Care Home: Kingsley House

What the care home does well Kingsley House is always trying to improve the service offered to the people either living in the home or to prospective service users. The service is flexible which helps to ensure that the home is able to respond to changing needs, which in turn enables people to maintain as much independence as possible. There is a strong commitment from everyone working at the home that helps to ensure that the quality of care is provided to a high standard. People are treated with respect and dignity and we found that staff members were able to demonstrate an awareness of the diverse needs of the people they were working with. Positive and warm relationships were seen to exist between service users and staff members, those people that commented all said that the manager and staff members were very good. Comments from people included; "I like living here". A good choice of meals are available for people to eat. Fully accessible and very well maintained gardens are available for people to use. What has improved since the last inspection? The building of a new en-suite in one of the bedrooms on the first floor has improved the facilities available in this room. A new covered outdoor smoking area has been built to fulfil the the requirements of the new smoking regulations. This has been well thought out and constructed and the service users that commented spoke positively about it. What the care home could do better: We consider that Kingsley House is a good service so rather than state what they could improve we would expect that the home continues to review its practice in order to ensure that the good standard of care provided to the service users at the present time is maintained and where possible improved upon. Key inspection report Care homes for adults (18-65 years) Name: Address: Kingsley House 16 Dudley Road New Brighton Wallasey Wirral CH45 9JP     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: Paul Ramsden     Date: 2 2 0 9 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 Adults (18-65 years) Page 2 of 26 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 Adults (18-65 years) 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 Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Kingsley House 16 Dudley Road New Brighton Wallasey Wirral CH45 9JP 01516303714 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: kingsleyr@btconnect.com Mr David Christopher Russell care home 16 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental disorder, excluding learning disability or dementia - Code MD The maximum number of service users who can be accommodated is: 16 Date of last inspection Brief description of the care home Kingsley House is a three storey, Victorian house, offering care and accommodation to 16 people with mental health needs. Situated in the centre of New Brighton, close to a variety of shops and community facilities. The home is within reach of the main waterfront, bus and rail services. Accommodation is provided in eight single and four shared bedrooms, one double room on the ground floor and one of the bedrooms on the first floor have en-suite facilities. There is an additional bedroom on the ground floor, which is used by staff for sleep in duties. Two communal lounges are available on the ground floor. The dining room is situated within the conservatory, which Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 16 Brief description of the care home overlooks the rear garden area. The kitchen is situated in the middle of the house in between the main lounge and the conservatory. Access between the ground, first and second floor is via a stairlift [ground to first floors only] or the main staircase. A passenger lift is not available in this home. The range of fees for living at Kingsley House are between £357 - £388. Further information about fees are available from the manager. A copy of this report can be made available upon request from the home or via the Commissions website. Care Homes for Adults (18-65 years) Page 5 of 26 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced visit took place on the 11 and 22 September 2009 and lasted for approximately six and a half hours. Paul Ramsden, Inspector, undertook the visit on behalf of the Care Quality Commission [The replacement body for the Commission for Social Care Inspection, CSCI, since 1 April 2009]. Any references to us or we in the report refer to the Commission. Feedback on the findings of the inspection was given to the home manager as it progressed. This visit was just one part of the inspection. Prior to the visit the home manager was asked to complete an Annual Quality Assurance Assessment [AQAA] to provide up to date information about the service provided in the home. This is a very detailed questionnaire that provides us with a lot of information about the service before the visit. During the visit various records and the premises were looked at. When looking at the Care Homes for Adults (18-65 years) Page 6 of 26 documents relating to the type of care each person needs [assessments and care plans]we use a system called case tracking. This is a method that allows us to follow or track a particular situation in order to ensure it was dealt with appropriately. A number of service users and members and staff were spoken with; they gave their views about the home and the service provided. Some of these comments have been quoted in the report. Care Homes for Adults (18-65 years) Page 7 of 26 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 Adults (18-65 years) Page 8 of 26 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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. Information and opportunities to visit are available and service users are assessed before moving in to ensure their needs can be met at the home. Evidence: The home has a statement of purpose and service user guide available. These are available to both current and prospective service users. Information about the facilities, services provided, fees, complaints procedure and the terms of residence are included in these documents. These contain all of the information required by us and we think they