Care Home: Kent Lodge Residential Home

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What the care home does well Kent Lodge provides a secure and comfortable home for service users to live in. The home offers a holistic service in a relaxed and homely setting. Good individual care and support is offered to the service users to meet their individual needs as identified in their individual person centred care plans. Staffing levels are good and on the day of this inspection staff were observed spending time with residents and undertaking activities. The staff were observed to be interacting warmly with the residents in a manner which respected their privacy and dignity and encouraged them to do as much for themselves as was safely possible. Residents spoken with were complimentary about their care." I am cared for very well here it is just like home from home". Another said " The staff are really fantastic so understanding kind and considerate even now that I am so very slow ".One relative said " I am very happy with all aspects of the care my relative receives all the carers are very kind and caring and always have time to talk and respond promptly to any concerns." The home retains a stable experienced and well qualified workforce. The home has clear management arrangements in place and staff reported that the management and the training opportunities they have supports them with their work. What has improved since the last inspection? Since the last inspection a number of works of improvement to the building and its environment have been completed including exterior and interior redecorations, the purchase of new carpeting in some bedrooms and new DVDs and TVs with bigger screens. In the gardens major tree surgery work has been undertaken and the surface of the entrance driveway resurfaced along with the provision of enlarged car parking facilities. The percentage of qualified staff has risen since the last inspection and a number of new training courses undertaken. Also since the last inspection the number of staff has been raised this to ensure that the increasing needs of the residents can be properly met. What the care home could do better: It would be advantageous for the home to have an Internet connection so as to readily be able to access up to date guidance and information. Night staff must attend the same range of training as the day staff this to ensure full safety for the service users at all times. The use of red bags for the laundering of soiled linen would further improve the existing infection control measures. CARE HOMES FOR OLDER PEOPLE Kent Lodge Residential Home 434 Woodbridge Road Ipswich Suffolk IP4 4EN Lead Inspector Mrs Jan Sheppard Unannounced Inspection 25th February 2009 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kent Lodge Residential Home Address 434 Woodbridge Road Ipswich Suffolk IP4 4EN Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01473 716146 01473 729896 Mrs Pauline Kent Mrs Anne K McNamee Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 13th March 2007 Brief Description of the Service: The home is situated in a residential area, close to Ipswich town centre. Public transport is available in the form of regular buses into the main shopping areas and local shops are easily accessible. The home provides accommodation for older people on two floors of the building with access to the first floor by either the staircase or stair lift. The home has an attractive private garden, with shrubs, trees and bird feeding tables alongside a patio area. There are 17 single and six double bedrooms which are appropriately carpeted and furnished. There are two lounges on the ground floor in addition to a number of smaller sitting areas and quiet locations around the home. The dining room that over looks the garden has adequate facilities to accommodate all the residents but individuals wishes to take their meals in their own rooms are always respected. The fees range from £355 per week but this does not cover the costs of hairdressing, newspapers and magazines. Requesting the Statement of Purpose and Service Users’ Guide direct from the home can provide more detailed information about the service. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2*. This means that people who use the service experience good quality outcomes. This report follows an unannounced inspection where the core standards of the Care Standards Act 2000 for the care of older people were examined. The inspection took place on a weekday between 9.45 and 16.45 hours. The registered manager was present throughout the day to assist with the inspection. During this visit the inspector made a tour of the building, had in depth discussions with the homes managers, met and spoke with a number of residents and visitors, spoke with staff on duty and made a number of spot checks of the homes records. The detail of this report reflects the findings on that day and also takes account of information sent periodically to the Commission by the home. Information contained in the AQAA, (annual quality assurance assessment) which was completed by the manager and in a number of pre-inspection surveys sent to residents, relatives, staff and other professionals was also taken into account. What the service does well: Kent Lodge provides a secure and comfortable home for service users to live in. The home offers a holistic service in a relaxed and homely setting. Good individual care and support is offered to the service users to meet their individual needs as identified in their individual person centred care plans. Staffing levels are good and on the day of this inspection staff were observed spending time with residents and undertaking activities. The staff were observed to be interacting warmly with the residents in a manner which respected their privacy and dignity and encouraged them to do as much for themselves as was safely possible. Residents spoken with were complimentary about their care.” I am cared for very well here it is just like home from home”. Another said “ The staff are really fantastic so understanding kind and considerate even now that I am so very slow ”. