Care Home: Kensington Hall

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kensington Hall Front Street South Hetton Durham DH6 2TG two star good service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Hilary Stewart Date: 0 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. They reflect the things that people have said are important to them: 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 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 Commission for Social Care Inspection aims to:  Put the people who use social care first  Improve services and stamp out bad practice  Be an expert voice on social care  Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: Kensington Hall Front Street South Hetton Durham DH6 2TG 01915170101 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Potensial Limited Name of registered manager (if applicable) Veronica Turner Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 Over 65 16 0 0 6 care home 16 learning disability old age, not falling within any other category Additional conditions: 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: Old age, not falling within any other category - Code OP, maximum number of places 6 Learning disability - Code LD, maximum number of places 16 The maximum number of service users who can be accommodated is: 16 Date of last inspection A bit about the care home 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 How we did our inspection: This is what the inspector did when they were at the care home The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. How the inspection was carried out, Before the visit we looked at the following, Information we have received since the home was registered. How the service dealt with any complaints concerns. Any changes to how the home is run. The providers view of how well they care for people. The views of people who use the service and the staff. The Visit An unannounced visit was made on 5th November 2008. During the visit we Talked with people who use the service staff and the manager. Looked at information about the people who use the service and how well their needs are met, Looked at other records which must be kept Checked that staff had the knowledge skills and training to meet the needs of the people they care for. Looked around the building to make sure it was clean safe and comfortable, Checked what improvements had been made since the last visit. We told the manager what we found We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future if a requirement is repeated it is likely that enforcement action will be taken. The fees at the home are 436.00p per week. What the care home does well The needs of the people who live at the home are assessed before and after they move into the home. This means that their care needs can be planned and properly met. All of the people at the home have care plans which give staff information about how to meet their needs. Information about the home is available to help people decide if it is the right home for them to move in to. Healthcare needs are well met by using a multi agency approach. This helps the people who live at the home to stay healthy. The home has medication systems for the staff to follow to make sure that the people who live at the home are not put at risk. The people have opportunities to take part in a variety of leisure pursuits and interests which provides them with a stimulating environment and helps them keep their social skills. The staff team at the home value the differing needs of the people who live there and make sure that they are aware of each persons preferences. They treat the people who live at the home as individuals and support them to live the life they choose as much as possible so they know they are valued. There are procedures in place at the home that make sure that the people who live there are protected and kept safe from abuse. The staff are supervised and trained so they know how to provide the people with good care. The manager is qualified and experienced. They are approachable and clearly present in the home to give direction and support to staff and make sure that the service is centred on the people whom live at the home. What has got better from the last inspection This is a new service. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Hilary Stewart St. Nicholas Building St. Nicholas Street Newcastle upon Tyne NE1 1NB 019 1233 3600 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 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 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 have their needs assessed before they are offered a place at the home. This makes sure that only people whose needs can be met at the home are offered a place. Evidence: People have an assessment by their care manager before they move into the home. The manager looks at this assessment to see if the home can meet the persons needs. They then carry their own assessment out prior to the person moving in so they can use this information for the care plan. People can visit the home before they make a decision. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . The home has care plans for each person who lives there so staff have the information they need to meet the needs of the people at the home some do not contain sufficient detail. People are supported to become more independent but at the same time staff look at the risks to keep them as safe as possible. Evidence: The manager said that the people who live at the home are consulted as much as possible about their care plans. Records showed that each person has a care plan. Any significant events are recorded in each individuals records sheets. The detail in the daily records varied some had very little detail such as a an entry for one day said fit and well. Each persons care plan contained information for staff about areas such as the persons mobility, hygiene, sleeping, eating and drinking. Again the care plans contained some detail but not enough in some areas to inform staff how to care for the people consistently and meet their needs. One care plan stated under the heading safety outside of the home, encourage the person named to be independent and reinforce road safety rules. The plan did not give staff information about how they should do this. It did not say whether the person needed