Care Home: Kingston House

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What the care home does well Kingston House provides a comfortable, homely environment with pleasant communal areas and bedrooms that reflect individual tastes. People living in the home and their relatives are complimentary about the environment and the care provided. One person said, "This has been a very nice place for my [relative] to live and they seem very happy". People living in Kingston House are cared for by staff who value and respect them as individuals. Their care plans are developed from a comprehensive assessment of the person`s individual needs and wishes, which leads to person centred care. A relative said, "everything they do and have done for my relative has been very efficient and with great care". Kingston House is well managed by a competent person who is committed to providing the people who live there with a good quality service. One relative said, "In my opinion the care home could not improve. It is being run extremely well and with the greatest of care".The menu in Kingston House provides people with a well-balanced and varied diet. Staff provide good home cooked food that is enjoyed by people living there. Relatives and visitors are made welcome and encouraged to visit; one of the visitors spoken with during the course of the inspection said they were, "always made welcome by Fran and the staff". Staff treat people living in the home with dignity and respect and find time to sit and chat with them throughout the course of the day. What has improved since the last inspection? All requirements and recommendations made in the last inspection report have been addressed. The manager demonstrates a commitment to improving the service and is willing to act on any areas that may need to be improved. There have been improvements to the environment since the last inspection. These include a new carpet in the lounge and on the stairs and new flooring in some of the bedrooms. Doors on bathrooms and toilets have been replaced so that they can open either inwards or outwards, making it easier to access the rooms in the event of someone with dementia not being able to get out if they fall or become confused. Recruitment of a number of new carers has improved staffing levels and there have also been improvements in staff training. People living in Kingston House particularly benefit from the dementia training that has been undertaken by the manager and also the level 2 in dementia care that has been completed by the majority of care staff. CARE HOMES FOR OLDER PEOPLE Kingston House 7 Kings Road Clacton On Sea Essex CO15 1BG Lead Inspector Ray Finney Unannounced Inspection 21st May 2008 10:00 X10015.doc Version 1.40 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 Kingston House DS0000017863.V364872.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 Older People. 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. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingston House Address 7 Kings Road Clacton On Sea Essex CO15 1BG 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) 01255 473513 01255 473513 Mrs Marie F Baya Mrs Marie F Baya Care Home 11 Category(ies) of Dementia - over 65 years of age (11), Old age, registration, with number not falling within any other category (11) of places Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 11 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia (not to exceed 11 persons) The total number of service users accommodated in the home must not exceed 11 persons Once a room accommodating two service users becomes a single occupancy it shall remain so, and the total number of service users accommodated will become 9 8th May 2007 Date of last inspection Brief Description of the Service: Kingston House is an established care home for older people who may also have dementia. It is a pleasant detached house in a quiet residential area of Clacton-on-Sea. The home is situated close to the seafront promenade and within walking distance of the town centre shops. Parking is available to the front of the property as well as unrestricted parking on the street outside. Accommodation is provided on both the ground floor and the first floor with access to the first floor by means of a passenger lift or stairs. There is a ramp leading from the lounge to a large well-maintained garden where people can sit in good weather. The majority of the rooms are for single occupancy, with two double rooms. The home is owned and managed by Mrs Marie Fran Baya. Mrs Baya takes a ‘hands on’ approach to managing the home and also lives for much of the time at the home, in private accommodation on the second floor. The home charges between £383.00 and £520.00 a week for the service they provide. Other services such as hairdressing, dry cleaning and chiropody are available at an additional charge. This information was given to us in May 2008. Information about the home can be obtained by contacting the manager. Inspection reports are available from the home and from the CSCI website www.csci.org.uk Kingston House DS0000017863.V364872.