Care Home: Kingsley Nursing Home

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Annual service review Name of Service: Kingsley Nursing Home The quality rating for this care home is: The rating was made on: two star good service 1 4 1 0 2 0 0 8 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 We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Rajshree Mistry Date of this annual service review: 0 3 0 9 2 0 0 9 Annual Service Review Page 1 of 13 Information about the service Address of service: 18 - 20 Kingsley Road Northampton Northants NN2 7BL 01604712411 01604711199 Carehome32@aol.com Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Conditions of registration: Category(ies) : dementia old age, not falling within any other category physical disability Conditions of registration: Hollyberry Care Limited Number of places (if applicable): Under 65 Over 65 0 0 0 25 25 25 Hollyberry Care Limited is registered to provide personal care at Kingsley Road Nursing Home for both male and female service users who fall within the following categories :Dementia - over 65 years of age DE(E) 25 Physical Disability - over 65 years of age PD(E) 25 Old age not falling into any other category (OP) 25 Kingsley Road Nursing Home is registered to accommodate a maximum of 25 service users To admit into Kingsley Road Nuring Home the person named in variation number V38033 who falls within category MD Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: Date of last key inspection: Date of last annual service review (if applicable): Brief description of the service No 1 4 1 0 2 0 0 8 Annual Service Review Page 2 of 13 Kingsley Nursing Home is a private nursing home and is registered to accommodate up to 25 older people, and can provide care for people living with dementia-related conditions and people with a physical disability. Kingsley Nursing Home is a large Victorian house situated in central Northampton opposite the racecourse, local shopping and leisure amenities are close by and the home has good access to local transport facilities. There are a number of single bedrooms, with and without ensuite facilities and four shared bedrooms. On the ground floor there is two lounges and one dining room. A central lift provides access to the first floor, and ramps and grab rails are fitted internally and externally around the property to assist people with limited physical mobility. To the rear of the property there is a pleasant garden and a private parking area. The fees for 2009/2010 are not known. People who are interested in using Kingsley Nursing Home should contact the Registered Manager and the home directly for the range of fees. Further information about Kingsley Nursing Home can be obtained from the home in the form of Service User Guide and the Statement of Purpose. The latest Inspection Report are available at the home or can be accessed via the Care Quality Commission (CQC) website: www.cqc.org.uk Annual Service Review Page 3 of 13 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received or asked for since the last key inspection. This included the Annual Quality Assurance Assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for the people using the service. It also gave us some numerical information about the service. We assessed the information we have about the service and how the complaints received have been managed. We looked at what the service has told us with regard to the things that have happened in the service. These are called notifications and are a legal requirement. We looked at the last key inspection report and the results of any other visits that we have made to the service in the last 12 months. We looked at relevant information from other organisations and what other people have told us about the service. We sent our surveys to the people using the service, their relatives/main carers, the staff working at the home and the health care professional such as the General Practitioner. What has this told us about the service? Kingsley Nursing Home sent us their Annual Quality Assurance Assessment (AQAA) when we asked for it. It was clear and gave us all the information we asked for. We looked at the information in the AQAA and our judgement is that the home is still providing a good service. Kingsley Nursing Home has demonstrated how it continues to maintain the standards and improvements to benefit the people using the service. The AQAA was comprehensively completed by the Registered Manager and provided details of what the service does well and the evidence to support the practice. They provided us with the details of the improvements made, which demonstrated the service continues to develop, ensuring they comply with changes in legislation and practice. The areas for improvements were also identified. This showed that the service recognises the need to continuously improve in line with changes in best practice and legislation. The AQAA demonstrated that people who use the service and their relatives receive information about the home in the form of the Service User Guide and the Statement of Purpose. This has been reviewed regularly and the Statement of Purpose is being replaced to reflect the changes in the service. Annual Service Review Page 4 of 13 The AQAA demonstrated that there is a comprehensive pre-admission assessment completed by a senior member of staff. This process ensures individual care needs, support and preferences are known and can be met by the home. The assessment also looks at areas of risk such as falls or nutrition to ensure individual needs are met. The assessment process has been improved to included the requirements of the Mental Capacity Act and the new Deprivation of Liberty legislation to assess individuals capacity to make decisions for themselves. People who are considering using Kingsley Nursing Home are involved in the assessment process to make an informed decision about using the service. The AQAA states the home offers people short respite stay and emergency placements and procedures are in place to support this. The AQAA states people who are considering using Kingsley Nursing Home are offered a trial stay, which can be extended. This enables people to decide if the home is the right place for them. People who use the service are