (MARs) and we found that there has been an improvement in the recording of these since our last inspection: the code F was now being recorded to say why the person did not have the medication. We noted that, during the medication round, the MARs were correctly signed, after the person had had their medication. The member of staff also examined all of the MARs to ensure that any new medication prescribed would not be missed. From our observations of the staff working with the residents we found that peoples dignity was valued. During lunch time we saw the staff respond to a persons care needs in a sensitive way, ensuring that the persons dignity was valued. We also noted that, with the exception of one occasion, all the staff knocked on peoples doors before they entered. One of the people, who we case tracked said All the girls are wonderful. It was unclear how the peoples decision as to their End of Life wishes are determined. We found that information within the peoples care plans was conflicting and the staff we spoke with were unclear what the person had wished for. The Manager explained that the home had encountered some difficulties to determine what people wanted as part of their End of Life wishes, due to the complexities of such a process. She said that this would be further developed and that current information would be clearly communicated to the staff, to ensure peoples wishes are respected, about this sensitive subject. Care Homes for Older People Page 15 of 31 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. People can be confident that they are provided with opportunities to live a good social life and that their views and suggestions are taken into account. Evidence: All of the residents surveys said that the home always or usually provided suitable activities that the person could take part in. We saw some of the residents making an Easter card and small chocolate Easter eggs with support from the homes activities co-ordinator. Photographs of people celebrating Valentines Day were on display in one of the lounge areas. Examination of the the homes newsletter and discussion with the Manager indicated that the people have taken part in celebrations for Mothers Day and St Georges Day. In the minutes of the most recent residents meeting, dated 16th March 2010, we saw that residents suggestions for a fish and chip supper, were acted on and, according to the Manager, people enjoyed a fish and chip supper, on the 26th March 2010 - the supper was obtained by the home from a local provider. According to the Manager, based on peoples suggestions, arrangements are being made to take people out to the coast, once the weather becomes more clement. We saw peoples rooms were provided with personal items such as photographs, Care Homes for Older People Page 16 of 31 Evidence: ornaments and pictures. It was unclear, from talking with the Manager, if one of the people (who we case tracked) had their own duvet quilt or if this was provided by the home: this quilt was discoloured and there was a lack of clarity if it was flame retardant. The Manager said that she would assess any peoples personal bedding to ensure that it was of an acceptable standard to them and met with the fire regulations. We saw people receive their guests in private and in the communal rooms. The visitors record book demonstrated that there is unrestricted visiting. All of the residents surveys said that the person always or usually liked their meals. Added comments said that the home does well as it Serves good meals and Food is rated highly & all home cooked with fresh ingredients. During 2009 and 2010 the registered provider had carried out a survey that included peoples views about the food: 48.33 said that they were very satisfied with the food and 23.33 said that the person was quite satisfied with the food. According to the staff peoples choice of what they would like to eat for their dinner is requested the day before. The staff said that approximately 85 of the current residents have difficulties with remembering. The manner in finding out what the residents would like to eat did not take into account such difficulties. We discussed this with the Manager and we were informed that she is reviewing the menus and how choice is to be offered to people. We observed some of the peoples lunch time experience and we saw that the staff fostered peoples independence in eating and we saw that the staff were following peoples care plans with regards to eating and encouraging their independence in such a care practice. According to the AQAA 100 of the staff have attended training in malnutrition care and helping people with their food. Care Homes for Older People Page 17 of 31 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. People can be confident that they will listened to and action taken if they were unhappy about something. They can also be confident that they are safe from the risk of harm. Evidence: The AQAA said Complaints at Keneydon are low and feedback from residents, relatives and visitors is always positive. The AQAA recorded that, within the last twelve months, there have been no complaints made against the home and no allegations of abuse against any of the residents. We have received no such complaints and no such allegations either. This tells us that people should be satisfied with their care and that they should be safe from the risk of harm. All of the staff surveys and all of the residents surveys said that the person knew how to make a formal complaint if they wanted to do so. The majority (4) of the residents surveys said that the staff always or usually listened to the person and acted on what was said to them with the remaining survey stating that this was sometimes the case. According to the AQAA Staff know how to respond and take action when abuse is suspected. Staff have had training in the forms, causes, detection of and responses to abuse. In October 2009 the home demonstrated to us its knowledge of the local safeguarding Care Homes for Older People Page 18 of 31 Evidence: reporting procedures: it informed us of untoward incidents due to a person becoming unwell and agitated, indicating that it was protecting any people from the risk of future harm. A requirement has been met as we found evidence that staff training in safeguarding