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 2 star. This means the people who use this service experience good quality outcomes. A range of evidence was looked at when compiling this report. Documentary evidence was examined, such as menus, staff rotas, care plans and staff files. Completed surveys were received from members of staff, people living in the home and their relatives. The manager completed an Annual Quality Assurance Assessment with information about the home. This document will be referred to as the AQAA throughout the report. An unannounced visit to the home took place on 21st May 2008. The visit included a tour of the premises, discussions with people living in the home, the manager, members of staff and visiting relatives. Observations of how members of staff interact and communicate with people living there have also been taken into account. On the day of the inspector’s visit the atmosphere in the home was relaxed and welcoming and we were given every assistance from the manager and the staff team. What the service does well: Kingston House provides a comfortable, homely environment with pleasant communal areas and bedrooms that reflect individual tastes. People living in the home and their relatives are complimentary about the environment and the care provided. One person said, “This has been a very nice place for my [relative] to live and they seem very happy”. People living in Kingston House are cared for by staff who value and respect them as individuals. Their care plans are developed from a comprehensive assessment of the person’s individual needs and wishes, which leads to person centred care. A relative said, “everything they do and have done for my relative has been very efficient and with great care”. Kingston House is well managed by a competent person who is committed to providing the people who live there with a good quality service. One relative said, “In my opinion the care home could not improve. It is being run extremely well and with the greatest of care”. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 6 The menu in Kingston House provides people with a well-balanced and varied diet. Staff provide good home cooked food that is enjoyed by people living there. Relatives and visitors are made welcome and encouraged to visit; one of the visitors spoken with during the course of the inspection said they were, “always made welcome by Fran and the staff”. Staff treat people living in the home with dignity and respect and find time to sit and chat with them throughout the course of the day. 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. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People choosing to live at Kingston House can be confident they will receive appropriate information about the home and their needs will be assessed before admission. EVIDENCE: There is a Statement of Purpose and a Service User Guide that are kept up to date. They provide appropriate information for anyone wishing to move in to Kingston House, including details of how to make a complaint. A relative spoken with on the day of the inspection said that their relative had been moved in as an emergency, but they were satisfied with the information they had received. The AQAA states that they, “offer the prospective resident and their representative several warm, welcomed visits to the Home, at any time within reasonable hours so they can spend time looking around and observe the Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 9 various activities taking place and assess the Homes quality, facilities and suitability”. A completed survey from someone living in the home said they “went to see the home” before moving in. The manager was able to demonstrate a good awareness of the importance of carrying out a detailed pre-admission assessment. The AQAA states, “We try to obtain as much information as possible from the prospective service user, relatives and the multi-disciplinary team”. When the assessment is complete, the manager develops an interim care plan to cover the first 72 hours after admission and then re-assesses the person’s needs when the person has settled in. Records examined show the pre-admission assessment is comprehensive and covers a range of needs including personal care and physical well being, diet and weight (including dietary preferences), sight, hearing and communication, oral health, foot care, mobility and dexterity, history of falls, continence, medication, cognition, social interests, hobbies, religious/cultural needs, personal safety and risk, family involvement and relationships. The AQAA says, “The life history, medical history and our own assessment within the residential home environment together with our observation will be the base for designing a plan of care”. A sample of three people’s files examined all contain an assessment of needs linked to the care plans. Kingston House does not offer intermediate care, therefore National Minimum Standard 6 does not apply Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that their personal and healthcare needs will be met in Kingston House and that they will be treated with respect. EVIDENCE: The AQAA states, “Good care involves assessment, time and well-trained staff to provide attention. Health and care needs are identified by examining the elderly persons relationships, lifestyle, cultural, spiritual and recreational choices as well as their individual needs and preferences”. A sample of three care plans examined confirm that they are developed from the pre-admission and ongoing assessments. The care plans summarise the assessment of needs in a particular area, the plan or objective around those identified needs and how this will be implemented. There are good details in the implementation section. The night programme of needs, for example, includes details such as whether the person likes the door open or closed, the light left on or turned off, how many pillows the person likes and whether there is anything else to help sleep such as a Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 11 small glass of whisky. This level of detail ensures staff are guided to provide care in a consistent manner and in the way the person likes. Care plans are regularly reviewed so that people’s changing needs can be identified and the plan of care adjusted to meet the person’s needs. The AQAA states, “the need for person-centred care is an essential element of care practice” and they “concentrate on the persons abilities, maintaining autonomy and changing as the person with dementia changes”. The manager was able to demonstrate a good awareness of people’s needs; other staff spoken with had a good understanding of people’s care plans. Minutes of team meetings confirm that issues relating to peoples’ care are discussed so that staff are kept updated and are consistent in the way they are following care plans. Relatives