Care Home: Kimberley Grace Care Home

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What the care home does well The manager and her staff were highly knowledgeable, experienced and well trained. The staff were well supported and in turn this gives all residents a good quality of support and care given. Documentation and recording in general was to a good standard. Medication was well maintained and accounted for. All people have good access to other health professionals and the home keeps good partnerships with them. Families are encouraged to be part of their relatives` lives. Activities within the home have been implemented and a car for the resident`s appointments and leisure interest has been purchased. The home has no odours, is clean, fresh, homely and comfortable for all of the residents. What has improved since the last inspection? This is the services first Inspection since being registered in 2008. What the care home could do better: The home has been taken over by the new providers and they have many plans to upgrade the much needed maintenance, re-decoration of many of the communal areas and some of the bedrooms. This will be on going as part of their business plan for within the next couple of years. Communal areas could include clearer information for all residents, staff and visitors of the safeguarding unit numbers and contact names and how to make a complaint or secure advocates if needed. CARE HOMES FOR OLDER PEOPLE Kimberley Grace Care Home 15/17 Grosvenor Road Westcliff On Sea Essex SS0 8EP Lead Inspector Sarah Hannington Unannounced Inspection 30th January 2009 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 Kimberley Grace Care Home DS0000072298.V373757.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. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kimberley Grace Care Home Address 15/17 Grosvenor Road Westcliff On Sea Essex SS0 8EP 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) 01702 347386 kgcarehome@aol.co.uk Tideswell Care Homes Ltd Post Vacant Care Home 14 Category(ies) of Dementia (14), Old age, not falling within any registration, with number other category (14) of places Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 category: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 14 First Inspection since being registered in 2008. 2. Date of last inspection Brief Description of the Service: Kimberley Grace Rest Home is owned by Tideswell Care Homes Ltd and has been registered since 2008. The property is a mid-terrace conversion, where two buildings have been made into one property. The home is registered for fourteen residents aged over 65 years old and suffering from dementia. The home is situated in Westcliff on sea and is a short distance from the seafront and local shops. Accommodation is provided on two floors with a stair lift provided. There is one double and twelve single bedrooms, some of which have en-suite facilities; There is a large separate dining room. Appropriate aids are fitted in toilets, bathrooms and corridor areas. There is a secure garden area to the rear of the property, and parking for four vehicles to the front. Fees range from £450.00 to £500.00 depending on the room and care needs of the individual. Kimberley Grace Care Home DS0000072298.V373757.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 Star. This means the people who use this service experience good quality outcomes. The site visit took five hours to complete and was carried out as part of the annual inspection programme for this service. This visit was conducted with assistance from the manager. As part of the process a number of records relating to residents, care staff and the general running of the home were examined. This was the first site visit since being registered in 2008. A number of people (who use this service), four staff and one relative were spoken with during the site inspection and a tour of the building was undertaken. We looked at all the information that we have received, or asked for, or what the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. This included; The annual quality assurance assessment, was sent to us by the service. The AQAA is a self-assessment, required by law that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. All information obtained was triangulated and reviewed against the commissions key lines for regulatory activity. This helps us to use the information to make judgements about the outcomes for the people who use this service in a consistent and fair way. What the service does well: The manager and her staff were highly knowledgeable, experienced and well trained. The staff were well supported and in turn this gives all residents a good quality of support and care given. Documentation and recording in general was to a good standard. Medication was well maintained and accounted for. All people have good access to other health professionals and the home keeps good partnerships with them. Families are encouraged to be part of their relatives’ lives. Activities within the home have been implemented and a car for the resident’s appointments and leisure interest has been purchased. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 6 The home has no odours, is clean, fresh, homely and comfortable for all of the residents. What has improved since the last inspection? 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. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 7 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 Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 8 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A clear and comprehensive assessment process assures people that their needs could be met prior to moving in their home. EVIDENCE: We were informed by the manager and by looking through records that once a person is referred and has shown an interest in the home, a service user guide and brochure of the home, would be provided to them. (Additionally a statement of purpose can also be provided) The service user guide is a document that gives a quick snap shot of what the home and staff provides and the brochure gives basic information and photographic references. The service user guide can also be provided in large print and upon request different languages. Both these documents are annually reviewed and updated. By providing these documents it allows people to make a decision to see if the home can provide for their individual needs before any visits or admission are arranged. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 9 The statement of purpose is a more in-depth document produced by the manager that describes what people can expect the staff and home to provide. It includes information such as, aims and objectives, policies and procedures, services that are provided, care that can be provided, the number of staff they have and their qualifications, specialist services that may be provided, costs, contracts, complaints assessment process, hours of operation and general information about the organisation and Kimberley Grace care home. We were told that once this information is given, then a date will be set for the manager or another qualified member of staff to carry out an assessment of need, with the individual and their representatives. Additionally we were told as part of this process a number of visits will be arranged to the home so that the person can meet the other residents and the staff. They will also have the chance to see what the home is like, how many communal rooms are available, bathing, kitchen and laundry facilities, look at the garden and general things they would like to know before making a decision. It also gives the person a chance to sample the food provided and ask about any issues that are important to them. Just as important is that the person can see if the room they would be offered if accommodation were to be provided. By having the different types of visits as suggested by the manager, a person can get to explore the local area and sample what is provided within the local and wider community. The assessment process is recorded onto the managers assessment document, which is then kept and forms part of a persons care plan. Additionally if a person is to be funded through the local authority or health or primary care trust, then these agencies will also supply their own assessment to the manager upon referral. These were seen on files looked at. The purpose of this assessment is not only to identify the person’s needs, but to also allow the manager to consider if they can provide a service for the person who has made a referral. If they can do so, then a letter is written to the individual confirming this. Once a person has moved in then a trail period of 4 weeks in put into place and a review will take place to see if the placement is suitable for the individual. During this period the individual and manager, can decide to terminate the contract if need be. We looked at the information of a new resident who has recently moved into the home. This information showed us that, good assessments and information about this individual were secured. The family and resident have been well informed and involved at each stage, this was told to us by a relative. Overall all documentation looked at, showed us that detailed and sufficient information is provided in both the statement of purpose and service users Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 10 guide and described well all information that would be of benefit to all interested parties. Kimberley Grace Care Home DS0000072298.V373757.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 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be confident that their personal care and health needs will be met. EVIDENCE: The management of medication was found to be of a good standard with appropriate ordering, administration and the recording of medicines by staff. The registered manager oversees the disposal of medication. The home operates the Monitored Dosage System and is supported by the local Pharmacist who undertakes periodic checks on the home’s administration and recording systems. All staff had received medication training. Health wise all people had support to access other professionals such as, dentists, chiropody, health care staff, district nurses, occupational health and consultants. All residents are encouraged to keep the GP of their choice. The information looked at such as visits, daily notes, and summaries were to a good standard. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 12 All residents spoken with told us that they felt the staff treated them with dignity, respect and that they knew their needs well. Kimberley Grace Care Home DS0000072298.V373757.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, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service can be confident that their identified needs will be met appropriately and that they will be able to live the lifestyle they choose. EVIDENCE: The residents have access to a regular hairdresser that comes in once a week, a chiropodist and an aromatherapist. A large number of the residents at Kimberley Grace Home have some varying form of dementia. As a result staff have good guidance in the care files of these people in how to engage them in activities and general choices. However producing different types of reference tools to use, such as, photographs, pictures and other things could develop this understanding of individuals further. This would help people identify choices such as what to eat and if they want to join in an activity more easily than at present. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Kimberley Grace are protected by staffs’ knowledge, training and understanding of safe guarding procedures and by the organisations policy and procedures in dealing with complaints. EVIDENCE: The manager advised us that there has been no reported complaints or safe guarding issues since being registered with us. Residents told us that they would feel comfortable about raising any matter of concern with a member of staff, indicating that they felt confident that any matter would be properly dealt with. Staff members on duty said that they had attended a ‘safeguarding adults from harm’ training course. All staff were able to discuss the process they would follow should an incident be suspected. However, communal areas could include clearer information for all residents, staff and visitors the contact names of the safeguarding unit and how to make a complaint, this would ensure that all people in contact with the service could access information easily than at present. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in an environment that is homely, safe and comfortable. EVIDENCE: Although most people living within the home have some issues around incontinence (some double) it is odour free. This gives residents a nice pleasant home to live in and preserves their dignity, self esteem and shows us that good practice in terms of infection control and hygiene is in place amongst the staff. People told us that their rooms were well maintained, decorated to their liking and personalised. People told us that they felt the communal areas are clean and comfortable for them and had plenty of areas for their visitors to use. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 16 The overall health and safety practices by staff are well monitored documented and training is regular. Staff spoken with have good knowledge and experience around these issues and were able to evidence that residents are well protected by them. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 17 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Kimberley Grace benefit from the care and support they receive from a competent and qualified staff team and are protected by recruitment policy and practices. EVIDENCE: The home has an experienced well-dedicated staff team in place. Apart from the care staff employed, the manager also employs housekeeping staff that are responsible for the kitchen, laundry and cleaning duties. Additionally a handyman is employed to maintain the building and gardens. No agency staff are used and all staff are permanent, this gives the residents a good quality and consistency of care. The staff rota showed that staff ratio is good and provide additional support depending on activities or appointments people may have. The majority of residents, staff and a relative commented that they felt there were sufficient numbers of regular staff on duty. Staff spoken with and documentation looked at, showed us that they receive good support through induction, handover’s, staff meetings, supervision and appraisals. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 18 The manager maintains robust recruitment checks and six of the staff files sampled, all evidenced that they had the required information available. The home’s induction programme was looked at and showed us that it follows the guidance in line with the, Skills for Care and includes further foundation and NVQ training. Staff spoken with said the training opportunities are good and relevant to the work they carryout. A training matrix evidenced clearly showed that the staff had completed courses. Training opportunities are good and include manual handling, health and safety, first aid, fire awareness, safeguarding and infection control. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 19 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a well run home that ensures that their best interests are met. EVIDENCE: The manager is also the registered provider and is currently being registered with us as manager of Kimberley Grace Care Home. The manager has employed a deputy manager who has a number of years experience within this care field. The manager and provider is a state Registered Nurse. She has twelve years experience as a manager in different care settings. And has also been a Registered Nurse for the last twenty-six years. She has specialist training and knowledge around dementia care and has many other specialist subjects related to the current resident group. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 20 Through discussion with the manager and documentation that we looked at, the manager evidenced that she has good management skills, strategies and creates a good ethos throughout the home, this was also evidenced through discussion we had with the staff on duty. The manager has made good progress to ensure that good practices amongst the team are implemented and that awareness around person centred approaches are raised. The day-to-day running of the home is efficiently organised. The manager is knowledgeable and is highly organised and efficient in her role. There are clear accountability of roles amongst the team and a strong shift leader support system. The management team lead by example and encourage the staff team to practice in terms of a residents rights and empowerment. Practice is continually changing and adapting according to individual and group need which in turn moulds the service provided. The health, safety and welfare of residents’ and staff have been made a priority. All health and safety checks that were inspected are up to date. Policy, procedures and documentation evidence that resident finances are protected. Within the fire records looked at were found to be to a good standard, risk assessments are in place for all residents and staff carried out annual fire training and regular fire drills. Fire safety officers visit every year and checks made by the team are regular and promotes the safety of all residents. Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 21 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 3 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 Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 22 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. Refer to Standard Good Practice Recommendations Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 23 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 Kimberley Grace Care Home DS0000072298.V373757.R01.S.doc Version 5.2 Page 24 - 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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