Care Home: Kibworth Knoll

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What the care home does well A comprehensive information pack is held in each resident`s room and includes a Statement of Purpose and Service User Guide and Terms and Conditions. Residents have access to a copy of the most current inspection report. All this information helps prospective residents make fully informed choices about whether or not a home is suitable for them. Residents health care needs are fully maintained and are treated with respect and their right to privacy upheld. Residents enjoy the lifestyle in the home and are able to maintain contact with their relatives. Residents were observed smartly presented in their own clothes and some male residents in jackets. Residents spoken to said- staff spoke to them with respect and were always kind to them. The manager and the cook in consultation with the residents choose seasonal menus carefully. Staff have received Protection of Vulnerable Adults (POVA) training. Residents spoken with said they were safe and that staff treated them well. The home is very well maintained and parts of the home are improving through an ongoing high quality refurbishment programme. A substantial extension is in the pricess if being developed and will significantly improve the layout of the home. Residents tell us the home is clean and comfortable. The residents` needs are met by the number and skill mix of staff; and are in safe hands. Staff are well trained and competent to do their jobs. Residents live in a home that is well run and managed and their health, safety and welfare are promoted and protected. The registered persons support the manager in the running of the home. They are both very experienced in running care homes. This arrangement works well for the benefit of the residents. The registered manager is training to be a moving and handling trainer and will continue to train up her staff team, which will benefit resident`s care and safety. What has improved since the last inspection? Care plans are sufficiently detailed on action, which needs to be taken by care staff to ensure that all health, personal, and social care aspects are included. Medicines that require cold storage are kept in the large fridge in the kitchen with daily temperature checks taking place daily. The complaints procedure is going to be updated and developed around responding to times scales and appropriate contact details. Two written references are in place for new staff in line with the required recruitment procedures. Now, water temperatures for all hot water outlets accessible to residents are checked regularly. This is to reduce the risk of scalding to residents. What the care home could do better: For new residents care plans need to be drawn up quickly. This will ensure residents receive the best care as soon as they enter the home. The complaints procedure needs updating including the summary in the Statement of Purpose. In line with the latest procedure, the complaints procedure needs to be altered to give the complainant the choice of the initial stage to go the investigating body- the local social services department- now the lead agency for investigating complaints- as well as the home. CARE HOMES FOR OLDER PEOPLE Kibworth Knoll 12 Fleckney Road Kibworth Beauchamp Leicester LE8 0HE Lead Inspector Helen Abel Unannounced Inspection 7th May 2008 10:15 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 Kibworth Knoll DS0000068566.V364046.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. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kibworth Knoll Address 12 Fleckney Road Kibworth Beauchamp Leicester LE8 0HE 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) 0116 2793879 F/P 0116 2793879 Kibworth Knoll Limited Ms Kate Flowers Care Home 36 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (36), of places Physical disability over 65 years of age (4) Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No one falling within category OP may be admitted into Kibworth Knoll where there are 36 persons of category OP already accommodated in this home. No one falling within category DE(E) may be admitted into Kibworth Knoll where there are 10 persons of category DE(E) already accommodated within this home. No one falling within category PD(E) may be admitted into Kibworth Knoll where there are 4 persons of category PD(E) already accommodated within this home. No person to be admitted to Kibworth Knoll in categories OP, DE(E) or PD(E) when 36 persons in total of these categories/combined categories are already accommodated in this home. 5th February 2007 Date of last inspection Brief Description of the Service: Kibworth Knoll Care Home can accommodate thirty-six older people in the purpose built property. It is set in the village of Kibworth Beauchamp close to a variety of amenities in the village. The premise consists of two floors. Service users occupy both floors and access to the ground and first floor is by use of the stairs and passenger lift. There are a variety of aids and adaptations throughout the premise based on service users care needs to support them to be more independent. The home has twenty-six single bedrooms and with the exception of one single bedroom the rest have ensuite facilities. There are five double bedrooms and two have ensuite facilities. There are sufficient toilet and bathroom facilities on both floors based on the number of service users residing in the home. Currently building works are ongoing to develop the provision. The home has an attractive garden to the side of the premises. The care fees charged cover food, heat, lighting, laundry, and provisions of staff and contributions towards maintenance and decoration of the home’s furnishing replacements. The most current inspection report is available to all residents upon request in the home. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting three people and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. People who live at Kibworth Knoll prefer to be called “residents.” Planning for this visit included: examining the last two inspection reports; assessing the service history of the home including the reporting of significant events. Examining the Annual Service Review (ASR) and the Annual Quality Assurance Assessment (AQAA). This was an unannounced Inspection. The Inspection started at 10.15 in the morning and lasted around five hours. The home’s registered manager was absent but the registered provider arrived shortly after the Inspector and assisted with the inspection process. The visit included a selected tour of the building, inspection of records and indirect observation of care practices, and the serving food at a mealtime. The Inspector spoke with five residents, three members of staff and both the registered providers. The quality rating for this service is 2 star. This means the residents who use this service experience good quality outcomes What the service does well: A comprehensive information pack is held in each resident’s room and includes a Statement of Purpose and Service User Guide and Terms and Conditions. Residents have access to a copy of the most current inspection