Care Home: Kimblesworth Care Home

What the care home does well The home provides a comfortable and homely environment. One visitor said, "It is homely, small enough to be personal". Staff take care of service users health care needs. Service users are able to keep in contact with the surrounding community and have varied social opportunities. People who live there benefit from the staff knowing them well and looking after their best interests. The home provides good training for staff. The manger is very approachable. What has improved since the last inspection? The refurbishment of the home has been continued and the conversion of multiple occupancy rooms is decreasing. Medication practise has improved. The manager has been given time specifically for management tasks. Water temperatures are now recorded and fire safety checks are carried out. Care planning has improved and the information in service user`s records is up to date. What the care home could do better: The home must continue to convert bedroom to single occupancy. Water temperatures must be recorded more frequently than once a month to ensure service users are safe. Key inspection report Care homes for older people Name: Address: Kimblesworth Care Home Elm Crescent Kimblesworth Chester le Street County Durham DH2 3QJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Tom Moody     Date: 1 7 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 21 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 21 Information about the care home Name of care home: Address: Kimblesworth Care Home Elm Crescent Kimblesworth Chester le Street County Durham DH2 3QJ 01913712259 01913712489 kimblesworth@mentalhealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mental Health Care care home 20 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home Kimblesworth Care Home is a converted school in a small village on the outskirts of Durham. It is run by a registered charity Mental Health CARE. The home provides 24hour personal care (with nursing) for up to twenty service users with mental health needs and most are over sixty-five years of age. Accommodation is provided on two levels, with a choice of lounges and dining room and other quiet areas for use by the service users. The home has four double bedrooms and twelve single bedrooms. The home employs registered nurses, care staff, domestic staff and kitchen staff. 1 8 1 1 2 0 0 8 20 Over 65 20 Care Homes for Older People Page 4 of 21 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. Before the visit We looked at information we have received since the last visit on 01 April 2009. how the service has dealt with any complaints since the last visit any changes to how the home is run the providers view of how well they care for people The Visit An unannounced visit was made on 08 December 2009 During the visit we talked with people who use the service, relatives, staff, the manager and visitors saw residents having a meal and looked at how staff support the people who live here looked at information about the people who use the service and how well their needs are met looked at other records which must be kept checked that staff had the knowledge, skills and training to meet the needs of the people they care Care Homes for Older People Page 5 of 21 for looked around parts of the building to make sure it was clean, safe and comfortable checked what improvements had been made since the last visit We told the manager what we found. We have reviewed our practise when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 21 What the care home does well: What has improved since the last inspection? What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 21 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 21 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home obtains information about possible new people so it can make sure it will be able to meet their needs. Everyone has a contract which sets out how much their care costs. Evidence: Care plans show that persons admitted to the home receive a thorough assessment from the placing agency. The care plans of service users are well ordered and show that their needs are known and the home has a plan to meet those needs. The majority of surveys returned from service users said that they had received enough information about he home before moving in. All service users have contracts in their records. Care Homes for Older People Page 9 of 21 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed plan, which explains how their care they will be given and peoples health care needs are met. The homes policies and procedures for dealing with medication protect service users. Service users feel that they are treated with respect by the staff Evidence: There is a good assessment of service users physical, mental and social needs in their care plans. This contains information from care specialists from many different disciplines. Records in the care plan indicate service users have access to health services such as hospital specialists, doctors, dentists and other practitioners. Clear medication records are kept. Medicines are stored safely in appropriate cabinets. A drug fridge is available in the clinical areas. Staff spoke to service users respectfully and allowed service users time to make choices. Service users were well dressed in appropriate clothing and were well groomed. This enhanced the dignity of service users. Staff always knocked before Care Homes for Older People Page 10 of 21 Evidence: entering bedroom or bathroom doors to preserve the privacy of service users. The home is continuing to reduce multiple occupancy of rooms and is converting all the remaining rooms to single occupancy. Care Homes for Older People Page 11 of 21 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes provision matches service users recreational, social and cultural needs, and helps them maintain contact with the surrounding community. They are able to exercise choice and control over most aspects of their lives and they enjoy nutritious and appetising food. Evidence: Survey returns from most service users indicate that the home performs well in this area but one asked for more outings. The manager did say that one service user attended a church some distance away and that some service users go on church outings. The home