Care Home: Kingsmead Lodge

What the care home does well The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind, encouraging and caring towards people living in the home. Staff have the skills and commitment to encourage people living in Kingsmead to live active lives and therefore individuals are able to access the wider community by attending day centres, outreach projects and local colleges. These activities are in addition to days out at local attractions and a wide range of in-house activities. Each individual has a comprehensive plan of care that clearly outlines his or her chosen daily living routines and preferred ways of receiving care. People moving into Kingmead Lodge are encouraged to bring in their personal possessions to personalise their bedrooms and the home has an attractive and well-maintained garden to the rear of the property, which is safe and accessible during good weather. There is an open-house policy, which welcomes visitors at all reasonable times and satisfactory arrangements are in place for dealing with complaints are ensuring that people living in the home and their relatives feel their concerns are listened to and acted upon. What has improved since the last inspection? The AQAA showed that as part of the quality assurance system within the home surveys are now also sent to stakeholders in the community such as other healthcare professionals, in order to gain a wider view on the quality of services provided by the home. All complaints are now logged in the homes complaints record and include actions taken and outcomes. What the care home could do better: Although individual bedrooms are well maintained and attractively decorated some communal areas need a thorough clean, need to be kept tidy and accessible and that minor repairs are carried out promptly. Not all recently recruited staff provided a reference from their last employer and this needs to be addressed to ensure the home fully complies with the regulations. CARE HOME ADULTS 18-65 Kingsmead Lodge Crawley Road Roffey Horsham West Sussex RH12 4RX Lead Inspector Gwyneth Bryant Unannounced Inspection 10 March 2008 07:30 th Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingsmead Lodge Address Crawley Road Roffey Horsham West Sussex RH12 4RX 01403 211790 01403 210424 kingsmeadlodge@sussexhealthcare.org sussexhealthcare.org Dr Shafik Hussien Sachedina Mr Shiraz Boghani Miss Eunice Mundopa Care Home 20 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Category(ies) of Physical disability (20) registration, with number of places Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Only service users with a physical disability may be admitted, some of whom may also have a learning disability. 22nd March 2007 Date of last inspection Brief Description of the Service: Kingsmead Lodge is a care home with nursing that is registered to provide a service to twenty people who are between the ages of eighteen and sixty-five years and who have a physical disability (PD). A condition of registration is that only service users with a physical disability may be admitted, some of whom may have a learning disability. Kingsmead Lodge is a purpose built, single storey building located on the outskirts of Horsham in West Sussex. There are twenty single rooms with en-suite facilities that include a toilet and wash hand basin. There is a large activities room, a small quiet lounge, two dining rooms, a sun lounge and a spa pool. There is an enclosed sensory garden and an indoor sensory room. Sussex Health Care own Kingsmead Lodge. The owners and responsible individuals are Dr S Sachedina and Mr S Boghani. The registered manager is Miss Eunice Mundopa who is responsible for the day-to-day running of the home. Kingsmead Lodge is on the same site as another care home that is owned by the Sussex Health Care Group. The fees are variable and based on individual care needs. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This was an unannounced inspection and took place over five hours. The purpose of the inspection was to check compliance with the requirements made at the last inspection and check key standards. Twenty people were in residence on the day of which one was spoken with. The Manager, two staff, the cook and the administrator were also spoken with in addition to three relatives contacted by telephone following the site visit. A tour of the premises was carried out and a range of documentation was viewed including care plans, personnel and medication records. Prior to the site visit we asked the Registered Providers to complete an Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. This was provided and the information included in this report as necessary. One survey from a member of staff was returned and fifteen from users of the service each of whom was assisted by staff to complete it. Comments in surveys included: the company could carry out major repairs quicker, sometimes it takes months to agree then months to complete. If I am unsure of anything I could speak to my team leader or the manager depending on the problem. I am really happy here, I enjoy being around others and their company. It’s a friendly home. I get on every well with everyone. The staff are wonderful, loving and caring. They take good care of me What the service does well: The atmosphere in the home was comfortable, homely and relaxed and staff were seen to be kind, encouraging and caring towards people living in the home. Staff have the skills and commitment to encourage people living in Kingsmead to live active lives and therefore individuals are able to access the wider community by attending day centres, outreach projects and local colleges. These activities are in addition to days out at local attractions and a wide range of in-house activities. Each individual has a comprehensive plan of care that clearly outlines his or her chosen daily living routines and preferred ways of receiving care. People moving into Kingmead Lodge are encouraged to bring in their personal possessions to personalise their bedrooms and the Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 6 home has an attractive and well-maintained garden to the rear of the property, which is safe and accessible during good weather. There is an open-house policy, which welcomes visitors at all reasonable times and satisfactory arrangements are in place for dealing with complaints are ensuring that people living in the home and their relatives feel their concerns are listened to and acted upon. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 3 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People moving into the home benefit from an admission process that ensures their individual needs and aspirations are comprehensively assessed and identified as being able to be met prior to moving into the home. EVIDENCE: As part of the care planning process all people moving into Kingsmead have a detailed assessment of their needs which is used as a basis for their individual plans of care. The admission assessments for four individuals were viewed and it was evident that a thorough assessment process had been undertaken prior to all four people coming to live at the home. Information is gathered from a variety of sources including social and healthcare professionals in addition to input from family and friends. A number of people are placed in the home under the NHS continuing care programme and therefore certain criteria must be met by the home as part of this process. One relative said she was able to stay with her daughter when she first moved in enabling to assist with the settling in process. Comments in surveys and from those spoken with included: • No one asked me if I wanted to move into this home or not, I moved in with the normal procedures and I like it here. DS0000024164.V359369.R01.S.doc Version 5.2 Page 9 Kingsmead Lodge • • I didn’t know anything about the home until I got here and they have proved to me they are the best. (name) didn’t have a trial period as the home she was in closed but we are very pleased with her care and it’s the best place she has been in. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The standard of care planning provides staff with an excellent foundation to support individuals in a way that both enables and protects them. People living in Kingsmead are fully consulted and involved in all decisions about their lives. EVIDENCE: Four care plans were viewed and found to be comprehensive and included clear information on preferred daily routines with evidence that the basis of care provision is person centred. In addition, the care plans are written in plain English and include pictorial information to ensure each individual has an understanding of their own care needs and how they will be met. Additional information based on input from the activity organiser, physiotherapist, dietician, care staff and other social and healthcare professionals are included in care plans. Care plans are reviewed monthly but are updated if changes are identified in the interim period. As a number of people living in Kingsmead have limited mobility it is important to ensure they are comfortable at night and to facilitate this photographs Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 11 showing the exact positioning of the person at night time and any equipment such as cushions is displayed in each bedroom providing clear direction to staff to ensure individuals are comfortable at night. A key worker system is in place ensuring that individuals receive consistent care from a named individual. Each care plan also includes details of the relationships important to the individual, including parents, siblings, and friends in addition to health and social care professionals. Discussion with the Manager, two staff and observation of their practices, it was evident that they have developed good relationships with the people they support and a good understanding of their needs as individuals. Care plans included information as to how individuals were consulted, both singly and as a group to ensure they have the opportunity to participate in the day-to-day running of the home. A range of detailed risk assessments were found to be in place in each of the care plans viewed. The home has a positive approach to risk taking and people are supported to take risks to maximise choice and independence. Through careful risk assessment and support plans, it was evident that the home has enabled people living in Kingsmead to achieve their goals and outline plans for future aspirations. Each risk assessment is directly linked to a training and support plan which shows how that risk is managed. There was evidence that risk assessments continue to be regularly reviewed and updated. Risk assessments demonstrate that the underlying principle is to enable people to live their lives as they chose with restrictions in place only if absolutely necessary. Comments from those spoken with and in surveys included: • • • • they look after (name) very well. They are excellent in the way the help and encourage (name) We are really pleased with the care Care overall is good. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in Kingsmead benefit from the ability to lead independent lives where they are appropriately supported to develop their educational, vocational and social skills and are involved in planning balanced and nutritious meals. EVIDENCE: People living in the home have a wide range of opportunities to participate in a variety of activities both within the home and in the wider community. Each individual attends college to participate in a chosen course of study linked to their preferences. They are also encouraged and enabled to attend various day centres, with one person attending a particular centre to enable them to mix, socially, with others in their age group with whom they have developed friendships. Relatives contacted confirmed that they are always made to feel welcome and they are generally impressed with the range of activities and added that people Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 13 living in the home would like to do more college courses especially during the holidays. The home provides a sensory room and spa bath and although the spa bath was not working on the day of the site visit, one person was seen to be enjoying the use of the sensory room. The home provides a full daily programme of activities in addition to days out to local attractions and summer barbeques. An activity co-ordinator is employed plus two assistants providing activities that include musical sessions, using computers, board games, cooking, gardening and arts and crafts. Following consultation with people living in Kingsmead outings have been arranged for visits to bowling centres, the seaside, concerts/shows, zoos and shopping trips. Care plans included information on those people who spend time outside the home with family either for days out or for weekends. Information in the AQAA confirmed that each person living in Kingmead has an annual holiday either arranged by the home or by family. A physiotherapist and her assistants provide various exercises to ensure individuals have the opportunity to use standing frames, have aromatherapy massages or just lie on the beanbags. Comments in surveys and those spoken with included: • • • I like going to concerts I am really doing well at outreach – I enjoy it. they (staff) do everything to make it an occasion esp at Easter etc and I got a mothers day card and we get birthday cards – we never had that at the last place and it’s the little things like that and it makes it feel like your daughter is still part of the family. We hadn’t realised they do so much for her – other places she went to didn’t do so much so she gets a lot more care and activities. They did a marvellous lunch for mothering Sunday at the home – I was very impressed as it was the first time I had been – I was bowled over at what they had done. • • Discussion with the chef found that he is knowledgeable about healthy eating and is aware of those individuals who have particular dietary needs. He confirmed that he consults residents on menus and new menus are tried for a month and then further consultation takes place before the menus become permanent. In addition, menus are seasonal and include the government recommended five portions of fruit and vegetables per day. For those individuals who are artificially fed, clear instructions are provided by the dietician to ensure satisfactory nutritional intake is achieved and that individuals are encouraged to eat small amounts of food normally. Care plans include information on the preferred eating utensils such as the size and type of spoon. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience excellent quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. . People living in the home benefit from the provision of flexible and respectful personal and healthcare support and are protected by the systems in place to manage medication. EVIDENCE: Care plans clearly outline the individual preferences in respect of transfers and the delivery of care with particular reference to respecting choice, privacy, dignity and independence each of which gives them control over their daily lives. Care plans also indicate preferred times for getting up and going to bed and identify what the individual is able to do independently and which tasks they need help with. The care planning systems include the type of specialist support and advice required from physiotherapists, dietician, speech and occupational therapist to ensure all aspects of healthcare needs are identified and met in full. The manager also sources information for needs outside the usual range. For example, one care plan included an article on how females with learning disabilities can be helped in dealing with menopausal symptoms and another plan includes a request to a consultant to consider a new form of treatment. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 15 These actions demonstrate that there is a firm commitment to explore options that are outside the mainstream healthcare options. Opticians, dentists and chiropodists visit the home regularly and are available as required. Staff spoken with individually and during the handover session were knowledgeable about the needs of individuals in the home and how best to meet those needs. A range of equipment is provided to assist with moving and handling including ceiling hoists in each bedroom in addition to portable hoists, standing frames, pressure relieving systems and lifting belts. Comments in surveys included: • • • • • I am really happy here, I enjoy being around others and their company. It’s a friendly home. I get on every well with everyone. The staff are wonderful, loving and caring. They take good care of me The staff takes care of me and I am happy with their service. The storage and administration of medication were found to be satisfactory. Medication administration records were clear, accurate and up to date. The nurse spoken with was clear on the administration of daily medication, homely remedies and controlled drugs. Care plans included clear information on the triggers for certain medication such as pain relief and seizures which ensures all staff are able to respond promptly to medication needs. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure with evidence that service users feel that their views are listened to and acted upon and service users are further protected by satisfactory safeguarding adult procedures. EVIDENCE: The home has a complaints procedure in place and a copy is kept in the lounge for residents’ and visitors to access and the AQAA indicated that policies and procedures on both complaints and safeguarding adults were available and regularly reviewed. The complaints log was viewed and there has been just one complaint since the last inspection and this was dealt with satisfactorily and included actions taken and outcomes. Not all staff have been trained in safeguarding adults but the manager confirmed that there is a rolling staff training programme to ensure all staff receive this training over the next few months. Comments in surveys included: • • If I were really unhappy I would speak to the manager. They (staff) do listen and act on what I say Relatives spoken with confirmed that they are listened to and any concerns have been taken seriously by the manager and dealt with satisfactorily. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Most parts of the home are homely, safe, well maintained and comfortable ensuring that it is a pleasant place in which to live. EVIDENCE: A tour of the premises was carried out and all bedrooms are light, airy and have en-suite facilities. The member of staff spoken with explained that most people living in the home choose to use communal toilet and bathing facilities as they are more spacious than the en—suite facilities. There are fully accessible shower rooms that are fully equipped with shower trolleys and hoists as necessary. Care plans showed that people in the home are consulted on the décor in their bedrooms and individual bedrooms are attractively decorated and it is evident that people are encouraged to personalise their rooms and many have done so with ornaments, posters and photographs. There is an on-going maintenance programme but it was disappointing to note that tiles were missing in toilets and bathrooms and several of the waste bins Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 18 did not have lids, even though they were used for the disposal of used gloves and aprons. In addition some shower trolleys and toilets need a thorough clean as grime has accumulated and one shower room was malodorous. These shortfalls need to be addressed as they not only detract from the general attractiveness of the home but are also potential sources of bacteria. Discussion with the manager found that they have been recruiting for a cleaner and in the interim care staff have been cleaning in between care tasks so do not have time to carry out deep cleaning. Currently the conservatory is used to store a variety of equipment, furniture and pots of paint. Visits carried out by the Area Manager, as part of the quality monitoring process, has identified this as needing to be addressed for over 12 months. The manager explained that alternative storage facilities have been identified but this has yet to be organised. Again this is disappointing as people living in the home have not had access to the conservatory for over 12 months although the homes Statement of Purpose and service users guide states that it is available. It is important that the Statement of Purpose and service users guide accurately reflect the availability of facilities and if they are not available for some time these documents need to be reviewed in light of this. Discussion with the manager and staff training records found that all staff are trained in infection control and were seen to be working in ways that minimised cross infection. There is an on site laundry that has washing machines that can wash clothes at temperatures that reduce the risk of infection. Care plans showed that some people prefer their clothes to be washed by family and the procedure for this is clearly documented in relation to individual preferences. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People living in Kingsmead benefit from a dedicated and competent team of staff and are protected by the robust recruitment procedures. Staff have both the skills and support to enable them to perform their roles effectively. EVIDENCE: At the time of the inspection, the atmosphere was observed to be friendly and relaxed and the positive relationships between staff and individuals were obvious. There are sixteen permanent care staff and five trained nurses employed, in addition to cooks, administration staff and a maintenance person. Currently five care staff have achieved at least National Vocational Qualification at level 2 with a further three to begin this course in May therefore the home will meet the required 50 of care staff with this qualification. Recruitment of a cleaner should be a priority to ensure care staff no longer have to take over this role as it impinges on their caring time in addition to their not having sufficient time to ensure all areas of the home remain thoroughly and hygienically clean. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 20 Discussion with the manager and examination of five staff files identified that training is ongoing with mandatory training in fire safety and moving and handling treated as priority for all new staff and additional training is provided that is related to the particular conditions of individuals living in the home. There is documentary evidence that new staff members complete an induction programme in line with Skills for Care. The manager confirmed that there is a plan to ensure all staff are trained in Protection of Vulnerable Adults within the next few months. Regular staff meetings are conducted with minutes recorded and these are held collectively in the main office. There is a supervision system in place that provides staff with formal 1-1 sessions every month and the manager confirmed that Sussex Health Care Group has clinical staff to ensure trained nurses receive regular clinical supervision. Recruitment records for the last five people to be employed were viewed and while most had provided all the required documentation including Criminal Record Bureau checks and proof of identity, two people had not provided a reference from their last employer. As these people were from overseas the manager believed that character references were used until references were received from overseas and agreed to look into the matter without delay. Despite this shortfall, people living in Kingsmead are not at risk as the homes policy is to ensure staff do not work alone until their induction is complete and their competency established. Comments in surveys and those spoken with included: • • • • • • • The staff take care of me and I am happy with their service. They (staff) are very good and caring. They (staff) are very nice to me staff are well trained and pretty good actually. You do get some changes of staff but the regular ones are really good. some staff are better than others – some are exceptional others not so good staff are generally well trained - some are better than others - I often feel new staff need more training. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The service is well managed and all aspects of the welfare, safety and health of people living in the home are protected and promoted. EVIDENCE: The Registered Manager has worked in the care industry for a number of years and has the skills, qualifications and experience to manage the home and provide clear leadership and direction to staff. The atmosphere of the home is open and throughout the site visit staff were obviously comfortable coming to the office and approaching her with any concerns. She is very knowledgeable about the day-to-day practice of the home and equally knowledgeable about the individual needs and preferences of people living in Kingsmead. Sussex Health Care has a company quality monitoring system that includes monthly audits, regular surveys for families and service users and on the recommendation from the last site visit the surveys have been extended to Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 22 social and healthcare professionals. The area manager makes monthly visits and the subsequent reports are held in the office, however a number were not available on the day. Discussion with the manager found that the visits have taken place but the reports may be waiting to be filed. Information in the AQAA also indicated that both staff and people living in Kingsmead are regularly consulted and the minutes of these meetings were available in the office. All accidents are recorded and monitored as part of the quality monitoring process to ensure that any risk areas can be addressed promptly. The home does not manage the finances of anyone living in the home. The manager either informs families if items are needed or they are purchased and the cost added to the monthly invoice. There was evidence to show that regular safety checks are carried out on all equipment, including electrical and gas appliances and systems. In addition there is an on-going programme of maintenance, upgrading and renovation of all parts of the home, including individual rooms. All staff receive regular fire safety training and a fire risk assessment has been carried out to ensure no part of the home poses a fire risk. Regular fire drills are carried and fire alarm systems regularly tested ensuring neither staff nor people living in the home are at risk in the event of fire. Self-closing devices, triggered by the fire alarm are fitted to all internal doors that require them. There was a fire test on the day of the site visit and all staff acted appropriately. It was of slight concern that while this was in progress people living in the home were left unsupervised for a short time. Discussion with the manager found that assessments showed that no one was at risk but she would review the procedures to ensue people were left unsupervised for the shortest time possible. Comments in staff surveys included: • • We have a good care team who are willing to help each other I receive support and discuss my problems through supervisions and her (manager) office is always open if I have any problems. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 3 LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 3 x x 3 x Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA24 YA34 Regulation 23 92) (b) (d) (h) 19 (1) (b) Requirement That all parts of the home be kept clean, tidy and well maintained. That all staff provide a written reference from their last employer Timescale for action 10/04/08 10/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA24 Good Practice Recommendations That the conservatory be cleared and made available for use by service users. Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kingsmead Lodge DS0000024164.V359369.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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