to be prompted or directed or how independent they already were. The staff could describe how they work consistently with the people. Records showed that the care plans are monitored regularly and updated. Staff said that the people who live at the home are given choices as much as possible.They take part in planning the activities.Their timetables showed that they had different individual activities. Activities include going to the cinema, a disco and Evidence: some had recently had a trip to Disney on Ice. The manager and staff said that they consult the people who live at the home as much as possible. Staff were aware of people likes and dislikes. The are general and more person centred risk assessments. Some give more detail for staff about how they care for the people at the home. One risk assessment had added control measures which gave staff more information about how to work with one of the people when using crossings and traffic signals. However it was observed during the visit that action identified in one persons risk assessment was not being carried out. The action in the risk assessment said that that nothing should be placed on the floor in one persons bedroom to reduce the risk of falls, however a piece of plastic floor covering had been placed under the persons table and chair. The covering was sticking up from the floor from one side which was a possible health and safety risk for the person in the bedroom. The manager said that this would be removed and that it had been put there at the request of the person whose bedroom it was to protect the new carpet. The manager said that they update the risk assessments regularly. During the visit building work was taking place on the ground floor so the people at the home were living upstairs temporarily the manager said that this had not been risk assessed but they agreed to carry it out as soon as possible. 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 . The people who use the service experience healthy stimulating activities, supported by staff who value them, while maintaining links with their families and friends. This means they can have new experiences and interests and do not become isolated. Evidence: The manager said that the meals served at the home are the choice of the people who live there. Meals served at the time of visit looked appetising and nutritious. A kitchen has been built in the upstairs of the building for people to use during the refurbishment. There were adequate stocks of food. The manager and staff said that they get enough in the food budget for the home. The people can have a meal different from that displayed on the menu if they choose and the manager was changing the menus at the time of the visit. Staff said that a record of food served to each person is kept at the home. The manager and staff said that the people at the home can have snacks and drinks whenever they want and fresh fruit and vegetables are always available. One person was observed having tea and biscuits in their room during the visit. Another person said the food is nice. The people at the home are supported to maintain contact with their families. All of the people have individual activities and most were out on the day of the visit. One person said I dont like going out as they prefer to stay in their room. Records show that activities take place with each person. The daily routines within the home are structured around the people who live at the home. Sufficient staff were on duty to enable people to take part in activities individually. The activities are based upon what Evidence: the people like to do. The manager said that they support the people to have experience of the wider community by using the local shops and facilities. Staff and the manager said that the people are involved in domestic routines. 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 . People have personal support when they need it so they can be as independent as possible. Healthcare needs are met, which ensures that people stay healthy. However while adequate medication systems are place to make sure that people are not put at risk more checks need to take place. Evidence: The care plans identify the personal support that each person needs with everyday tasks. However as already stated the level of support that staff offer is not always clearly detailed in the individual care plans. One person needs assistance to get out of the bath but relevant details were not in their care plan. It did not say in the plan what type of support the person needs or the gender of the staff needed to support them. Specialist support is available from psychologist psychiatric services when required. Records are in use to monitor the administration of prescribed medicines. The administration sheets that are in use are known as a monitored dosage system. Only staff that are authorised and have completed training administer medicines. When re ordering medications the home does not keep a copy of the prescription so they are unable to check that the the medicines they receive from the pharmacy are correct. Other changes in the Mars sheets which had been hand written did not have a witness signature the manager agreed to rectify this immediately. 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 . Complaints are dealt with so any problems are taken care of quickly which helps good relationships to be maintained. Staff know about and have had training in how to protect people from harm, so the people who live at the home are kept safe. Evidence: Copies of the homes complaints procedure are in the information about the home. It is also displayed on the wall. The manager and staff said that the people who live at the home and their relatives know how to make a complaint. One of the people at the home when asked what they would do if they were unhappy about something said they would tell the staff. A record of complaints is kept at the home and it looked up to date. No complaints had been recorded since the last visit. The manager said that all staff have had training in how to safeguard the people they care for.There is a copy of the Local Authority procedures and the home has copies of their own adult protection procedures for staff. Staff said that they have had the training and they could describe what they needed to do if someone disclosed abuse to them. The home has a whistle blowing policy and procedure. 