report. All this information helps prospective residents make fully informed choices about Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 6 whether or not a home is suitable for them. Residents health care needs are fully maintained and are treated with respect and their right to privacy upheld. Residents enjoy the lifestyle in the home and are able to maintain contact with their relatives. Residents were observed smartly presented in their own clothes and some male residents in jackets. Residents spoken to said- staff spoke to them with respect and were always kind to them. The manager and the cook in consultation with the residents choose seasonal menus carefully. Staff have received Protection of Vulnerable Adults (POVA) training. Residents spoken with said they were safe and that staff treated them well. The home is very well maintained and parts of the home are improving through an ongoing high quality refurbishment programme. A substantial extension is in the pricess if being developed and will significantly improve the layout of the home. Residents tell us the home is clean and comfortable. The residents’ needs are met by the number and skill mix of staff; and are in safe hands. Staff are well trained and competent to do their jobs. Residents live in a home that is well run and managed and their health, safety and welfare are promoted and protected. The registered persons support the manager in the running of the home. They are both very experienced in running care homes. This arrangement works well for the benefit of the residents. The registered manager is training to be a moving and handling trainer and will continue to train up her staff team, which will benefit resident’s care and safety. What has improved since the last inspection? Care plans are sufficiently detailed on action, which needs to be taken by care staff to ensure that all health, personal, and social care aspects are included. Medicines that require cold storage are kept in the large fridge in the kitchen with daily temperature checks taking place daily. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 7 The complaints procedure is going to be updated and developed around responding to times scales and appropriate contact details. Two written references are in place for new staff in line with the required recruitment procedures. Now, water temperatures for all hot water outlets accessible to residents are checked regularly. This is to reduce the risk of scalding to residents. What they could do better: 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. Kibworth Knoll DS0000068566.V364046.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 Kibworth Knoll DS0000068566.V364046.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): 1,2, 3, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have information available to them to enable them to make an informed choice about whether a home can meet their needs. EVIDENCE: Prospective residents receive an assessment by the homes manager before entering the home. A care plan is carefully drawn up from the initial assessment. A comprehensive information pack is held in each resident’s room and includes a Statement of Purpose and Service User Guide and Terms and Conditions. Residents have access to a copy of the most current inspection report. All this information helps prospective residents make fully informed choices about whether or not a home is suitable for them. Some updates are needed around the Compliments and Complaints section in the information Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 10 provided to residents. This aspect was discussed wit the registered provider who agreed to look again at this. A new resident reported, “I can’t fault the staff, very helpful,” Kibworth Knoll DS0000068566.V364046.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): 7,8,9,10, 11 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents health care needs are fully maintained and are treated with respect and their right to privacy upheld. EVIDENCE: Care plans were sampled for three residents. Overall care plans were very comprehensive and included a wealth of information about the residents needs. This included a photograph, daily and monthly updates and reviews. Records of visits from health professionals, regular weighting programmes and information received from family members and friends. The care plan format has sufficient details of any actions, which need to be taken by the care staff to meet individual residents needs. For one new resident the care plan was still in the process of being drawn up. It is good practice for care plans to be set up within short timescales. This Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 12 aspect was discussed with the registered providers. This would ensure the residents receive the best care as soon as they enter the home. A new dedicated medication room has been established. Staff were observed administering medicines around a mealtimes. Medicine records were sampled and were clear and in good order. Photographs of residents were included in the medicine record as a further guide to staff. Medicine stocks were wellorganised and all senior staff and managers have received accredited training with medicines. Attention is sensitively paid to ensuring residents wishes are respected around death and dying. Residents and their relative’s views are sought when first entering the home and continue to do so when care needs change. The home has established a firm link with a nursing team that provides a service to residents - Decisions at the End of Life (DALE). A resident’s care plan confirmed an individual’s choice to spend long periods in their bedroom. Staff respected these wishes but steps were taken to ensure regular contact and short periods of time were given by staff, managers and the registered providers. Residents were observed smartly presented in their own clothes and some male residents in jackets. Residents spoken to say staff spoke to them with respect and were always kind to them. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 13 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): 12-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy the lifestyle in the home and are able to maintain contact with their relatives. EVIDENCE: Residents told the Inspector: “My niece comes to see me and she is made welcome” “ Its alright here not bad. My friend comes to see me.” “ Its very comfortable here, generally good. My bed and bedroom is lovely.” One resident asked for more contact with the local community and another resident felt there was not enough to do in the home. The registered providers will look into these aspects. There is a regular religious open service to residents. The garden area has garden table, chairs and sun umbrella and residents were reported to be sitting outside in the warmer weather. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 14 Residents were observed coming and going around the home. People were seeing the hairdresser, sitting and reading books and newspapers, watching television and listening to music. There was a relaxed and homely atmosphere and staff were observed talking to residents in a friendly and polite manner. The midday meal was observed and appeared nutritious and appetising. There was plenty of choice and variety. Staff were heard asking each resident their choice from the menu for lunch. There is a seasonal menu chosen carefully by the manager and the cook in consultation with the residents. Past menus offered wide ranging dishes such as pork and apricot casserole, chicken and white wine sauce, kippers and pate on toast, crab stick salad. The dining room is in the process of being refurbished. Dining room tables were attractively set up for residents with wine glasses or glass tumblers, table clothes, mats, and material napkins in holders. This was a pleasant environment for residents to take their meals. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 15 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): 16-18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are confident that their complaints will be listened to and acted upon. EVIDENCE: The Commission for Social Care Inspection (CSCI) has not received any complaints about this service since the last inspection. The home holds their own complaints record and has received one complaint in March around bed linen, this ongoing and being addressed by managers. A copy of the home’s complaints procedure is available in each resident’s bedroom. This is also displayed in the entrance hall with other relevant agencies contact details including the CSCI. The complaints procedure needs to be updated to ensure this provides residents with current information. Staff have received Protection of Vulnerable Adults (POVA) training. Residents spoken with said they were safe and that staff treated them well. Information regarding local procedures on vulnerable adults is available in the office, and one of the registered providers who are active in a Care Homes Association is also aware of his responsibities in protecting adults from abuse. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 16 Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 17 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): 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is maintained to a high standard and residents tell us it is clean and comfortable. EVIDENCE: The home is very well maintained and parts of the home are improving through an ongoing high quality refurbishment programme. A substantial extension is in the pricess if being developed and will significantly improve the layout of the home. Residents spoken to say the home were clean and comfortable. One resident told the Inspector “They come in and clean every day, hoover, dust, wipe the Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 18 windows and the surfaces down.” The home has pets a cat and fishes. Staff with responsibilities for cleaning spoke of a range of health and safety and training they had undertaken. This ensures residents live in a safe clean environment. To prevent residents being scalded by hot water temperatures staff regularly monitor hot water temperatures. Attention should continue to be given to monitor closely the hot water outlets to around 43.c. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 19 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- 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are met by the number and skill mix of staff; and are in safe hands. EVIDENCE: Staff rotas were examined and the registered provider confirmed planning is around the needs of the residents. The Inspector suggested including the night on-call staff member is included on the written rota, so as it is clear which staff are on duty and in what capacity. Recruitment records were up to date and included all the necessary checks. Residents can then be assured they are supported and protected by the homes recruitment policy and practices. All new staff receives a thorough Induction sometimes lasting up to 12 weeks. There is regular staff appraisals carried out by the provider, manager and deputy. Staff receive a range of training dementia care, first aid, health and safety, dignity and respect, infection control and adult protection training. 90 of staff holds a National Vocational Qualifications (NVQ) Level 2. Eight staff is Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 20 at the point of moving up to a NVQ level 3, and all senior staff have NVQ level 3 in Management. Staff are well trained and competent to do their jobs. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 21 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, 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is well run and managed and their health, safety and welfare are promoted and protected. EVIDENCE: The registered manager was absent on the day of our visit. The registered persons were present and support the manager in the running of the home. They are both very experienced in running care homes. This arrangement works well for the benefit of the residents at Kibworth Knoll. Regular training is undertaken and the provider is aware of conditions associated with the current client group. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 22 Residents meetings are held every eight weeks and staff meetings are quarterly in between there are senior meetings and shift handover meetings. This ensures plenty of consultation in the best interests of individual residents care. Due to the good standard of paperwork within the home information is available to staff and the home appears well managed. Records were seen of staff training and mandatory training is completed at regular intervals. The registered manager has a qualification in moving and handling. Senior care staff are training to be a moving and handling trainers which will benefit resident’s care and safety. Managers are looking to develop computer based records and investigate web or DVD based staff training in the future. All accidents are recorded and information of accidents or incidents is sent to the Commissions ensuring that we are kept up to date of anything that may adversely affect a resident. Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 23 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 3 3 3 x x N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 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 3 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 x x x 3 Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP7 Good Practice Recommendations For one new resident the care plan was still in the process of being drawn up. It is good practice for care plans to be set up quickly to ensure residents receive the best care as soon as they enter the home. The complaints procedure needs updating including the summary in the Statement of Purpose. In line with the latest procedure, the complaints procedure needs to be altered to give the complainant the choice of the initial stage to go the investigating body- the local social services department- now the lead agency for investigating complaints- as well as the home. 2 OP16 Kibworth Knoll DS0000068566.V364046.R01.S.doc Version 5.2 Page 25 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. 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