who completed surveys made positive comments about the standard of care provided by the home. One relative said, “Everything they do and have done for my relative has been very efficient and with great care” and another said, “In my opinion the care home could not improve. It is being run extremely well and with the greatest of care”. Another said their relative, “looks very good when I visit”. Records examined also contain risk assessments, including a manual handling assessment, identifying areas of the person’s life where there may be a risk and actions to be taken to minimise that risk. The AQAA states, “We liaise with the District Nurses and other members of the multi-disciplinary team for opinions regarding the health of our residents”. Care plans examined contain records of input from healthcare professionals such as G.P. visits, hospital appointments, optician and district nursing services. Daily records are kept of what people eat and whether they have any specific nutritional needs. Care plans contain details of people’s medication, what it is prescribed for and possible side effects. The manager explained that they are constantly monitoring medication and side effects because some medications can increase the risk of falls in elderly people. The manager displayed a good awareness of how medication can be overused in dementia care and is passionate that it will not happen in her home. The Department of Health document ‘Medicines Management: Everybody’s Business’, which is a guide to medication for those working with people with mental health issues, is available for staff guidance. The storage of medication is in a secure cabinet. Medications are well organised with external preparations stored separately from oral medicines. Medicines are clearly labelled in individual containers. Preparations requiring controlled temperatures, such as eye drops, are stored in a separate compartment in the refrigerator. Medicines Administration Record (MAR) sheets were examined and found to be completed appropriately. Overall, there is a robust system in place for supporting people with their medication. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 12 There were no controlled drugs in use at the time of the inspection. The manager was able to demonstrate an awareness of their responsibilities in appropriate storage and recording of controlled drugs. Thought should be given to installing an appropriate facility for the storage of controlled drugs so that they meet the requirements of recent changes to legislation. On the day of the inspection we observed that staff treat people with respect. Interactions between staff and people in the home were good and staff took time to sit and talk to people. The manager said that listening to people and giving them time is an important part of their care. A visiting relative said they ‘couldn’t be happier’ about the way their relative is treated in Kingston House. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Kingston House have opportunities to maintain a lifestyle that meets their needs and wishes. EVIDENCE: The AQAA states, “Independent activity is promoted. As part of our risk assessment on a new resident, we continue to consider the persons hobbies, personal interests and social activities so that suitable options are offered to meet their needs”. The activity rota includes group activities such as floor basketball, skittles, gentle exercise and films as well as individual activities such as reading, manicures and going for walks. The planner shows that individual activities tend to take place in the morning and group sessions in the afternoon. One member of staff enjoys singing with people and during the course of the day other members of staff were observed spending time just sitting and talking with people. A visitor spoken with said, “there are things like skittles” but often their relative didn’t want to join in and “they respect that”. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 14 On the morning of the inspection the atmosphere was relaxed, a visitor sat playing cards with their relative, other people were looking at magazines and staff were sitting talking to people. In the afternoon a member of staff played floor basketball and skittles with people in the lounge and they were laughing and enjoying the activity. The manager explained about a party they had a few weeks previously when one of the people in the home celebrated their 100th birthday. They arranged for entertainers to come in and the local newspaper was contacted. Throughout the day of the inspection a number of visitors were coming and going. One relative said that they came most days, but were happy knowing that if they couldn’t visit their relative was “happy” and “in good hands”. One of the visitors spoken with during the course of the day said they were, “always made welcome by Fran and the staff”. The manager explained that they try to make sure people can choose how they live their lives. The AQAA says, “They have a choice of when to go to bed and when to get up, what they eat and when, how they spend their time and with whom they make personal and social relationships”. When people are unable to communicate their choices and wishes well, the manager gathers evidence from relatives about what the person liked to do before moving in to the home and their life history and then uses observational skills to judge whether the person likes or dislikes something. Kingston House has a menu that rotates over a four week period and care plans contain a record of meals eaten. A good range of fresh foods including fruit and vegetables was seen during a tour of the premises. The AQAA says, “residents who are interested are offered to contribute to choosing food and other items by On line shopping and they are pleased to see the items they choose being delivered”. Lunch on the day of the inspection was fish with mashed potatoes and beans. People appeared to be enjoying the food. People spoken with said the food was, “good” and “very nice” and confirmed that if they ever didn’t like anything they could have something different. A completed survey said their relative, “likes the food. If [he/she] does not eat the meal they will make something more later for [him/her]”. Staff who were supporting two people to eat were doing so in a sensitive and caring manner. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Kingston House are kept safe by the home’s procedures around complaints and protection. EVIDENCE: The AQAA says, “Complaints are an inevitable fact of life for every organisation and we welcome, reflect and learn from them, using them as powerful drivers of change. We ensure the Service users or representatives know how to complain and who to complain to”. Records examined confirm that Kingston House has policies and procedures in place relating to complaints and safeguarding. The safeguarding policy was updated as required at the last inspection. Records examined show that there have been no formal complaints recorded, but there is a process in place for recording complaints when necessary. The management team know people well and deal with any minor issues as they arise. Three visitors spoken with were all confident that if they had any concerns they would be listened to. All said that they have never had to make a complaint. People spoken with are all very happy with the home and all are confident that their wishes are acted upon. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 16 Personnel records examined contain evidence that staff have received training in issues around safeguarding people (previously called Protection of Vulnerable Adults or POVA). Records examined show that there are guidelines in place for staff and an up to date safeguarding adults training pack. All staff have undergone Criminal Record Bureau (CRB) checks and POVAFirst checks are also carried out as part of the recruitment process (POVAFirst is a national system for maintaining a register of people who are prohibited from working with vulnerable people). Staff spoken with have a good understanding of their responsibilities around keeping people safe. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Kingston House benefit from environment that is well maintained and clean. EVIDENCE: A tour of the premises showed the furnishings in Kingston House to be domestic and comfortable and people living there benefit from the homely surroundings. Furnishings are in keeping with the style and age of the property and are well maintained. People’s bedrooms contain ample evidence of personal possessions, ornaments and photographs. One person had photographs and posters on their wall relating to past achievements in the world of children’s entertainment. People spoken with on the day of the inspection said the home is “lovely”. a homely, comfortable Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 18 As stated in the AQAA, “Since all of our residents have impaired memory, they need to see where they want to go and what they need rather than depending on their memory. Signs and symbols are in place to make rooms more accessible, attractive and appropriate for people with dementia”. One visitor spoken with, whose relative had recently moved to Kingston House, said their relative had settled in quickly and was able to find their way about. Other considerations to ensure the environment is appropriate for people with dementia is providing good lighting, positioning beds so that the ensuite toilet can easily be seen if the person wakes up in the night and making sure people are surrounded by familiar possessions. Doors on communal toilets and bathrooms have been replaced so that the door can be opened outwards in an emergency in case anyone is confused or falls whilst in the toilet, staff will be able to provide assistance to them more easily. The AQAA states, “We keep the environment pleasant and the premises clean, hygienic and free from offensive odours”. Throughout the home there is a high standard of cleanliness with no evidence of odours anywhere. The laundry and sluice are clean and contain appropriate washing and drying facilities for the size of the home. The laundry is situated so that soiled laundry does not need to be carried through areas where food is prepared or served, which helps protect people by maintaining good infection control. There is liquid soap and paper towels for hand washing in toilet and laundry areas. The minutes of the latest staff meeting were examined and confirm that any issues relating to the environment of the home are discussed together with what steps are to be taken to improve, such as replacing a shower curtain, painting skirting boards and the door frame in one bedroom, replacing a toilet seat and looking at whether one person would benefit from having alternative flooring in their bedroom and toilet. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in Kingston House benefit from being cared for by a competent, well trained staff team and are safeguarded by the home’s procedures for employing staff. EVIDENCE: There have been improvements in staffing levels since the last inspection. It says in the AQAA that “members of staff on long term sickness have left and have now been replaced with enthusiastic carers”. Rotas examined show that there are two staff on shift during the day and one at night as well as the manager who lives on the premises for much of the time. On the day of the inspection staffing levels were seen to be appropriate and people’s needs were being attended to promptly. The manager knows the people living in Kingston House well and ensures staffing levels are tailored to meet their changing needs. People spoken with were complimentary about the staff team. One person said, “the staff are very attentive” and another said, “the staff and Fran are very good”. A discussion with the manager and information provided in the AQAA confirmed that over 50 of care staff now have a National Vocational Qualification (NVQ) and the sample of personnel records examined contained evidence of NVQ. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 20 A sample of three staff files examined and all contain the documents required in the Care Homes Regulations. These include an appropriately completed application form with a declaration of the person’s health and no unexplained gaps in previous employment, two references, relevant proof of the person’s identity and a photograph. There was an appropriate current work permit for one person who required this. The manager was able to demonstrate a good awareness of the importance of thoroughly vetting prospective carers and ensuring that she employs staff who will work well within the home. As previously mentioned in this report, records examined contain proof of Criminal Record Bureau (CRB) and POVAFirst checks. People living in Kingston House may be confident that staff are only employed after all relevant checks are made about their suitability for the job. When new staff are recruited they receive an in-house induction. Records examined show that staff have received a range of training relevant to their jobs, including Dementia Awareness, Palliative Care, Moving and Handling, Basic First Aid, Fire Safety, Adult Protection, Mental Health, Health and Safety, Diabetes Awareness and Care Planning. Staff spoken with were positive about the training provided. As stated in the AQAA they have addressed the requirements made at the last inspection in relation to training and now “75 of all staff have completed level 2 in Dementia Care”. The manager states she has, “attended a 6 months course in Dementia Care at Anglia Ruskin University” and her research “has contributed to the implementation of innovatory ideas in the improvement of environment and care delivery”. As stated earlier in this report, the manager is using her knowledge of the needs of people with dementia to improve the environment and lifestyle of people living in Kingston House. Staff spoken with were able to demonstrate a good knowledge of their responsibilities and ensuring they follow good practices. Observations on the day of the inspection also confirm that staff carry out their roles in a caring and professional manner. Overall people living in Kingston House benefit from being cared for by a competent staff team. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Kingston House can be confident the home is run in their best interests and there are health and safety systems in place to ensure the welfare of both individuals and staff. EVIDENCE: As previously reported the proprietor of Kingston House also manages the home. She is a Registered Nurse and has completed NVQ level 4 in care and management and is appropriately qualified to run the home. Information requested by us at the Commission such as the Annual Quality Assurance Assessment document and Regulation 37 notifications are sent in promptly and with good detail. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 22 The manager spends much of her time living in the home and takes a hands on approach working alongside the staff team. People living in the home are complimentary about the way the home is run. A completed survey from a relative said the home, “is being run extremely well and with the greatest of care”. Staff spoken with confirm that they get excellent support from the manager. On the day of the inspection the Quality Assurance system was discussed. The manager seeks the opinion of people living in the home and other interested parties in a number of ways. There are a variety of surveys for people in the home, relatives, friends, advocates and visitors. Similarly staff are able to give their opinions through regular staff meetings. People spoken with, including relatives, staff and people living in Kingston House all confirm that they are consulted on matters relating to the way the home is run. The manager used the information to form an Annual Development Plan for Kingston House and this was sent to us at the Commission. Overall the manager of Kingston House is able to demonstrate that the service responds to people’s views and wishes. There is a process in place to support people with their spending money. A sample of finances examined confirm that the process is robust to ensure people living at Kingston House are protected. Individual records and small amounts of money are stored separately and securely. As at the last inspection, there continues to be a process in place for the supervision of members of staff. This was confirmed in the sample of personnel files examined, which contained evidence that supervisions are carried out approximately three-monthly and staff appraisals yearly. Staff spoken with felt well supported. This should enable them to provide a good quality of care to meet people’s needs effectively. People living in Kingston House and their relatives can have confidence in the ability of staff to meet their needs. Records examined show that appropriate maintenance checks are carried out and a range of certificates relating to Health and Safety were examined, including the Fire Safety Audit, Fire Alarm check, Gas Installation and Hoists. A Fire Risk Assessment was carried out in July 2007 and the fire procedure is clearly displayed on the notice board. Fire Drills are also carried out. Tendring District Council Environmental Services carried out a premises inspection in November 2007 and there were no contraventions found. Kingston House DS0000017863.V364872.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 OP9 Good Practice Recommendations An appropriate facility for the storage of controlled drugs should be available in the event someone in the home may be prescribed medication that requires this type of secure storage. Kingston House DS0000017863.V364872.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Kingston House DS0000017863.V364872.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. 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