given documentation about how the home is run, the complaints procedure and a contract with the terms and conditions of stay. Kingsley Nursing Home has a person centred care plan that takes into account individual wishes, using a multi-disciplinary team approach with the trained nurses at the home and the health and social professionals. Care planning takes into account safety measures identified from the assessment of risk for falls, moving and handling and nutritional. The home ensures people have access to specialist equipment such as hoists, mattresses and cushions. The home has staff trained to perform venepuncture. The AQAA states the home operates a named nurse/key worker system whereby individual staff are responsible for ensuring individual requirements with regards to daily living is met. There are internal systems of reviewing care needs and auditing of records to ensure changing needs are met and records are kept up to date. Staff conduct ensures peoples privacy and dignity is respected and their well-being is promoted at all times. The AQAA states people who use the service have good access to health care support and medical support is sought when required. There are good links and effective communication with the Community Psychiatric Nurse, General Practitioner, Dietician, Community Physiotherapist, the Tissue Viability Nurse and the Speech and Language Department. Staff at the home accompany people who use the service to attend appointment if the relatives are unable to do so. Kingsley Nursing Home has a good system for the management and administration of medicines. The home conducts regular internal quality audits to ensure practice is in line with the procedures. The AQAA states the improvements made with regards to meeting individual health and personal care needs included the involvement of the Tissue Viability Nurse. The staff have also received training in the prevention and treatment of pressure ulcers by the wound care expert. Kingsley Nursing Home plans to encourage more people who use the service to use the new dental treatment that has been identified. The AQAA states Kingsley Nursing Home has strong links with the surrounding Annual Service Review Page 5 of 13 community who are involved in activities in the home. The activities plan for the week and the newsletter with the months events is displayed on the notice board. People have a choice of communal areas that they can use, watch the new large televisions in the lounge, which now has more channels available to people. Special days in the calendar are celebrated. The home has employed a new singer and people enjoyed a recent social event whereby, staff dressed up in World War II uniforms and sang songs that they knew. The home operates open visiting to encourage people to receive visitors at any time. People who use the service can have their own telephone lines in their bedrooms. The hairdresser and the chiropodist visit the home regularly to meet individual needs. The AQAA states the home offers three meals a day with snacks and drinks available at all times. There is always a choice of meals offered to suit individual dietary needs. Peoples individual dietary requirements and preference of meals are recorded and are known to the staff. The cook conducts their own quality questionnaire and reviews the menus regularly with the people to ensure they enjoy the meals provided. The AQAA states the complaints procedures is provided to everyone using the service and their relatives. A copy of the complaints procedure is displayed in the home. The contact details for Advocacy Services is available to people at the home including the involvement of IMCA, a support service. The complaints book is kept of all the complaints received and the actions taken to resolve the complaints. The AQAA states Kingsley Nursing Home received 2 complaints, both were substantiated and resolved quickly. The Care Quality Commission received no expressions of concerns or complaints about Kingsley Nursing Home. The AQAA states there are robust procedures in place for safeguarding of vulnerable adults and whistle-blowing. Safeguarding means promoting and protecting the wellbeing of people using the service from harm risk and abuse. All staff are trained in safeguarding and are made aware of their responsibility. The AQAA states the home is aware of their responsibility to comply with new legislations such as the Mental Capacity Act and the Deprivation of Liberty. This means where a person is unable to make decisions for themselves or are able to make some decisions and not others, which is called lacking capacity. Staff have received training and procedures have been updated to ensure referrals are made to the local authority for people to be assessed. The home has made 2 referrals to the local authority under the deprivation of liberty, which shows the service adheres to their new responsibilities in line with changes in legislation. The Care Quality Commission receives timely notifications of events that affects the well-being of people who use the service. The content of the notifications are detailed and include the actions taken. This demonstrated the home follows procedures that protects the health, safety and well-being of the people who use the service. The AQAA states Kingsley Nursing Home is a well maintained property with a routine programme of maintenance and servicing of equipment. The home has good provision Annual Service Review Page 6 of 13 for people who use walking aids and wheelchairs. Specialist equipment is provided to ensure peoples health and safety and helps in promoting their independence. There are comprehensive details and evidence in the AQAA of the systems, servicing and maintenance of the building and equipment. The Registered Manager conducts their own quality checks of the home including the cleanliness. Staff training includes health and safety and infection control. The home has started to install automatic door closures to improve the safety for people who use the service. The AQAA demonstrates the staff recruitment is robust. Pre-employment checks are carried out and maintained on file such as two satisfactory references, criminal records bureau (crb) checks and the protection of vulnerable adults (pova) checks. This is a check to assess the suitability of the applicant to your with vulnerable people. With regards to the employment of nurses, checks with the Nursing and Midwifery Council (NMC) are carried out. The staffing levels and skill mix meets the needs of the people using the service and promotes continuity of care. The AQAA states all staff are requirement to complete induction training and receive a staff handbook. All staff complete mandatory training, which is regularly updated. The trained nurses are required to undertake regular training to maintain their competency and registration as trained nurses. Staff have received information and training with regards to the Mental Capacity Act and the Deprivation of Libertys, as these are new legislations that have been introduced and affects all care establishments. The home as attained the Investors in People Award that demonstrates the staff are trained and valued. At present over 50 of the care staff have attained the National Vocational Qualification (NVQ) level 2 or above in care. The AQAA states the home has recruited a new singer that provides entertainment to the people who use the service and appointed a night staff to fill the vacant post. The Registered Manager and the Deputy Manager have completed the Registered Managers award. The Registered Manager has also completed the Institute of Leadership and Management level 5 in coaching and mentoring. The AQAA demonstrates the management structure in the home ensures the service meets the needs of the people who use the service. Staff are deployed to ensure peoples needs are met timely and safely. The home provides mentoring for student nurses from the University College of Northampton and considers this valuable experience for the student nurses and the staff at the home to continuously adhere to best practice and procedures. The AQAA states staff supervision takes regularly. There are regular staff meetings to ensure staff are kept informed of important matters relating to the home, the people who use the service, training and the management of the service. The AQAA states the policies and procedures are reviewed and were last updated in April 2009. These are available to the staff and any changes are shared with staff at the staff meetings. The AQAA states there is a good system in place for the safe-keeping of peoples money and valuables. Records are maintained of all transactions including receipts and the account balance. These records are included in the quality checks carried out by Annual Service Review Page 7 of 13 the Registered Manager and demonstrates there is an internal monitoring system in place. The AQAA details the range of quality assurance monitoring systems in place. These includes the Residents and Relatives Meetings. Minutes of these meetings are kept as a record of the discussions and decisions made. This demonstrates people are involved and consulted about important matters that affects them with regards to changes and improvements made to the service. The AQAA states the Registered Manager conducts quality checks within the home on a monthly basis. The representative of the Responsible Individual (registered owner) conducts the monthly visits known as regulation 26 visits and produce a report of their findings including an action plan. This demonstrates the service has good internal quality assurance systems in place to ensure the home environment and the service people receive promotes their health, safety and well-being. We sent out 24 surveys to the people who use the service, which included relatives surveys, should they wish for their relatives to comment. We received 13 surveys back from the people who use the service and 10 from relatives. All the surveys responses received indicated people continue to be satisfied with the quality of care provided, meeting individual needs including medication, health and nursing needs. All the responses indicated people like the choice of meals provided and can choose to participate in activities arranged by the home. All responses indicated that staff listen, act and are available when needed, which shows staffing levels are sufficient. All responses received indicated people were aware of the complaints procedures and know who they should speak with if they have any concerns. All the responses received indicated that the home is fresh and clean. The additional comments received in the surveys from the people who use the service and their relatives were: Individual care for Dad, which is personal and friendly Always available to talk to me (son) about any concerns Caring and allowing residents to lead best quality of life possible Everything The staff ensure that my wife is well cared for The home is very good at the welfare of the residents. There is always plenty of staff around when needed and the standard of care and cleanliness is extremely good As the daughter of this resident it is always a pleasure to visit them no matter what time of day. I turn up, staff are always happy and welcoming and my mother always has positive things to say about the home and looks well cared for, which is a great relief to myself The care my mother has received has been wonderful and I have seen a great improvement in her health and well-being since going to Kingsley that wasnt present Annual Service Review Page 8 of 13 in her last home. The staff are excellent Only that I can only speak very highly of the home and the staff, which is a great relief to me as a daughter Looks after my father I am very happy with the way they look after my father and what they do for him The care for me Dad is a way that I could never do. They have given him back his dignity I am very lucky to have Dad in this nursing home. They are like an extended family Meets peoples likes / dislikes. Treats people individually Always listens. Very helpful The home does well in its care, commitment and kindness The home looks after my wife extremely well in all aspects, it may not be of help to my wife but the home and all the staff show kindness and understanding to myself and all my family at all times. Thank you! My wife appears very comfortable in Kingsley and while she accepts her family, its as though she has new family and friends among the wonderful staff. My