does arrange group activities and outings and there is an up to date record of this. Photographs were on display showing recent social activities. One service user said I am going to York in two weeks. There are no restrictions to visiting and visitors were coming into the home during the time of the site visit. There were service users in the music room and they said they enjoyed the choice of music that was available. Rooms were pleasantly decorated and had many personal effects and items that were treasured by the occupants. Care Homes for Older People Page 12 of 21 Evidence: The majority of service users who replied to their surveys said they enjoyed the meals in he home although one said they did not like the Healthy Eating menu. The menu does have some pasta and salad choices but in the main the food of traditional home cooked type. The meal that was served was appetising and there was a choice of cheese and potatoe pie or steamed fish with vegetables and potatoe wedges. All of the service users who spoke to the inspector said they enjoyed it. Care Homes for Older People Page 13 of 21 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users and relatives know how to raise issues and they are confident staff and managers will act on their concerns. Training and procedures ensure service users are protected and that their rights are upheld. Evidence: Survey returns from staff and service users indicate that the home performs well in this area. Relatives and service users said they would be happy to approach the manager or staff if they had any concerns. A visiting professional commented that The staff are approachable and the patients are cared for. The manager holds regular meetings with service users and relatives. Staff said they had received training in Protecting Vulnerable Adults (POVA) and they had a good awareness of these issues. This was confirmed by training records. Guidelines were available from the local authority. Recruitment records indicate all pre employment checks are carried out including Criminal Records Bureau, POVA list and previous employers references. Care Homes for Older People Page 14 of 21 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and comfortable environment with good access to all areas. The home is very well equipped in most respects, and well furnished. It is spacious, clean and meets the service users needs Evidence: The home is a converted building and has pleasantly landscaped surroundings. There is a secure and sheltered patio and ample parking. The home has generous communal and circulatory space and a variety of environments including a music lounge. One visitor said, It is homely, small enough to be personal. The home is well ventilated and warm. There was no excessive noise and the atmosphere was calm. Showers toilets and bathrooms are of appropriate size and fitted with rails and hoists. Water temperatures are controlled by thermostatic valves at outlets. temperatures are tested monthly and recorded. it would be better if more frequent testing was carried out. A suitable call system has been installed. Bedrooms are well decorated and furnished. They contain many personal items and photographs. the multiple occupancy of rooms is being phased out and most rooms are now converted to single use. The home has a laundry and suitable hand washing facilities for service users and Care Homes for Older People Page 15 of 21 Evidence: staff. There were no discernible bad odours during the time of the site visit and the home was clean and tidy in all areas. Care Homes for Older People Page 16 of 21 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing of the home meets service users needs. They are supported in a safe manner, by staff who are properly recruited, and have the appropriate training. Evidence: Staff rotas were seen and there were a suitable amount of staff on duty at the time of the site visit. Service users needs were met, call buzzers were answered within a reasonable time and care was given in an unhurried manner. Staff said they received an induction, and training, and records confirmed this. Staff records indicate all pre employment checks are carried out including Criminal Records Bureau, Protection Of Vulnerable Adults list and previous employer references. Records also show that staff are interviewed and they receive terms and conditions. Care Homes for Older People Page 17 of 21 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced, and qualified person who has service users interests at heart. The home is run in the best interests of service users. They are kept safe and their welfare and rights are protected by good record keeping and the promotion of good practise Evidence: The manager of the home is a registered nurse and has many years of experience. He has a suitable management qualification. The manager now has supernumerary shifts to enable him to manage the home more efficiently. Staff said they felt well supported by the manger and found him approachable. Service users also found him easy to access and it was observed that they felt able to come into his office and talk to him when they felt this was necessary. The home has a quality assurance system that carries out regular surveys of residents and relatives. The home manger and senior managers of the company review surveys and other feedback and decide how this should inform the development for next year. Care Homes for Older People Page 18 of 21 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 19 12 When one person moves permanently out of a double room, the owners must convert the double to a single. This is essential to promote the privacy and dignity of people who live in the home. 14/01/2010 Care Homes for Older People Page 19 of 21 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, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 21 4 Water temperatures must be 29/01/2010 monitored more frequently than a monthly check. The home must be kept free of preventable hazards to ensure the safety of service users. 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 23 The home should continue the programme of conversion of multiple occupancy rooms to single occupancy. Care Homes for Older People Page 20 of 21 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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