Care Home: Kingswood

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What the care home does well People who want to live at Kingswood have a full assessment of the help and support they require by the manager or proprietor. This information is used to develop a care plan so that staff know what they have to do. Staff also have time to spend with people living in the home. Comments from people living at Kingswood include:"Robert Leslie and all the staff at Kingswood listen and involve us as a family and try to act on everything we ask" "we love the music sections, parties and bring and buys that staff organise" "Robert is always available and resolves things quickly" People receive the care and attention they need and their health care needs are also met. Comments from visiting professionals include:"They provide a warm caring environment akin to their own home. Communicates well with health professionals to ensure clients health and social needs are met" "staff are responsive to suggestions given by district nurse in order to meet/improve individuals health needs" "despite some residents lacking insight and suffering from short term memory loss the carers respect the residents privacy and treat them with respect" The staff who work at the home are thoroughly checked before they start their employment and they receive some training to ensure they have the skills needed to do their job. What has improved since the last inspection? Since the last inspection there has been a change in manager and this has had a settling effect on the home and staff said that "my manager is brilliant, she is supportive and approachable and encourages the staff to do our job well" She has also introduced a quality assurance programme and is assisted with this by the new deputy manager. The introduction of the Quality Assurance system has helped them to identify areas of staff training that need updating. It has also helped them to identify activities that the people living in the home want to take part in. The manager has also introduced staff supervisions and appraisals. This allows her to identify individual training needs and also allows the staff time to discuss any issues they may have with their job. Everyone who lives in the home has had their social interests noted. This means activities are now tailored to the individual and the group so that even those who lack insight can take part in meaningful activities. What the care home could do better: The internal decor of the home requires updating. It is clear that no work has been recently been carried out to maintain the decor to an acceptable level. The provider needs to supply the Commission with a programme of works that show when the decor will be done. Staff would also benefit from regular training in the complaints procedure, whistle blowing and the vulnerable adults procedure. This would help them to identify any problems more easily and give them the knowledge and confidence to deal with any issues raised. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Kingswood 48 West Street Scarborough North Yorkshire YO11 2QP     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pauline ORourke     Date: 2 1 0 4 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Kingswood 48 West Street Scarborough North Yorkshire YO11 2QP 01723363263 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Robert Leonard Devine,Mrs Brenda Devine care home 18 Number of places (if applicable): Under 65 Over 65 18 old age, not falling within any other category Additional conditions: 0 Registered for 18 Elderly Service Users 5 of whom may also have dementia Date of last inspection Brief description of the care home Kingswood provides personal care and accommodation for a maximum of eighteen older people up to five of whom may also have been assessed as having a significant dementia. The home does not provide nursing care. The home is located in the South Cliff area of Scarborough and is conveniently situated for all of the main community facilities and the public transport network. Information is given to new and existing service users to the home detailing the accommodation, facilities and services provided. Kingswood is built on three floors with a passenger lift serving all floors with bath and toilet facilities on each floor. The communal space consists of two lounges and a dining room situated on the ground floor. There is a garden area with seating at the front of the building. Unrestricted parking is available on West Street. Care Homes for Older People Page 4 of 26 Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The Care Quality Commission inspects homes at a frequency determined by how the home has been risk assessed. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a site visit. More information about the inspection process can be found on our website www.cqc.org.uk We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been Care Homes for Older People Page 6 of 26 deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The key inspection has used information from different sources to provide evidence for this report. These sources include: Reviewing information that has been received about the home since the last inspection. Information provided by the registered person in an Annual Quality Assurance Assessment form (AQAA) Comment cards returned from people living at Kingswood and from other people with an interest in the service. A visit to the home by one inspector that lasted for six hours. During the visit to the home people who live there, staff and a visitor were spoken with. Care records relating to four people who live at Kingswood, four staff members and the management activities of the home were inspected. Care practices were observed, where appropriate, and time was also spent watching the general activity within the home. This enabled the inspector to gain an insight of what life is like at Kingswood for the people living there. Information about the home is available in a Service User Guide and the weekly cost of staying at Kingswood is up to three hundred and seventy five pounds. The amount payable is dependent on a financial assessment. The Registered Provider and manager were available for feedback at the close. What the care home does well: What has improved since the last inspection? Since the last inspection there has been a change in manager and this has had a settling effect on the home and staff said that my manager is brilliant, she is supportive and approachable and encourages the staff to do our job well She has also introduced a quality assurance programme and is assisted with this by the new deputy manager. The introduction of the Quality Assurance system has helped them to identify areas of staff training that need updating. It has also helped them to identify activities that the people living in the home want to take part in. The manager has also introduced staff supervisions and appraisals. This allows her to identify individual training needs and also allows the staff time to discuss any issues they may have with their job. Everyone who lives in the home has had