should provide sufficient information for anybody who is thinking of moving into the home. Prospective service users are free to visit the home, view the premises and chat to other people living there and staff. An assessment demonstrating that the service users individual needs could be met by the home had been undertaken prior to admission for the the one person admitted since the last key inspection visit. The manager undertook the assessment on behalf of the home. The assessment for prospective service users can be done in a persons own home, another care home or hospital. This provides an opportunity to make sure Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: the home can accommodate the person and their individual needs. When someone is funded by the Local Authority they also provide an assessment of the persons needs prior to admission. This provides background information as to the reasons why a move to the home is needed and is very useful when combined with the homes own assessment. Care Homes for Adults (18-65 years) Page 11 of 26 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 care plans seen were well maintained and provided all of the information needed for staff members to be able to take appropriate action to meet an individuals needs. Evidence: The care plans seen were all up to date and provided staff members with the necessary information for them to look after a persons needs. The health and well being of service users was being monitored and an appropriate record of actions being taken was kept. The plans were being reviewed and where necessary being re-written on a regular basis. The home currently keeps risk assessments in a separate file; whilst looking at these we found that some had not been reviewed regularly. During a discussion with the manager it was agreed that these would be put into each persons care folder and that they would be updated [if needed] and reviewed with the care plans. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: The service users spoken with during the visit told us that the standards of care provided were good and they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that the people using the service were being treated with courtesy, respect and good humour by staff. They were seen to be mixing with people in an appropriate way, knocking on bedroom doors before entering and addressing people according to their wishes. Care Homes for Adults (18-65 years) Page 13 of 26 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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. Service users living at Kingsley House are able to maintain contact with family and friends and those spoken with were positive about the home and the support they received. Evidence: On the day of the inspection we saw service users coming and going from the home as they wished to do so. There were a variety of opportunities for service users to become involved in community activities and events; these include, college courses, attending the local gym, visits to the pub and shopping trips. There is a total of 22 extra hours available for the organising and running of social and other events; at the time of the visit these were being shared by four of the care staff members. Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: People have built up their own personal networks of friends and relatives either within or external to the home. We saw examples demonstrating that people had a variety of hobbies and interests that they enjoyed. Some of the service users were going to Spain for a holiday shortly after the inspection took place; those people that commented said they were looking forward to the trip. Holidays for other people are also planned. Service users were able to move freely around the home and a choice of sitting areas was available. Routines within the home were flexible and they confirmed that they were able to make choices in many areas of daily living; for example, times of rising and retiring, whether or not to join in with planned activities and where to spend time and with whom. Service users are able to participate in the running and development of the home by their involvement in house meetings. Meals can be eaten in the main dining room or in the privacy of a persons own room. The menu is flexible and can meet an individuals needs and choices. Special diets can be provided if needed; these are discussed upon admission. We did not receive any negative comments during this visit. The kitchen area was seen to be clean and well organised. The manager explained that the dining room furniture was to be replaced shortly. Care Homes for Adults (18-65 years) Page 15 of 26 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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. Service users were positive about the home and the support they received so they could maintain as much independence as possible. Evidence: Service users are enabled to live their lives an independently as possible. Staff members do this by respecting their privacy. Personal care, if required is provided in private and takes into account an individuals preferences and needs. Staff members spoken with could show that they had a good understanding of the people they were supporting and they were able to meet their diverse needs. The changing needs of individuals are discussed as and when required. We were able to see this in practice during the visit when information about individual service users was passed to the manager. Care staff work to a good standard in order to ensure that service users receive the care they need. They monitor a persons health and emotional needs daily and there was evidence to show that people were receiving the appropriate support from district nurses, GPs etc. Care Homes for Adults (18-65 years) Page 16 of 26 Evidence: Policies and procedures in relation to medication are in place. Medicines are administered using a blister pack system provided by a local pharmacist. The arrangements for the administration of medicines were looked at during this visit; no issues were seen. People are being given their medication as prescribed. There is an assessment process and monitoring