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 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 clean warm home. The home is being completely refurbished. Evidence: The home was in the process of being refurbished during the visit. Most of the work has been carried out upstairs so the people were living on that floor. A kitchen and dining room had been built for them to use. The manager said that they were only providing a service for six people until the work was finished. Black plastic floor covering was being used in the kichen as a temporary measure to protect the carpet. This had been taped down at the edges but was lifting in the middle and was not flat to the floor. It was a possible health and saftey risk as a person might trip. The manager agreed to replace this with something safer immediatley. There are enough bathrooms and showers for the people who live at the home. All of the bathrooms had hand soap and paper towels. Each person has their own bedroom and they looked comfortable and clean. The manager said that the people will be encouraged to personalise them when the work is finished and they have chosen their bedrooms. The laundry is organised and clean. 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 . Sufficient numbers of staff are in post to meet the diverse needs of the people who live at the home and they have opportunities fro training so they know how to give them good care and meet their needs. Furthermore the home has a recruitment procedures in place, which help to prevent risk of harm to the people who live there. Some records did not show that all checks had been carried out. Evidence: Staff said that they receive training, which helps them with their work. The manager said that all staff receive the training and support they need. Staff said and records showed that they all have mandatory training such as first aid and food hygiene. The manager said that all staff have received training in the homes procedure in safeguarding adults. Staff were familiar with the homes safeguarding procedure. All of the staff have vocational qualifications. Sufficient staff were on duty at the time of the visit. Staff said and records showed that sufficient staff had been on duty in the home the previous week. The manager said that enough staff work at the home and there is always at least two people on duty. The manager said that all staff have been CRB Criminal Records Bureau checked at an enhanced level to make sure they are suitable people to work at the home. All staff go through a recruitment process and they cannot start to work at the home until this is completed. They are interviewed and are only successful when they have two satisfactory references. Copies of staff records showed that checks had been carried out. Some records showed gaps in staff work history that had not been explored during the recruitment process. In on member of staffs file there was only one reference, the manager said that they will have been two but it must be mislaid. 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 registered person is qualified and experienced and runs the home in the best interests of the people who live there and there are procedures in place that make sure they are protected as much as possible. Evidence: The manager said that the people who live at the home and their families are asked their views about the running of the home as much as possible. Safety checks have been carried out on the equipment in the home such as testing electrical equipment. The central heating boiler has just been replaced as part of the major refurbishment and the manager said that the builder still has the safety certificates. Fire safety risk assessments had been completed. The fire logbook showed that fire drills and fire instruction take place but fire instruction was not as regular as it should be. The manager said that this has taken place but had not been recorded. Staff said that they have fire drills and instruction. Records showed that regular training is provided for staff in fire safety and first aid. The manager said and records showed that they are qualified and experienced to run the home effectively. It was observed that there was a friendly atmosphere at the home and a pleasant rapport between the people who live at the home the manager and staff. The staff said that they could approach the manager with any concerns. Staff said that they liked working at the home. The home is visited monthly by the registered person. Evidence: The home has procedures for staff when they deal with the peoples money so it is kept safe. Records showed that staff sign records when any of the residents money is used and the manager checks them regularly Are there any outstanding requirements from the last inspection? Yes  No  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 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 Description 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 Description Timescale for action 1 6 15 Care plans must have enough detail about the persons assessed needs and how they are being met at the home. 31/01/2009 Care plans must have enough detail to inform staff what actions they need to take to meet each persons needs. 2 9 13 Unnecessary risks must be 31/12/2008 identified and action taken to minimise them. Any risks relating to the on going building work must be assessed and action taken to minimise them. 3 34 15 The registered manager 31/12/2008 must hold two references for each member of staff at the home. Two references must be obtained by the manager for each member of staff to help make sure only suitable people work at the home 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 1 20 Handwritten changes to medication records should signed and have a witness signiture. The home should keep a copy of presriptions sent to the pharmacy so they can check the medication recieved is correct. Any temporary floor coverings should be fixed so they do not become a health and saftey risk. 2 24 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.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 © (2008) Commission for Social Care Inspection (CSCI). 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. 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