their social interests noted. This means activities are now tailored to the individual and the group so that even those who lack insight can take part in meaningful activities. Care Homes for Older People Page 8 of 26 What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People moving in to the home have an assessment of the help they need and so can be assured that their care needs will be met. Evidence: Four case files seen showed that a proper assessment had been carried out before the people concerned had been admitted to the home. The information covered the physical, health and social needs of the person concerned. Information pertinent to the equalities and diversity policy is also collected at this point. The assessment information was detailed and highlighted the individuals right to decide how they wanted assistance provided. The provider and manger were present during the inspection and both confirmed that when admitting someone to the home they try and consider the level of support required by people currently living in the home so that they can be sure they could Care Homes for Older People Page 11 of 26 Evidence: meet everyones needs. Staff said that they received enough initial information to enable the to support people coming in to the home. Information about the home is available to people looking to move in to the home in a service user guide. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care and support they need and this is reflected in the care plan. The staff provide support in a sensitive way that promotes the persons independence and dignity. Evidence: The files seen each contained a care plan pertinent to the needs of the individual concerned. Several people were aware that the staff kept records about them and did talk to them about the help they needed. There was evidence in the files that the plans are reviewed monthly. Risk assessments were also in place where necessary. Staff keep daily records for people in the home and this information was used to inform the monthly reviews. Staff ensure that verbal and non-verbal communication methods are recorded in the file for each person. This enables staff to have a fuller understanding of the people they are looking after. Staff spoken with said that they have a handover for each shift and they are encouraged to read the care plans regularly. There is a key worker system in place and it is the responsibility of the key worker to spend time with the people in the home and review their care plans. Care Homes for Older People Page 13 of 26 Evidence: The files contained information about their health needs and details of GP and district nurse visits are recorded. People spoken with said that they could see their GP on request and that any visits made either to the home or the surgery were carried out in private. Feedback received from three health professionals indicated that the staff are responsive to suggestions made by them to enhance the health needs of people in the home and will ask for advice if they need to. The system for administration of medication was seen. The system is a monitored dosage system supplied by a pharmacist in which ongoing medication records are pre printed and any short course medication, such as antibiotics, is added to the record sheets by hand. Information supplied during the visit said that staff who handled the medication had undertaken a course on the safe handling of medicines. The recording of medication given was up to date. Storage of medication was secure. Currently there is one person in the home who self-medicates and documentation is kept in their files to support this. During the visit staff were seen to treat all the people in the home with respect and dignity. One health care professional said despite some residents lacking insight and suffering from short term memory loss the carers respect the residents privacy and treat them with respect People said throughout the day that the staff are nice and will do anything for you. One person said the staff are very good at dealing with difficult people. A relative said the staff are always welcoming when you visit and they keep in touch with you if there any problems. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are able to make choices on a daily basis and are supported to do this by the staff. They enjoy a varied diet. The recreational programme reflects the full range of needs in the home. Evidence: There is a mixture of people living in the home, some people who can make decisions about the whole of their life and others who have a degree of confusion. Those people who were able said that they could follow their own routine during the day. Staff spoken with said there was no pressure from colleagues to make sure people were up on a morning or ready for bed on a night. This has changed over the last year and they all said the home was calmer as result. Activities are organised on an ad-hoc basis and during the inspection staff were observed spending time with people on a one-to-one basis. One person in the home said that there were not many activities to join in with but they also recognised that other people in the home were reluctant to join in, another said we love the music sections, parties and bring and buys that staff organise Where people do not suffer from confusion or dementia then staff try to spend quality time talking to them as this is something they cant do with most of the current population. One person said Robert, Leslie and all the staff at Kingswood Care Homes for Older People Page 15 of 26 Evidence: listen and involve us as a family and try to act on everything we ask A health care professional said They support people to live their own lives where possible and my client has been very well supported by care staff despite exhibiting some difficult behaviour Another said They provide a warm caring environment akin to their own home. Communicates well with health professionals to ensure clients health and social needs are met There is a visitors policy in place and people spoken with said that their visitors could come at anytime during the day. One visitor spoken with said that she called at anytime and always found the staff to be welcoming and friendly. She said that the manager keeps her informed of any issues relating to her relative. The home works with a four-week menu where alternatives to the main meal are offered rather than a choice. People in the home said that the food was good and the meals always excellent. The cook said that fresh produce is used when possible. One person said The meals are always good The meal observed was unhurried and people were assisted discreetly. People appeared to enjoy their dinner. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at Kingswood and their representatives are able to express their concerns through the complaints procedure and are protected from abuse, so their rights are protected. Evidence: The home has a complaints procedure in place and details of how to make a complaint where available around the home. Several people spoken to were clear that if they were not happy they would speak to the manager, deputy manager or the proprietor. A visitor said that they would speak directly to the manager if there were any problems. A record is kept of any complaints received and there have been no complaints received by the home in the last twelve months. One person said Robert is always available and resolves things quickly The manager should look at providing the complaints policy in different formats to ensure that it accessible to people with differing needs. There are policies on the protection of vulnerable adults and a whistle blowing policy so that staff can disclose poor practice without fear for their own position. Care staff spoken with said that they would report any suspected abuse to the manager or senior staff, so that people who live at the home would be safeguarded. The manager said that there had been little training in safeguarding or the whistle blowing policy in the last 12 months. It is recommended that this training is carried out on a regular basis. Care Homes for Older People Page 17 of 26 Evidence: All staff are thoroughly checked prior to the commencement of their employment to ensure they are suitable to work with vulnerable adults. Care Homes for Older People Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean comfortable place to live, although the decor throughout the building requires updating. Evidence: All the general areas of the home, some bedrooms and bathrooms, the kitchen and laundry were seen. Several people had keys to their own rooms and could lock their door when they left it. The home was clean and there was no unpleasant smell. People who live at the home are provided with comfortable seating in two sitting areas so that they can choose where and with whom they spend time. Some of the chairs are showing signs of wear and the manager needs to ensure these are repaired or replaced as part of the improvement programme. The overall appearance of the home is tatty and all areas seen would benefit from being decorated. One person spoken with said it is a little shabby but the care provided is excellent this was echoed by a visitor who felt the care her mother received was more important than the state of the decor. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff, that, have been thoroughly vetted prior to the commencement of their employment, support people. They are in sufficient numbers to ensure they can provide the support required by the people in the home. Evidence: At the time of the visit there were two care workers, and one cook on duty plus the proprietor was around helping. The staff team meets the needs of the people in residence. Staff spoken with said that there was enough staff on duty to allow for more personal interactions particularly on an afternoon. People in the home said the staff are wonderful and will do anything for you. Feedback received from staff indicated enough staff to meet individual needs and we are encouraged to work together in order that we have more time available to spend with the residents There are also two waking night staff on duty during the night. A cook is employed four days a week and the management team cover the rest of the catering shifts. Currently 60 of the staff have a National Vocational Qualification level two in care or are working towards it. Staff also have statutory training in manual handling, first aid, fire safety, infection control and food hygiene. Staff have received training in dementia awareness feedback from one professionals said Staff from Kingswood have attended our Carers Awareness Sessions in the past to learn about dementias and what Care Homes for Older People Page 20 of 26 Evidence: resources are available and another said staff have the skills needed to do the job and senior staff are skilled at supporting clients social and health care needs. Four staff records were seen and they contained an application form, two references, a POVAFIRST check and/or a Criminal Records Bureau disclosure, evidence of training and supervision notes. Staff spoken with all said that they could not start work until all the necessary checks had been carried out. New staff shadow another member of staff for a week before being rostered in to the shift. Staff receive formal supervision and appraisals. Care staff and records showed that appraisals were carried out twice a year, supervison is a recent addition to staff support and it is planned for each member of staff to receive six sessions each year. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the service is managed by a competent person. The development of a formal quality assurance system has assisted the manager to identify areas of service which can be improved. Evidence: The current manager is experienced and has been at Kingswood for several years, she is currently doing a relevant management qualification. She has also submitted her application to be the registered manager of Kingswood. Feedback received before and during the visit indicated that she was approachable and always available for support and advice. One member of staff said my manager is brilliant, she is supportive and approachable and encourages the staff to do our job well. Throughout the inspection people said that the home was a much more relaxed and happier place to live and work since the change in manager. Since the last inspection a quality assurance system has been established. All aspects Care Homes for Older People Page 22 of 26 Evidence: of the care home are monitored, including surveys for people living in the home, relatives, staff and team meetings, complaints, and policies. One person said Robert Leslie and all the staff at Kingswood listen and involve us as a family and try to act on everything we ask Work done so far has improved the equality and diversity monitoring and has identified the need for further staff training and outings for people in the home. The manager does not handle any monies for people living in the home. The health and safety records were checked and all were found to be up to date. Risk assessments for fire, the environment, COSHH and people who live in the home. All accidents and incidents are recorded and when necessary they are reported to the Care Quality Commission. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 19 23 The registered person must ensure the premises are kept in a good state of repair externally and internally, so must supply the Commission with a plan of works for the building. By ensuring the home remains in a good state of repair the safety and well being of the people who live there is promoted. 29/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 16 The registered provider should look to produce the complaints procedure in to different formats to ensure it is accessible to as many people as possible. Staff should have training on safeguarding and whistleblowing on a regular basis to ensure they remain aware of their responsibilities in relation to the safety and well being of the people who live in the home. 2 18 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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