systems in place if someone wants to manager their own medication. Care Homes for Adults (18-65 years) Page 17 of 26 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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. Service users and relatives are able to complain/make suggestions and action would be taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. Evidence: There is a clear and effective complaints procedure for the home; this is included in the statement of purpose and the service user guide. One complaint had been recorded in the complaints log in the previous 12 months, this had been investigated appropriately. We have not received any complaints and nobody made any to us during the visit. Those people that commented said they would inform the manager or another senior staff member of any issues. There is a suggestion box in the entrance hall available for people to use if they wish to do so. The home has a safeguarding procedure that complies with all of the relevant legislation and good practice guidelines. This is designed to ensure that any possible problems that arise are dealt with openly and people are protected from possible harm. All staff members undertake training in this area. We have not received any issues regarding safeguarding. Care Homes for Adults (18-65 years) Page 18 of 26 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 facilities and accommodation provide service users with a comfortable and homely place to live. Evidence: A tour of the premises was undertaken; this included communal [lounges/dining room]areas and a number of bedrooms. These were seen to be personalised and contained many personal items. The building is generally well maintained and no obvious issues requiring attention were seen during the visit. The manager explained that a new en-suite had been fitted into one of the bedrooms on the first floor; this has improved the facilities available within this room. Aids to help maintain independence, for example a stair lift have been provided. There are fully accessible garden areas available for residents to use. A new covered smoking area has been constructed outside. The laundry within the home is appropriately equipped and good systems are in place for the care of peoples clothes. Care Homes for Adults (18-65 years) Page 19 of 26 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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. Staff members work positively with service users to improve their quality of life and a robust staff recruitment process is in place to protect them from possible harm. Evidence: Care staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was able to meet the needs of the people living within the home. The staff members were cheerful and friendly and the service users spoken with were complimentary about their attitude and competence. The manager confirmed that 13 of the 14 care staff [this includes the manager herself] are either qualified [11] or are working towards, [2] a National Vocational Qualification [NVQ] level 2 or 3 in care, a recognised qualification for people working in the care profession. The two staff files seen contained all of the required information and a robust recruitment procedure was in place for the protection of service users. The homes manager confirmed that all new staff are checked against the POVA list and that a satisfactory CRB disclosure must be obtained before employment commences. The current staff team have the skills, knowledge and experience to meet the diverse needs of the people using the service. Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: New staff members undertake an internal induction training programme plus some elements from the Skills for Care common induction standards [this is a nationally agreed programme of induction for staff working in the care profession]. Kingsley House provides a range of training courses for staff members these include, moving and handling, first aid, health and safety and adult protection. The manager confirmed that all mandatory training was up to date. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 being very well run and managed on a day to day basis, this helps to ensure that the needs of the service users are met and that there are appropriate procedures in place to maintain their safety. Evidence: The home has a very experienced and competent manager who displays a clear sense of direction and best practice. She regularly attends courses/training in order to keep her practice up to date and to fulfill her management responsibilities. She has completed her Registered Managers Award [one of the deputies has also completed this] and can clearly demonstrate an awareness of the needs of the service users living in the home and how to manage the staff team. Two deputy managers and senior staff members support the manager. This is a strong and committed team who work hard to ensure that the quality of care provided is maintained at as high a level as possible. The service users that commented said that the people running the home were approachable and supportive. The home has a quality assurance system in place in order to ascertain whether Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: service users and the local authority are happy with the standards of care being provided. We were able to see some of the most recently completed questionnaires. Service users personal allowances were looked at; these were being well managed. All records seen were being kept securely. The home has a comprehensive range of policies and procedures to promote and protect both service users and staff members health and safety. The fire safety log book showed that the tests on the system and emergency lighting were being carried out at the recommended intervals and that drills and training were also up to date. Care Homes for Adults (18-65 years) Page 23 of 26 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 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 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 Adults (18-65 years) Page 25 of 26 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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