Care Home: Kingsleigh House

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What the care home does well There was a welcoming and friendly atmosphere within the home. The home was clean and comfortable with well maintained grounds. People living at the home are able to engage in a range of social activities within the home and within the wider community. People have access to the adjoining church and are able to have their religious needs met. Systems are in place to ensure that a quality service is provided. Staff receive training and supervision to enhance their skills and knowledge. What the care home could do better: The management, storage and recording of medication and creams needs to be improved to ensure that systems are safe and that people can be confident that they will always receive they medicines as prescribed. Improvement in the recruitment procedures are needed to ensure that safeguards arefully in place to prevent unsuitable people gaining employment caring for people. Systems for ensuring that any allegations of actual or potential abuse are reported under safeguarding procedures need to be improved. In addition the service needs to ensure that other events or incidents are reported to the appropriate agencies without delay. Random inspection report Care homes for older people Name: Address: Kingsleigh House 37 Harbinger Road Kings Norton Worcestershire B38 0AD 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: Andrew Spearing-Brown Date: 1 8 0 5 2 0 1 0 Information about the care home Name of care home: Address: Kingsleigh House 37 Harbinger Road Kings Norton Worcestershire B38 0AD 01214599995 01214512868 Telephone number: Fax number: Email address: Provider web address: www.cch-uk.com Name of registered provider(s): Name of registered manager (if applicable) Mrs Pauline Bateman Type of registration: Number of places registered: Conditions of registration: Category(ies) : Christadelphian Care Homes care home 30 Number of places (if applicable): Under 65 Over 65 30 30 30 dementia old age, not falling within any other category physical disability Conditions of registration: 0 0 0 The maximum number of service users who can be accommodated is: 30 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 categories: Old age, not falling within any other category (OP) 30 Physical disability - over 65 years of age (PD(E)) 30 Dementia - over 65 years of age (DE(E)) 30 Date of last inspection Care Homes for Older People Page 2 of 11 Brief description of the care home Kingsleigh House is owned and run by Christadelphian Care Homes, (formerly Bethany Guild which was formed in 1943), and is a registered charity. The service is registered to provide residential care for up to 30 older people. Respite (short stay) care can be provided when a room is available. The home is administered by a Board of Trustees. The home is situated on the borders of Worcestershire and on the edge of Birmingham. It is a purpose built, two storey building which also incorporates a sheltered housing unit for more independent older people. The stated aim of Kingsleigh House is to provide care and support in safe, warm and comfortable surroundings where residents, relieved of the many pressures of life, can maintain a high standard of dignity, and can enjoy a good quality of life in the company of those who share their faith, hopes and values. For up to date information upon the fees payable the reader should contact the service directly. Care Homes for Older People Page 3 of 11 What we found: This inspection was unannounced. Therefore nobody within the home knew that we were going to visit. This inspection was carried out by one compliance inspector over the period of a day. The last key inspection at Kingsleigh House was carried out during June 2007. The outcome of that inspection was that we rated the service as Excellent. We carried out this inspection to assess whether the service is maintaining this level of service. Since our last key inspection we have written two Annual Service Reviews (ASR) about the service. An Annual Service Review is a document we produce taking into account information we have received about the service without carrying out a visit to the home. As part of this inspection we assessed the management, storage and administration of medication. A dedicated fridge is provided for any item needed such storage. The recording of the temperature of this piece of equipment had not happened during May 2010. The records for April were in order however, gaps in the records were seen for March and February. A controlled drugs cabinet for medication requiring special storage was held within a cupboard which also contains electrical fuses. The area felt warm. A record of the temperature in this area was not maintained. In order that medicines are stored within manufactures guidelines they need to be kept at 25 degrees Centigrade or below. The manager undertook to commence the keeping of records immediately. The continual use of this cupboard for storing controlled medication should however be reviewed to establish whether this is the most ideal location. The Controlled drug registered was generally completed as needed. We did however see a couple of occasions when only one member of staff had signed for medication given. We audited medication and found them to balance correctly. We looked at many of the current months Medication Administration Record (MAR) sheets and overall found that they were documented with a signature for administration. There were however examples when this was not the case and gaps existed whereby nobody had signed the sheet or entered a code to record a reason if medication was not given. At times staff used a code but had not indicated why they had used it, as a result we were not always able to audit some medication to confirm that people have received their medication as prescribed. We were told that care staff maintain separate records to show that they had administered eye drops and applied creams. We found these record sheets to have a large number of gaps upon them. We spoke to staff about creams and found that staff had a good awareness of items to be applied. The manager recongised our concern about the record keeping however was she was confident that staff were carrying out these tasks but failing to record. The daily records maintained by staff did not offer any further reassurance to us that the regimes were followed in order that peoples health care needs are always maintained. Care Homes for Older People Page 4 of 11 Each resident has a care plan in place and we saw that these are regularly reviewed to ensure that staff have information available to them in order to carry out their duties in a consistent way. We saw reference on one care plan to the need to have blood pressure monitored regularly. We saw no indication that this had happened since the persons admission during early March 2010. People we spoke to during our visit we confident that their care needs are met by staff in the home. The Residents Guide states that the home has a strong Christadelphian (Christian) ethos and that all residents are welcome to join in the daily Bible reading sessions if they so wish. Information on the notice board gave times of hymn singing and Breaking Bread services. Residents residing at Kingsleigh House are able to gain access to the Kings Norton Christadelphian meeting room via an integral entrance. Staff told us that they receive training into the ethos of the church. Information was on display about forthcoming events at the home or within the community. These included shopping trips or outings to places such as the Botanical Gardens in Birmingham. While we were at the home a number of residents seemed to be enjoying a game of bingo. We saw two different complaints procedures on display in the lounge. One gave details of the former commission and a former address. A more recent one made reference to the different commissions covering England, Wales and Scotland. The information within the Residents Guide was seen to be incorrect regarding our address. The registered manager informed us during our visit that the home has not received any formal complaints. We, the commission have not received any concerns regarding the service provided at Kingsleigh House. We spoke to a small number of residents who told us that they had no complaints about the home. People we spoke to during our visit were confident that any concerns they may have would be listened to and acted upon. While viewing some records we saw information regarding a situation which was potentially abusive. It was evident that the home had taken steps to investigate and ensure that people were not placed at further risk. However, the service had not informed any other bodies of the incident. The local authority should have taken the lead regarding who was best placed to investigate and ensure that no other people were at risk. We asked to view policies within the home. A policy was available however this referred to Birmingham and not Worcestershire. We asked whether the home had any procedures or information provided by Worcestershire, none could be found. We were informed that staff have received training in relation to safeguarding and when we spoke to staff they told us that they would report matters as necessary. We gave the manager details regarding reporting the matter retrospectively, obtaining information from Worcestershire and how to access some further training. Under Regulation 37 of the Care Homes Regulations the service is required to inform us of certain events within the home. We had not received any such notifications. However, it was evident that a number of things have happened within the home of which we should have known about. These incidents included deaths, an injury to a resident, an outbreak of an infection as well as the above safeguarding issue. The service must therefore ensure that we and other agencies, such as the local authority, are informed in the future of such events. Care Homes for Older People Page 5 of 11 Kingsleigh House is a two storey modern building situated on the border between Worcestershire and Birmingham. The home has a large communal lounge and dining area. A conservatory at the rear of building provides a pleasant place to sit with views of the well maintained garden. All bedrooms have en suite facilities. We found the home to be clean and tidy throughout. The found the premises to be a safe environment for people to live with the exception of one wardrobe which was not secured to a wall and therefore could potentially topple over. We looked at the documentation regarding the recruitment of two members of staff. The manager informed us that the staff concerned had shadowed other members of staff initially and therefore not carried out personal care on their own. However, the records showed that staff had commenced duties prior to the home receiving references and a Criminal Records Bureau (CRB) disclosure. The file of one member of staff contained a reference not requested by the service while one application form had a page missing. Having suitable recruitment procedures in place such as references and a CRB helps to reduce the risk of someone who is unsuitable gaining employment within the home. Staff informed us that they receive regular training and supervision to ensure that have the skills and knowledge needed to carry out their role. The manager informed us that 11 out of 19 carers hold an NVQ (National Vocational Qualification) level 2 and that all senior carers have achieved a level 3 NVQ. Staff showed a dedication to provide a quality service up holding the rights, privacy and dignity of residents. We saw that the home has a range of quality assurance systems available in order to monitor the service provided. People are able to have money held in safekeeping for them. We checked the money held for a small representative number of people and found them to balance. We viewed the fire records and found them to be completed as needed showing that the fire alarm is tested in sequential order each week. What the care home does well: What they could do better: The management, storage and recording of medication and creams needs to be improved to ensure that systems are safe and that people can be confident that they will always receive they medicines as prescribed. Improvement in the recruitment procedures are needed to ensure that safeguards are Care Homes for Older People Page 6 of 11 fully in place to prevent unsuitable people gaining employment caring for people. Systems for ensuring that any allegations of actual or potential abuse are reported under safeguarding procedures need to be improved. In addition the service needs to ensure that other events or incidents are reported to the appropriate agencies without delay. 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 7 of 11 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 8 of 11 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 1 9 13 Regulation 13 (2) The service must ensure that people residing within the care home receive their medicines as prescribed. Medication Administration Record sheets must be accurate and up to date with the necessary signature or code in place. This is to ensure that peoples health care needs are maintained and that records reflect what medicines have been given to people. 30/06/2010 2 18 12 Regulation 12 (1) Systems regarding the reporting to other bodies any allegations of abuse must be reviewed. This is to ensure that any allegations are able to be followed up and action taken to ensure that people are safe. 30/06/2010 Care Homes for Older People Page 9 of 11 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 3 29 19 The service must ensure that 30/06/2010 recruitment procedures within the home are reviewed to ensure that all necessary checks are carried out prior to people commencing employment. This is so that suitable people are employed in the care home. 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 Care Homes for Older People Page 10 of 11 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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