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 6 One relative said “ I am very happy with all aspects of the care my relative receives all the carers are very kind and caring and always have time to talk and respond promptly to any concerns.” The home retains a stable experienced and well qualified workforce. The home has clear management arrangements in place and staff reported that the management and the training opportunities they have supports them with their work. What has improved since the last inspection? What they could do better: It would be advantageous for the home to have an Internet connection so as to readily be able to access up to date guidance and information. Night staff must attend the same range of training as the day staff this to ensure full safety for the service users at all times. The use of red bags for the laundering of soiled linen would further improve the existing infection control measures. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 does not apply as the home does not offer intermediate care. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to receive an assessment of their care needs prior to their admission to the home. EVIDENCE: Good information about the home and the level of services offered is given to all prospective applicants. The homes Statement of Purpose and Service User Guide is displayed in the entrance hall of the home and this was seen to include all the elements required by regulation including information about staffing and staff qualifications, private and communal facilities and space, fees Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 10 and contractual conditions. Information about local advocacy services was also seen to be readily available. The Manager carries out pre admission assessments visiting the prospective applicant either in their own home or in hospital. Medical and social reports are always sought so that the home can be fully informed about the prospective residents circumstances. Relatives and prospective residents are invited to visit the home to view the accommodation and to spend some time with the other residents. The manager said that in most cases the prospective resident spends a whole day in the home joining in with any activities and meeting the staff and that this is an important time enabling each to get to know the other before any decision about admission is made. All admissions are made initially on a one months trial basis. Kent Lodge has comprehensive pre admission assessment documentation covering all areas of care need including mobility, personal hygiene, diet, continence, cognition, current medication, past medical history, relevant social history and the current involvement of relatives. All these areas were seen to have been completed on the files of the recently admitted residents that were examined. Comments from relatives and also from newly admitted residents themselves confirmed that their admission process had been handled sensitively and had been conducted at a pace that suited them. The records evidenced that pre admission needs assessments are constantly reviewed with time intervals set as individual needs dictate this to meet any quickly changing circumstances. Relatives are invited to be involved with these reviews if they wish and with the residents agreement. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9and 10. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to have a person centred care plan which adequately documents their needs and how these should be met. The homes medication practices offer protection to the residents. EVIDENCE: Personal care was seen to be being delivered by experienced staff in a kindly manner that respected the residents’ dignity and individuality. The staff were observed to be knocking on doors prior to entering bathrooms and bedrooms and to be calling residents by their preferred name. The staff clearly knew the residents very well and all grades of staff were seen to work well together as a team and that they promoted a calm homely atmosphere in which the Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 12 residents seemed relaxed and were very talkative. All the residents spoken with reported very positively about the standard of the care they received in the home. One said “ I have everything I want here the food is very good and nothing is too much trouble for the carers”. Four care plans were examined and all were well maintained with clear documentation set out in easily accessed sections of the file. The Manager said that the review of the format of the care plans which had been underway at the time of the last inspection had now been completed and that now key workers regularly added information to the daily records of their residents. This new format ensures that care needs are recorded in a more person centred way. End of life wishes were seen to be recorded and better evidence given of residents wishes and involvement with care plan reviews could be seen. Clear recording of weights and referral to dieticians and doctors had been recorded. A risk monitoring system is in place to monitor residents whose needs are changing. Care staff confirmed that they were responsible for reviewing care plans on a monthly basis and evidence in the files examined supported this. On the day of this inspection a social worker visited the home to carry out a review of the service being delivered to a number of residents who they were funding. The Manager reported that the home maintains close working relationships with local GPs and District nurses who were seen to visit the home during this inspection and that they benefit from having a large medical practice almost next door. Feedback from consultation with other medical professionals in the pre inspection surveys was all positive with comments including “ they offer a really caring service “ and the home refers medical problems to us promptly” being made. A visiting nurse was seen to be providing aids to assist with the prevention of pressure areas and to be offering consultation for the carers concerning the best method of providing on going care for this condition. The homes records evidenced that a CPN will make visits to the home and the manager who said that the home felt very well supported by the local medical