Care Home: Kepplegate House

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What the care home does well We received a good response to our written survey and a number of completed questionnaires were received from residents and staff members. In general, people were very complimentary about the care provided and some very positive comments were made. These included; `Everything I need is here, I am looked after very well by very kind people.` `The manager ensures that the home is constantly improving and involves residents and carers in this.` `We are more than happy with the care provided, the home is very well run.` During our visit we observed staff and residents going about their daily routines. There appeared to be ample numbers of staff on duty to meet people`s needs and carers went about their duties in a pleasant and professional manner. Residents appeared content and comfortable in their surroundings. In discussion, the manager demonstrated that she was committed to person centred practice and this was evident throughout the inspection. The home had become involved in a project called `My Home Life` which involved carers taking part in a forum to discuss how outcomes for residents could be continually improved. As a result of the forum, staff had agreed to implement a new keyworker system and at the time of our visit, work was ongoing for all keyworkers to meet with residents` families to encourage them to be involved in their loved one`s care planning.We viewed a sample of care plans and found that they contained a very good level of information about residents` daily care needs. In addition, more person centred information such as social histories and preferred daily routines was included. Care plans were well organised and we were also able to confirm that risk assessments were in place for all residents in areas such as pressure care, moving and handling and nutrition. Residents` daily diary notes provided evidence that the home work well with various community health care professionals such as district nurses and GPs. The home have procedures in place for the safe receipt, storage, administration and disposal of medication. We viewed some records relating to medication and medicines stock and found that these were all in good order and well maintained. We carried out a check of one resident`s medication which was prescribed on a variable dose basis. The stock and records were accurate and there were no anomalies. This demonstrates that carers check records carefully when administering medication. We were able to confirm that all staff receive external training in managing medication and that the manager ensures that staff are competent before they are allowed to administer. We were able to confirm during this inspection that there are processes in place to safeguard residents and to enable people to raise any concerns they may have. In discussion, the manager demonstrated a very positive view of complaints, rightly describing them as opportunities for improvement. The manager advised us that she maintained a frequent presence in the home and always attempted to be approachable to residents, relatives and staff. We viewed the home`s complaints record and found that all complaints received by the home had been responded to in a very positive fashion. One concern raised had resulted in changes in a specific procedure across the home. Records showed that the manager had met with the complainant to feed this back and had also arranged ongoing meetings to ensure that the complainant remained satisfied. Staff training records showed that the majority of carers had received training in safeguarding vulnerable adults and that this training was regularly updated. In addition, 13 out of 14 carers held nationally recognised qualifications in care which is commendable. What the care home could do better: No requirements were made as a result of this inspection. Some recommendations were made to support the home`s further development. We noted during our visit that some residents` personal records were stored in an area where unauthorised people could get access to them. We advised the manager to review these arrangements and ensure that all personal records were stored securely. This willhelp safeguard the residents` right to confidentiality and their privacy. We were able to establish that the manager carried out competence assessments for all carers who deal with residents` medication. However, we made a recommendation that this process be formalised and recorded. In addition, competence assessments should be regularly reviewed. Currently the home`s complaints procedure is available in a standard written format and a large print format. We advised the manager to consider making the procedure available in a variety of other formats such as audio to help ensure that more people have access to the information. Random inspection report Care homes for older people Name: Address: Kepplegate House Sandy Lane Preesall Poulton-le-fylde Lancashire FY6 0EJ three star excellent service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Marie Cordingley Date: 2 6 0 4 2 0 1 0 Information about the care home Name of care home: Address: Kepplegate House Sandy Lane Preesall Poulton-le-fylde Lancashire FY6 0EJ 01253811957 01253813862 Kepplegate@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Karen Louise Shaw Type of registration: Number of places registered: Conditions of registration: Category(ies) : Kepplegate Ltd care home 16 Number of places (if applicable): Under 65 Over 65 16 old age, not falling within any other category Conditions of registration: 0 The registered person may provide the following category/ies 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 The maximum number of service users who can be accommodated is: 16 Date of last inspection Brief description of the care home Kepplegate House is a purpose built two-storey home, located in the village of Preesall, just a short drive from the sea front at Knott End. Care Homes for Older People Page 2 of 9 Brief description of the care home The home is within close proximity to shops and local amenities. Residents are encouraged to retain their links within the community and every effort is made to ensure that relationships, hobbies and interests are pursued. Kepplegate is registered with the Care Quality Commission to provide personal care for a maximum of 16 older people of both sexes. There are attractive garden areas at the front and rear of the home which residents can use weather permitting. Car parking is available either at the side of the home, or in the road alongside the home. The home provides personal care for older people, and is equipped to suit the needs of its residents. For example, there is a stair lift to the upper floor, grab rails, raised toilet seats and ramps for easy access. All of the rooms are single rooms, and toilets and bathrooms are conveniently situated. There is sufficient communal space, with a large lounge/dining room and conservatories at the front and rear of the