family and myself feel as if a great mist of worry and uncertainty has been removed. Again thank you all In respect of any health issues, are promptly and efficiently dealt with Overall, I am satisfied with the care my mother receives The care that mother receives at the home cannot be faulted, they are very caring to her and she is well looked after It looks after my mother We also received some comments with regards to how the service could be improved, which we shared with the Registered Manager. They told us that they have employed a singer recently and people seem to enjoy the singing in the home. The Registered Manager welcomed the comments and assured us that they would look at how the service could still be improved. The comments received included: Maybe a little more privacy for residents when relatives visit Activities for the residents a little more stimulation although Im sure this is difficult with such varying needs More activities or stimulation would be nice Annual Service Review Page 9 of 13 Food It could spend more time with the residents and help stimulate them. Too often residents are left on their own Occasionally, a little more care and thought could be taken when attending personal needs It could be cheaper We sent out a survey to the General Practitioner, which they completed and returned. The responses indicated the home meets peoples health care needs, seeks timely advice and supports people with their medication. The responses indicated that the staff are available, respect peoples privacy and dignity and promotes their preferred choice of lifestyle. The comment received in the survey was: Good attitude towards patients and working with the GPs here. They have volunteered to be trained to hold and prescribe Tamiflu for their own patients. They maintain high quality records and offer pro-active care We sent out 26 surveys to the staff, of which 17 were returned. The responses received indicated staff receive up to date information about the people who use the service and their care needs. The responses indicated that staff were appointed with satisfactory pre-employment checks and received induction and training that covered the requirements of their role and responsibilities. The responses received indicated that staff felt they had the right skills, knowledge and experience to look after the people who use the service and respected their individual diverse needs. The responses indicated that staff were confident to respond to concerns and complaints received from the people who use the service and their relatives. The majority of responses indicated that staff receive support and have meetings to discuss work issues. The additional comments received in the staff surveys were: Nursing care is very good Palliative care There are good carers here and they make the home do well The home gives a very high standard of care, understanding and dedication to all of its clients It caters for the clients needs, and trains all the staff well I am happy with working at the home I am trained well in my role, the matron is a fantastic manager to us, she always supervises us and listens to us We offer a caring environment, we try to give good person centred care and involved service users and their families Annual Service Review Page 10 of 13 We have a good working relationship with the local GPs Pharmacist, etc We promote independence and encourage people to maintain a healthy, happy life Understanding peoples individual needs and different likes and dislikes Communication is very good Senior staff are very supportive of both carers and residents All personal care needs are met, with a friendly greeting All staff are friendly and well trained If you have any problems within the home all matters are dealt with professionally There is always someone to talk to in confidence This is the best home I have worked that can keep its staff The home is run very well and I feel that the care that our service users receive is very good Keeps our clients/service users/ patients/residents clean, dry and comfortable and safe Encourages family to be involved with loved ones care and spiritual needs etc We also received comments with regards to what the service could do better, which we shared with the Registered Manager and they gave us assurance that they would consider how the service could be improved. The comments received included: Cleanliness of the home More activities A full time activities organiser would be helpful The home could do with new carpets, new wheelchairs, fresh paint on the walls and better meals for the residents Provide more activities - perhaps in a voluntary way Have more outsiders come in and do activities with the service users Also someone to do laundry, so we can interact more with the service users (residents) We could do with a laundry assistant even if it was part time just to ease the work load so that carers could spend more time with service users Annual Service Review Page 11 of 13 We could do with a catering assistant as the carers have to handle food as well as bathing, toileting and changing the poor bed ridden souls We shared some comments with the Registered Manager, which related to care practice individual members of staff, the lack of response from the management team to respond to concerns and issues relating to the call bell system not working and equipment. We have asked the Registered Manager to respond to these specific issues raised in the staff surveys in writing to us. Kingsley Nursing Home continues to work well with us and have shown us that the service continues to provide good outcomes for the people who use it. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and will do a key inspection by 13th October 2010. However, we can inspect the service at any time if we have any concerns about the quality of the service or the safety of the people who use the service. Annual Service Review Page 12 of 13 Reader Information Document Purpose: Author: Audience: Further copies from: Annual service review CQC General Public 0870 240 7535 (national contact centre) Our duty to regulate social care services is set out in the Care Standards Act 2000. The content of which can be found on our website. 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