services also said that when needed an assessment from a specialist Consultant in Elderly care could usually be arranged promptly. The home uses an MDS (Monitored Dosage System) for medication storage and administration. This is supplied by a local pharmacist who gives prompt service and good support and training. Medication reviews are undertaken by the local surgery on an annual basis. Part of a medication round was observed during this inspection and staff were heard to be explaining appropriately to the recipient resident and to be administering and recording the medication in a safe manner. MAR (medication administration record) sheets checked were seen to have been fully completed with no gaps. The manager makes regular checks of the accuracy of these MAR sheets but no evidence of these checks are recorded. A check was made of the Controlled Drugs and these records Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 13 were found to tally with the controlled medication held. All staff who administer medication are fully trained to do so. It would be advantageous for the home to have a small medication fridge so that especially in warm weather the temperature of stored medication can be accurately maintained and an up to date list of the signatures of staff who administer medication should be complied. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to be encouraged to maintain contact with family and friends, to be offered a range of activities and to have a well balanced diet. EVIDENCE: Feed back from residents and relatives confirmed that the standard and variety of food continues to be very good. The manager explained that since the last inspection and following consultation with all the residents the menus had been revised to include new dishes requested by individuals. It could be seen from the menus that choices are available for each meal and residents told the inspector that if they make a particular request the cook is usually be able to provide an individual alternative. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 15 The serving of the lunchtime meal was observed. The meal smelt extremely good and residents confirmed that it was hot and appetising. Staff who were serving clearly had good knowledge of individuals likes and dislikes and were heard to be asking residents about the portion sizes. Staff who were observed to be assisting residents to eat their meal were seen to be doing so in an appropriate manner whilst constantly consulting with them. The meal period was protracted to accommodate the varying eating speeds of the residents and was a very relaxed and happy occasion with easy conversation and laughter between the residents and staff. Staff confirmed that any residents wishing to eat alone or in their rooms were always facilitated to do this and several were observed during the inspection. One told the inspector that she preferred to eat along but knew that she could always join the others in the dining room if she wished. The dining room is of a good size a light and airy room that overlooks the garden. Individual and small group dining tables were neatly set out and further improvements which could be made to the table settings were discussed. The manager also discussed with the inspector her plans to change the dining chairs to those with arms and skids this to facilitate the comfort and easy use for the residents. The kitchen was visited and found to be well appointed, clean and tidy. Temperatures of refrigerators and freezers are recorded daily and showed that they were functioning within safe limits. There was a wide range of dry ingredients and fresh fruit and vegetables. Staff had a good awareness of the need for good hydration especially in hot weather and residents who want can have fresh supplies of fruit and water in their rooms. The kitchen had been subject to an Environmental Health Inspection on 10th June 2008 when it was found to meet all the requirements with no recommendations made. The cook said that she had good training opportunities and that the kitchen followed the procedures set out in the Safer Food Better Business guidelines. She also confirmed that the ingredients that she requests are always available promptly. The home provides daily activities for the residents who wish to participate and the records evidenced that these usually take place in the afternoons. Feedback in some of the surveys from relatives and others had said that more activities were desirable. The manager explained that since the last inspection following consultation with the residents the activity programme had been enlarged and a programme of individual and small group activities is now available throughout the week. This includes knitting bingo, chair exercises, board games, manicure and make up sessions, hairdressing, small cake and biscuit making, flower arranging and the planting of flower and tomato tubs in the garden. Staff will accompany residents who are able to visit the local shops and photographic evidence of outings and visits made into the locality could be seen in the home. The manager said that the visits from a Pat Dog were particularly appreciated as were the regular music concerts given by an Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 16 individual singer and by the choirs from local schools. Residents consulted all said that they had plenty of opportunities for activities and confirmed that they were given free choice whether or not to attend. These choices were seen to be recorded in their care plans along with comments as to their attendance at their chosen activities. The home has an open visiting policy and a considerable number of relatives and friends came and went during the day of this inspection. Many made their way to the managers office for a chat. Those spoken with said that they were always made very welcome in the home were offered refreshments and could if the wished have their visits in private. All said that they were very happy with the care that their relative received and spoke very positively about the homely and relaxed atmosphere of the home and the calm and warm manner in which care was delivered to the residents One said “ I visit nearly every day I find the service always to be very professional staff are always on hand to assist and nothing is too much trouble and management always keep me informed.” The care files examined all contained the spiritual persuasion of the residents, if any, and final wishes were also seen to have been recorded. The home is regularly visited by representatives of different religions who conduct services or meet with individuals in the home. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that complaints are listened to and are handled properly and that the homes policies and procedures will ensure that they are protected from abuse. EVIDENCE: The complaints policy was on display in the home. Pre-inspection surveys from residents and relatives and those spoken with during the inspection said that they would know what to do if they had any reason to make a complaint. Residents spoken with told the inspector that they would immediately speak to the manager and that they had confidence that she would sort it out. One said “All the managers are very approachable and the owner visits regularly and speaks with us all”. There have been no complaints made to the home since the last inspection neither has the CSCI received any complaints about the care received in the home. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 18 A record of compliments is kept and was shown to the inspector. This evidenced a number of grateful thanks from relatives and friends. The home has a copy of the guidelines issued by Suffolk Joint Agencies for the protection of vulnerable adults and a comprehensive Whistle Blowing policy to protect staff and residents. Staff interviewed confirmed that they were aware of these policies and the steps that they should take if they ever had any concerns relating to the safety and protection of a resident. There have never been any POVA incidents reported in the home. All staff complete POVA courses during their Induction training and again during the NVQ studies. The homes training records evidenced that refresher POVA training had been attended by most staff during the past year but did not fully evidence that all staff had attended this. The Manager is aware of the new E learning POVA programme provided by the local social services and intends that this short distance learning programme shall be completed by staff regularly as a means of updating and refreshing their knowledge and awareness of this aspect. The Manager and some others of the management team have completed training concerning the Mental Capacity Act including the Deprivation of Liberty module. Information concerning the facts and implementation of this new legislation are being cascaded down to all staff during the home internal staff training meetings. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can expect to live in an attractive well maintained and safe environment that is spacious and homely and is well appointed with specialist equipment to meet their needs. EVIDENCE: A tour of the building was undertaken as part of this inspection. The building was found to be clean and tidy with no unpleasant odours. Residents bedrooms were all found to be well personalised in a homely manner which reflected their individual tastes and styles. In each room the radiator was covered with a low surface temperature cover and each room had a lockable storage area. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 20 Call bells were seen to have extension leads so as to be accessible in every area of the room. The whole home was seen to be well appointed and the manager was able to evidence an on going maintenance and refurbishment programme both internal and externally. All the bedrooms are regularly re-decorated and where possible the resident is able to contribute to the choice of colours etc. Since the last inspection new carpeting and soft furnishings have been provided in some bedrooms and the manager said that it is planned to renew a number of beds. Double rooms have appropriate screens to ensure residents individual privacy and agreements are in place in relation to sharing. The home has a good sized laundry which is appropriately located away from the communal areas and has direct access to the garden drying facilities. The staff confirmed that the laundry equipment is adequate for the amounts of laundry generated by the home. The staff showed a good awareness of appropriate infection control measures although the use of red bags for soiled linen would give further infection contamination protection. Supplies of gloves and aprons were seen to be available at strategic points around the home and some staff were observed to be carrying their own supplies of hand wash. The training records evidenced that training on Infection Control had been undertaken since the last inspection. The residents asked were complimentary about the standard of their laundry and on the day of this inspection they were seen to be well dressed with freshly ironed clothing. Specialist equipment is provided for each resident to meet their particular needs following an OT assessment if required. This promotes the residents ability to retain their independence for as long as possible. Hoists had individually designated slings and were seen to be subject to regular maintenance and servicing checks. Staff reported that the home has sufficient hoists and other such equipment to meet the residents needs and that where a new need is identified appropriate equipment is promptly obtained. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People who use this service can be confident that they will be supported by appropriate numbers of skilled and trained staff who have been safely recruited to protect and support them and to ensure the smooth running of the home. EVIDENCE: Staff were seen to be working well together as a team and to be providing support for the residents in a kindly unhurried manner allowing them to do as much for themselves as it is safely possible for them to so do. Staff were found to be familiar with the needs of the residents and a good rapport was seen to exist between them. The home continues to retain a core group of very dedicated and well trained staff, many of whom have worked at the home for many years. The home was fully staff at the time of this inspection and the manager stated that they never used agency staff but could provide cover for sickness and other absences from within the existing staff group. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 22 Staff spoken with during the inspection and those who had completed pre inspection questionnaires reported that they were happy working in the home, happy with the manner in which they were managed and the training opportunities afforded them. Since the last inspection the records evidenced that training on the following subjects had been attended Dementia Awareness, Protection of Vulnerable Adults, Manual Handling, First Aid, Fire Awareness, Infection Control and Health and Safety, Equality and Diversity Awareness and the Mental Capacity Act. Since the last inspection the number of staff holding NVQ qualifications has increased to over 80 . All the senior staff have attained NVQ at level 3 and the Manager has NVQ level 4 and the Registered Managers Award. The manager said that from a slow start a few years ago day staff now had a very positive attitude towards training with many carers wanting to progress on to Level 3 studies. The records evidenced that the training programme for the night staff had not been fully completed and the manager said that she is aware of the need for them to fully access all the appropriate training courses. She also said that it would be her wish to have all the staff holding recognised professional qualifications. Because of the increasing care needs of the residents now coming to the home the numbers of staff have since the last inspection been increased so as to fully meet their needs at all times. The recruitment records examined for staff most recently appointed to the home evidenced that all the required checks had been made this to ensure the safety of the residents. New staff commence their duties only after the results of a full CRB check have been received and then work on a supernumerary basis for the first weeks whilst they are completing their comprehensive induction training programme. The home compiles an annual training programme to meet the assessed training needs of all staff carers cooks and housekeepers. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 and 38. People who use this service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service can be confident that they will be safeguarded by the sound management approach led by an experienced and qualified manager and management team and that there are administrative systems in place to ensure their rights and encourage their independence and choices. EVIDENCE: The home benefits from having a stable management team who are well qualified and experienced and whose shared ethos is very clearly to put the Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 24 needs of the residents first. Their confident and calm approach to their work positively influences the homely and relaxed atmosphere in the home. The manager holds NVQ qualifications at level4 and has attained the Registered Managers Award. The three senior carers all hold NVQ qualifications at Level3. This means that at all times the person in charge of the home is appropriately qualified. All the management team continue to undertake regular training to update their knowledge and to keep abreast of new developments. The availability of an internet connection in the home would further improve their access to information about new care service initiatives and government guidance as this comes on line. Residents relatives and visiting professionals interviewed for this inspection confirmed that the manager and her team are always very approachable and make every effort to sort out any problems quickly. A relative commented “ I am always made to feel very welcome when I visit and the manager is most informative and supportive”. The records evidenced that a supervision matrix is in place to ensure that all staff receive formal supervision at least six times a year. Staff spoken with confirmed that they feel themselves to be well supervised and managed and that they could speak to the manager at any time. Regular staff meetings are held with appropriate agendas and minutes being kept. Quality assurance systems are in place and discussions with the manager evidenced that she is proactive in addressing quality issues within the home. Quality surveys are regularly sent to relatives and other professionals and the results of these are regularly fed back to the staff as part of their ongoing learning process to continually improve the service they offer. The manager is committed to promoting equality and diversity in the service and meeting the individual needs of the residents. The records relating to fire testing, the monitoring of water temperatures, risk assessments for the environment and safety checks for the homes equipment were all seen to be well maintained this ensuring the safety of the residents at all times. The home has a policy and procedures for the protection of residents monies held by the home and records of these that were checked were found to tally with the required records relating to expenditure and that records of transactions were properly maintained. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP30 Regulation Requirement Timescale for action 30/04/09 18 (1) (c ) The registered manager must (1) ensure that all groups of staff access all the training required to ensure the safety of the residents at all times. 18 (1) 2 OP18 The registered manager must 30/06/09 ensure that all staff regularly complete refresher POVA training this to ensure the safety of the residents at all times. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP26 Good Practice Recommendations It is recommended that to ensure the highest levels of DS0000024426.V374425.R01.S.doc Version 5.2 Page 27 Kent Lodge Residential Home infection control are maintained that red bags are used for the handling of soiled linen. Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kent Lodge Residential Home DS0000024426.V374425.R01.S.doc Version 5.2 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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