home. Relatives, friends and visitors are made welcome at the home at any time. Activities are organised within the home and outings are arranged for residents who wish to participate. At the last visit weekly fees ranged between 386 pounds and 418 pounds dependent upon assessment of needs. Additional extras like hairdressing and newspapers are paid for by the residents. Care Homes for Older People Page 3 of 9 What we found: The inspection of this home included an unannounced visit. As the visit was unannounced the manager, staff and residents did not know it would be taking place until we arrived. During the visit we held discussions with the manager of the home and observed staff and residents going about their daily routines. We also viewed a selection of records including residents care plans and the homes complaint records. Prior to the visit we asked the manager to complete an Annual Quality Assurance Assessment (AQAA). This gave us a lot of information about how the home is managed and also details such as numbers of staff employed at the home and their qualifications. We also wrote to a selection of residents and staff and asked them to share their views on various aspects of the service provided. The purpose of the inspection was to ensure that the home was maintaining excellent standards as assessed in the key inspection carried out in May 2007. The inspection concentrated on two outcome areas for which the home were rated excellent in their last key inspection, namely Health and Personal Care and Complaints and Protection. What the care home does well: We received a good response to our written survey and a number of completed questionnaires were received from residents and staff members. In general, people were very complimentary about the care provided and some very positive comments were made. These included; Everything I need is here, I am looked after very well by very kind people. The manager ensures that the home is constantly improving and involves residents and carers in this. We are more than happy with the care provided, the home is very well run. During our visit we observed staff and residents going about their daily routines. There appeared to be ample numbers of staff on duty to meet peoples needs and carers went about their duties in a pleasant and professional manner. Residents appeared content and comfortable in their surroundings. In discussion, the manager demonstrated that she was committed to person centred practice and this was evident throughout the inspection. The home had become involved in a project called My Home Life which involved carers taking part in a forum to discuss how outcomes for residents could be continually improved. As a result of the forum, staff had agreed to implement a new keyworker system and at the time of our visit, work was ongoing for all keyworkers to meet with residents families to encourage them to be involved in their loved ones care planning. Care Homes for Older People Page 4 of 9 We viewed a sample of care plans and found that they contained a very good level of information about residents daily care needs. In addition, more person centred information such as social histories and preferred daily routines was included. Care plans were well organised and we were also able to confirm that risk assessments were in place for all residents in areas such as pressure care, moving and handling and nutrition. Residents daily diary notes provided evidence that the home work well with various community health care professionals such as district nurses and GPs. The home have procedures in place for the safe receipt, storage, administration and disposal of medication. We viewed some records relating to medication and medicines stock and found that these were all in good order and well maintained. We carried out a check of one residents medication which was prescribed on a variable dose basis. The stock and records were accurate and there were no anomalies. This demonstrates that carers check records carefully when administering medication. We were able to confirm that all staff receive external training in managing medication and that the manager ensures that staff are competent before they are allowed to administer. We were able to confirm during this inspection that there are processes in place to safeguard residents and to enable people to raise any concerns they may have. In discussion, the manager demonstrated a very positive view of complaints, rightly describing them as opportunities for improvement. The manager advised us that she maintained a frequent presence in the home and always attempted to be approachable to residents, relatives and staff. We viewed the homes complaints record and found that all complaints received by the home had been responded to in a very positive fashion. One concern raised had resulted in changes in a specific procedure across the home. Records showed that the manager had met with the complainant to feed this back and had also arranged ongoing meetings to ensure that the complainant remained satisfied. Staff training records showed that the majority of carers had received training in safeguarding vulnerable adults and that this training was regularly updated. In addition, 13 out of 14 carers held nationally recognised qualifications in care which is commendable. What they could do better: No requirements were made as a result of this inspection. Some recommendations were made to support the homes further development. We noted during our visit that some residents personal records were stored in an area where unauthorised people could get access to them. We advised the manager to review these arrangements and ensure that all personal records were stored securely. This will Care Homes for Older People Page 5 of 9 help safeguard the residents right to confidentiality and their privacy. We were able to establish that the manager carried out competence assessments for all carers who deal with residents medication. However, we made a recommendation that this process be formalised and recorded. In addition, competence assessments should be regularly reviewed. Currently the homes complaints procedure is available in a standard written format and a large print format. We advised the manager to consider making the procedure available in a variety of other formats such as audio to help ensure that more people have access to the information. 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 9 Competence assessments relating to medication administration should be recorded and regularly reviewed. This is to help safeguard the health and well being of people who live at the home. Residents personal information should be securely stored. This is to help safeguard the privacy and dignity of people who live at the home. The homes complaints procedure should be made available in a variety of different formats. This is to help ensure that more people have access to the information. 2 10 3 16 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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