has improved. The staff training matrix indicated that all staff had attended or been booked on such a training course. On the day of this inspection the staff were attending a first session of a long distance course in safeguarding awareness. Information about how to make a complaint or report any suspicion or allegation of abuse was available throughout the home. We spoke with a member of the staff who told us what constituted abuse and what they would do if they became aware of such incidents against any of the residents: we were satisfied with the member of staffs answers. We discussed, with the Manager, that the home should consider starting mental capacity assessments to ensure that care is being provided in a consenting or best interest way. Care Homes for Older People Page 19 of 31 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a home that is becoming better maintained but could be more comfortable, safer and homelier. Evidence: With the Manager we looked around the premises of the home. It was evident, from our observations and from discussion with the Manager that there is work in progress to improve the environment of the home with redecoration of some of the internal and external areas; quotes for the cost of replacement windows have been obtained; the chopping down of an intrusive tree; the removal of the (unsafe) front porch and arrangements have been made to replace the rotten wooden gables of the home. Due to the discolouration of the corridor carpets the Manager said that these are due to be replaced. We saw worn and frayed towels and face cloths in some of the rooms that we visited: the Manager said that they are intending to change these with new replacement items. The extension of the building, which provides six bedrooms, had a clinical feel: the Manager agreed with our view and went on to explain that the change of purpose of this area of the home is under consideration. We noted that the large garden to the rear of the building would be difficult for people Care Homes for Older People Page 20 of 31 Evidence: to access, independently and safely, due to the lack of paved areas. The Manager stated that this would be considered as part of the homes environment improvement strategies. Following our last inspection we recommended that the Environmental Health Officers (EHO) opinion be obtained with regards to the laundry room. According to the Manager the EHO has visited this area of the home and considered that there is a reduced risk of infection that would lessen with a change of flooring. We saw that the floor was covered with a stained carpet although no personal laundry or other laundry items were placed on this floor. Nevertheless the current flooring remains a risk in nurturing spores and air borne bacteria unless it is replaced. The Manager said that the change of flooring is under consideration by the home. According to the AQAA The home has recently been furnished with new communal and individual items, i.e. dining tables, armchairs and bedroom furniture. Keneydon House is compliant with all requirements and regulations for fire safety, health and safety, Building Acts and environmental health. The majority of peoples rooms, that we visited had a lockable drawer. In room number six we found no such furniture and we were unable to open the persons wardrobe without difficulty as there were no handles on the outside of this piece of furniture. Following our observations and discussion with the Manager the home took action to hide away, from sight, toilet rolls, disposable gloves and incontinence pads in peoples rooms and toilet areas: this was to make these areas more homely and less clinical. The lighting and ventilation throughout the home was variable: in one of the most recently decorated (but vacant) rooms we were unable to open the sash window; some areas of the home were hot (although none of the residents said that they were too hot) and we saw that energy saving bulbs were in use, in peoples bedrooms that we visited. We discussed the issues of using such bulbs, as the intensity of light may not be fully sufficient for people with ageing eye sight, especially when the lights are first switched on. Temperatures for hot water, that is accessed by residents, were seen and these were recorded, each month, as being delivered at a safe level. According to the Manager discussions are in progress regarding the future of two baths that are not currently in use. One bath, located on the ground floor, is in use, but not accessible for any person requiring assistance of a hoist. The home currently cares for at least one person who needs this assistance: their care plan noted that they were unable to have a bath; the Care Homes for Older People Page 21 of 31 Evidence: Manager confirmed that this was due to the lack of assisted baths. All of the residents surveys said that the home was always or usually clean and fresh and we found that this was the case. Care Homes for Older People Page 22 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are safer due to the improved recruitment procedures and training of the staff. Evidence: Although one of the residents surveys said that the home could have Extra staff on duty all of the surveys indicated that that the staff were always or usually available when the person needed them.The majority (9) of the staff surveys said that there was always or usually enough staff on duty to meet the needs of the residents with the remaining surveys saying that this was sometimes the case. We timed the response of staff to a call bell and this was less than one minute duration. We saw the staff were carrying out their care duties in an unhurried manner and were sufficient in number to provide 1:1 individual care and attention to the residents. The AQAA said that More than the 50 of care staff either hold an NVQ Level 2 or 3 or are registered candidates for completing one. This tells us that people should be in safe hands due to the level and amount of trained staff at the home. Following our last inspection a requirement was made for all staff information to be obtained before any person was allowed to work at the home. This requirement has now been met as our examination of three staff files provided documentary and recorded evidence that all the required information was obtained before the person was allowed to work at the home, including verification of the references obtained. Care Homes for Older People Page 23 of 31 Evidence: All of the ten staff surveys said the person was satisfied with their induction training and ongoing training and felt that they always had enough support, experience and knowledge to meet the different needs of the residents. One of these surveys added that the home does well as I feel that the staff and residents are looked after very well. Another of these surveys added I enjoy working here... The staff training records and staff training files were examined and we spoke with some of the members of the staff, including the Manager: evidence indicated that the staff have opportunities to attend training in topics such as dementia care and safe medication practices as well as health and safety training. The staff records indicated that the Manager has implemented the Skills for Care induction standards training and we saw that this was used for one of the most recently recruited staff. Care Homes for Older People Page 24 of 31 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People benefit from a generally well managed home that could be safer with regards to fire safety measures. Evidence: According to the AQAA The new home manager meets the criteria of having had at least two years management supervisory experience in a relevant care setting in the past 5 years and has obtained the level 4 NVQ qualifications in care and management. She was appointed to this present post in June 2009 and said that she is applying to become the registered manager of Keynedon House. Results of the homes quality assurance surveys for 2009 and 2010 were seen and these demonstrate that peoples views were sought about their care and services provided and overall people were very satisfied or quite satisfied with these things. Copies of reports of monthly visits made by a representative of the registered company were seen for January and March 2010: these provided evidence that peoples views about the home are sought, to include meals, reporting that Residents Care Homes for Older People Page 25 of 31 Evidence: happy and enjoying breakfast at the time of the visit. Other areas taken into account during these visits include any residents health issues and action being taken in response to these and any staffing issues, such as staff vacancies. The home currently safeguards one persons personal allowances. This was held in a safe that was secure. We were unable to assess how the home fully safeguards the persons money as there was no record kept of any transactions. The Manager stated that she would introduce such a (required) record. The AQAA was completed to a satisfactory standard and demonstrated that there is a quality assurance system in the home by reviewing where the home does well and what improvements need to be made, including what action will be taken to make such improvements. The AQAA told us that people should live in a safe place as there are in date service checks for portable appliance equipment (PAT), fire detection and fire fighting equipment and those for hoists and the stair lift. We saw records of these and, with the exception of room number six PAT tests, all other service checks had been carried out. Fire alarms and emergency lights were recorded as being tested weekly and monthly respectively, by the home. The appropriate record for fire drills was not completed: the Manager stated that fire drills had been carried out during the fire alarm tests but agreed that the appropriate record must be used and completed with the full names of any person attending such fire safety practices. Fire training records indicated that most, but not all of the staff have attended a yearly refresher training session in fire safety. There was recorded evidence that the Manager has made arrangements for the remaining staff to attend this mandatory training. All the staff had a record that their moving and handling training was in date. According to the AQAA all of the staff have attended training in prevention and control of infection. The majority of the fire doors were held open with methods approved by the Fire Safety Officer. The exceptions to this was the door to the quiet lounge: this was held open with an approved door guard supplemented by a piece of rock; the door to room number six had a door guard that was supplemented with a folded up and crushed down metal tin lid. The Manager took immediate action to remove these unapproved items; both doors stayed open with the door guards. Some of the door guards in the extension part of the home were alarming, indicating that the batteries were low or run out. A fire door leading out to a courtyard, was not provided with an appropriate lock: the Manager explained that action is being taken to replace the batteries of the door guards and to ensure that the fire door meets with Care Homes for Older People Page 26 of 31 Evidence: the fire safety regulations. The fire escape leading in to the courtyard was clear from any obstruction and clear of debris. The home was awarded five stars (excellent) rating from the EHO, for its food hygiene, in March 2009. Since our last inspection the home has collected the award. Care Homes for Older People Page 27 of 31 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 28 of 31 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 1 9 13 Accurate information must 04/10/2010 be entered in the designated records of temperatures where the medication is stored and also within the controlled drug register. This is to ensure that the quality of medication is maintained and that there is a clear audit trail of medication received and administered in the home, respectively. 2 38 23 The opening and closure of any fire door must comply with the current associated fire safety regulations. This is to ensure that people are safe from the risk of spread of fire. 02/04/2010 Care Homes for Older People Page 29 of 31 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 30 of 31 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). 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. Care Homes for Older People Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!

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