Care Home: Kingswood Lodge

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What the care home does well Some of the staff team have worked at the home for many years and therefore know some service users extremely well. They are able to talk with them about things that they have done together in the past. A large proportion of the staff team have gained an NVQ qualification, which helps staff have the necessary skills to care for the people at the home. The majority of staff are up to date in training that is necessary for them to perform their role as a carer. What has improved since the last inspection? All people who live at the home now have a written plan of care to guide staff about how to care for this person. These care plans now include clear guidance on how to meet people`s healthcare needs. Information in the home that is intended for residents, such as the `Service User Guide` and complaints procedure are now written in a way that has more meaning to the people that live in the home. The guides contain short sentences and lots of pictures, including actual photographs of the home. Areas of the home previously identified that could potentially place service users at risk of harm, such as scalding hot water and a potential lack of maintenance of the electricity and gas services supplied at the home, have now been addressed to make service users safe. A number of areas of the home, such as bathrooms and toilets have been renewed, which makes the home more hygienic. A system is now in place at the home, which seeks the views of people living and visiting the home about the quality of care that the service provides. The service has taken the appropriate action to improve areas of the service that were identified at the previous inspections. What the care home could do better: Not all staff are following the homes` procedures on what to do if a GP prescribes a new medicine verbally. This can put residents at risk of receiving the wrong dosages of a medicine.Kingswood LodgeDS0000028918.V376178.R01.S.doc Version 5.2 A general service agreement has been written in a way that is more meaningful to the people that live in the home, using pictures. It is recommended that this service agreement be made individual to each service user and that this is the document that is signed and retained by each service user. One toilet in the home is not pleasant or hygienic and does not meet the expectations of people that live in the home. Key inspection report CARE HOME ADULTS 18-65 Kingswood Lodge 25 Railway Street Gillingham Kent ME7 1XH Lead Inspector Nicki Dawson Key Unannounced Inspection 22nd July 2009 10:05 Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care home adults 18-65 can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop. The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kingswood Lodge Address 25 Railway Street Gillingham Kent ME7 1XH 01634 580797 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) Doson Ltd Manager post vacant Care Home 18 Category(ies) of Learning disability (18) registration, with number of places Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD). The maximum number of service users to be accommodated is 18. Date of last inspection 29th April 2009 Brief Description of the Service: Kingswood Lodge provides accommodation and support for up to eighteen adults with a learning disability. The home is located in the centre of Gillingham. It is a short walk from the high street and other amenities. It is close to the main railway station and bus services. The home is owned by Doson Ltd who own a number of other residential care homes. The home provides accommodation on three floors. There is a lift to the first floor. Residents have use of two lounges, an activities room, a dinning room and conservatory. There is a garden to the rear of the home, some of which has been laid to lawn and another area that is paved and suitable for the wheelchair users. There is a small car parking area. At the time of the inspection we were told that the current fee levels are assessed on individual need and range between £367.72 and £679.44 per week. Information about the facilities and services provided by the home are contained in the Statement of Purpose and Service User Guide which are available at the home. Kingswood Lodge DS0000028918.V376178.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. The inspection was unannounced, which means that the service users and staff did not know that the inspector was calling at the home. Key unannounced inspections are aimed at making sure that the individual service is meeting the National Minimum Standards and that the outcomes for people using the service promote their best interests. The inspection started at 10.05 am and took just under 7 hours. Three service users, five staff and the home owner were involved in the inspection to gain their views and knowledge of the level of care, provided by the service. The main areas of the home and a number of service user bedrooms were entered. A number of records to do with service users care and safety were looked at. It is now a legal requirement for services to complete and return 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 gives us some numerical information about the service. The service returned their AQAA to us within the timescale requested and it contains all the information that we asked for. Survey questionnaires (Have Your Say About) were sent by us to the home before the inspection visit. These comment cards are useful in gaining the views of the people who live and work in the home about the quality of care that is provided by the service. Seven comment cards were returned from service users, five from staff, and two from social/healthcare professionals. Everyone was satisfied with the level of care provided by the home with the exception of one social care professional. Service user comments include: Like it as it is; treat me well. Staff comments include: Changes have been for the better; I feel the home is improving. Social and healthcare comments include: Since the change of management appears to have a more homely and open atmosphere; Ongoing concerns with the running of the home, the environment and the lack of understanding in relation to person centred approaches and individual requirements. In this report the person who manages the home will be referred to as, the appointed manager. This person has been appointed by the registered home Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 6 owner to manage the home, but has not been formally assessed by us as competent to do so. What the service does well: What has improved since the last inspection? What they could do better: Not all staff are following the homes procedures on what to do if a GP prescribes a new medicine verbally. This can put residents at risk of receiving the wrong dosages of a medicine. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 7 A general service agreement has been written in a way that is more meaningful to the people that live in the home, using pictures. It is recommended that this service agreement be made individual to each service user and that this is the document that is signed and retained by each service user. One toilet in the home is not pleasant or hygienic and does not meet the expectations of people that live in the home. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 8 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 Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 9 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1 – 3 and 5 People using the 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 considering moving to the home have access to information about the home in a format that they can understand so that they can decide whether it is the right place for them to live. People living at the home benefit from a staff team who have received training in their specialised care needs. EVIDENCE: The aims and objectives of the home are clearly set out in the homes Statement of Purpose. This document is now kept up to date. The way that information is presented in the Service User Guide has changed so that it is more meaningful to the people who live in the home. The guide contains short sentences and lots of pictures, including actual photographs of the home. This is a good piece of work. Both documents are available to anyone who visits the home. Information obtained from the local authority evidences that they are not currently placing any new residents in the home due to ongoing concerns Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 10 about the home. There is currently a lack of communication between the home owner and appointed manager about the best way to assess any potential new service users. The appointed manager said that he would develop a new assessment tool but no evidence was found at the inspection that such a tool has been developed. However, the registered home owner said that the current assessment tool is fit for its purpose. It is recommended agreement is obtained on the current assessment tool to be used. Some people living in the home have specific care needs such as dementia, epilepsy, diabetes and autism. Most of the staff team have received a one day training course in how to care for people with dementia and the care of people with epilepsy. Others have undertaken training in learning disabilities, diabetes, stoke awareness and swallowing. Care plans evidence a good understanding of people who are on the autistic spectrum. It is important that when a person enters the home that their rights and responsibilities are explained to them, before signing a contract of their terms and conditions. Three service user contracts were examined and found to contain the necessary information. Contracts have been signed by service users but there is no evidence that their content has been explained to them and they also have not been dated. A general service agreement has been written in a way that is more meaningful to the people that live in the home, using pictures. It is recommended that this service agreement be made individual to each service user and that this is the document that is signed and retained by each service user. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 11 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 6 , 7 and 9 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from having a plan of care that gives clear guidance to staff as to how to meet their assessed needs. Service users can be confident that their monies are spent in their best interests. EVIDENCE: Each service user should have an individual plan of care that clearly sets out their health, personal and social care needs, together with the staff support that is required to meet these assessed needs. Evidence was seen that each service user now has such a plan. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 12 Three service users care plans were examined. The quality of the information recorded in each plan is good and easy to understand. Each plan has a life story, which contains important information about the persons past history, daily routine, personality traits and communication needs. Plans are person centred in that the individual needs and preferences of each service user are included. For example, one plan states that the service user likes to help look after the homes cat. All three care plans examined contained individual assessments of potential risks together with a written plan of how to minimise the effect of these risks. For service users that may display behaviours that challenge, a list of triggers to potentially set off these behaviours is also included in the plan. This gives clear guidance to staff about in which situations that they should be extra vigilant. The home takes responsibility for the management of some service users monies. The financial record of one service user was examined. There is a clear audit trail of outgoing and incoming monies with receipts so that it can be certain that service users monies are being used in their best interests. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 13 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): This is what people staying in this care home experience: 12 - 17 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service are offered a range of things to do and are supported to keep in touch with people who are important to them. Service users benefit from being helped to understand what food choices are available to them at meal times. EVIDENCE: Evidence was seen that the people who live in the home have been formally consulted about their preferences for activities and food in the last nine months. The home has changed the way that it arranges activities for people who live in the home. A new person has been put in charge of arranging activities. This Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 14 person has developed a folder containing useful information about activities and events. The activity programme on offer for service users is available on the notice board in the dining room and includes, bingo, the use of sensory equipment, outings, music for health, arts and crafts, bowling and shopping. Some of these activities are available in signage so that service users can clearly see what activities are on offer for the day. Evidence was seen in service users daily notes that they take part in drawing and colouring, music and movement, art, watching TV, going out for lunch, college, day centre, aromatherapy, word search and shopping. On the day of the inspection three service users were on a day trip, two were at a day centre and three were at home engaged in art work, watching TV and reading newspapers. One service user said that they had not wanted to go on the day trip and had chosen to stay at home, showing that routines are flexible. The staff rota shows that a driver is available during the week so that service users have transport to go out. Evidence was seen in daily notes that service users family members visit the home. One family member recently joined service users on an annual holiday, much to the enjoyment of the service user concerned. The home encourages service users to maintain friendships. Regular contact by phone and visits are supported between some service users and a service user who has recently moved to another residential care home. The whole of the four weekly menus has been made into picture format and is kept in a folder in the dining room. This is a good piece of work. Service users are asked each day their preferences for meals for the next day. The cook explained, If someone understands what a pie is then that is fine, but if they do not understand what a quiche is then you can show them a picture of one to remind them. The menu shows that service users have a hot option at lunchtime and tea time. Photos of the actual cereal packets are used for breakfast. Staff indicated that this is more meaningful to service users than using drawings or symbols. The staff rota shows that a cook is employed Monday to Saturday. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 20 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users healthcare needs are met. Service users are not always protected by the homes polices and procedures for dealing with medication since care staff do not always follow them. EVIDENCE: There is written guidance in place for staff to follow so that they can ensure that they offer personal support to service users in the way that they require and prefer. For example, for one service user it is written that they are able to manage the toilet by themselves, but they need to be reminded to do so due to the onset of dementia. In the three care plans that were looked at, there was clear information on the assessed health care needs of each person. This means that staff have good information to guide them about the healthcare needs of the people that live in Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 16 the home. Day and night reports show that any health issues are passed between staff teams. Evidence was seen that service users have regular contact with a range of healthcare professionals, including, the GP, district nurse, dentist, chiropodist and optician. One health professional commented, All staff appear keen and happy to liaise with District Nurses if help or advice is needed regarding clients. A new hospital assessment form has been completed for each service user. This form contains all the information that hospital staff would need, should the person be admitted to hospital. Evidence was seen that each service users medication is reviewed on a regular basis. Staff training records show that staff who administer medication have received training in how to do so safely. Staff now have their competency to administer medication assessed on a regular basis. The homes policies and procedures on medication, which give guidance to staff, have now been extended to include a wider range of aspects concerning the administration and storage of medication. The home uses a pre-dispensed system for administration of medicines. This system is used to reduce the risk of service users receiving incorrect doses or incorrect medication. There are no gaps in the medication administration record (MAR) indicating that service users receive their medication as prescribed by their GP. There are now written protocols in place for medication that is given when required referred to as PRN. One exception to this good practice is that three medications have been hand written on the MAR sheet by a member of staff who has not recorded their name. Although there was no evidence that an error had been made, there is a higher probability of a mistake being made when entries are written by hand. This risk is reduced when the instructions are checked by another member of staff. It was required at a previous inspection that this safeguard was put in place so that it can be certain that service users receive the correct dosage of their medicine. When this was last checked at a visit in April, this requirement had been met. To minimise the possibility of this error occurring again, it is required that the MAR sheets are audited regularly to make sure that staff are following the homes policies and procedures on the safe recording of medicines. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are confident that any compliant they make will be listened to and procedures are now in place to make sure that it would be resolved to their satisfaction. Staff feel confident to speak out and take action to protect service users, if they have any concerns about their care. EVIDENCE: The last time it was looked at, the complaints procedure was not prominently displayed so that people were aware of it. The complaints procedure was also not written in a way that was easily understood by the people that use the service. Now the complaints procedure is available to anyone who lives at or visits the homes and has also been written in a picture format which is more appropriate to the people that use the service. In the homes annual quality assurance assessment (AQAA) it is stated that the home have received a number of complaints that have been upheld. The complaints log contains a clear record of all complaints received, together with the outcome and any response made by the home to the complainant. The home has been subject to an ongoing safeguarding vulnerable adults investigation since December 2007 and some alerts remain open. Staff training Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 18 records show that the majority of care staff has received formal training in how to safeguard vulnerable adults. Care staff demonstrated that they knew what to do if they had any concerns about the welfare of a service user. One service user commented that the living in the home makes me feel safe. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 24 to 28 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from the changes that have recently been made to the home environment. One service user would benefit from having the toilet near their room being made more pleasant. EVIDENCE: The homes Statement of Purpose identifies that the service is planning to make some changes to the way that it supports people with learning disabilities in the future. The registered owner stated that the home is committed to providing long term care to the people that currently live in the home. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 20 In the last six months there have been some changes made to the environment which have benefited the people that live there. Signage is now in place for bathrooms and toilets to help people understand the use for each room. The downstairs toilet has been completely refitted as has the staff toilet. The first floor bathroom has been refitted as a walk in shower. The conservatory has had a staff filing cabinet removed so that it is more welcoming to service users who may want to use it. A hand wash basin has been provided to one service users bedroom where it had previously been omitted. One room has been designated as a treatment room where healthcare professionals can see service users in private. There is evidence that there are plans in place to convert a toilet into a toilet that is accessible for people who use a wheelchair. The potential of service users being scolded by hot water has been reduced since the water temperatures are regularly checked and recorded. A number of service users bedrooms were entered and seen to contain personal belongings that are important to the people to whom they belong. Each resident has a single room and no one has to share. Two service users have moved bedrooms recently. One service user, who was asked about the move, said that they preferred the bedroom that they had moved to. During the inspection, some redecoration of the home was taking place. The home was clean on the day of the inspection. A new person has been employed to undertake cleaning of the home on a daily basis. The exception to the cleanliness of the home is one toilet where the carpet is split and a smell of urine is present. This is a hygiene concern. The registered owner stated that he would address this oversight. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 21 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 32 - 36 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from being supported by a qualified staff team. Service users are protected by the staff recruitment practices in the home. EVIDENCE: The staff rota indicates that there is a minimum of four care staff on duty during the day and two waking night staff at night. One service user requires one to one support and the staff member assigned to this service user each day is usually highlighted on the rota. A cook is employed Monday to Saturday to cook the lunchtime meal and teatime meal and alternate weekends. There are two part-time drivers who provide a service each week day and a cleaner available daily during the week. Photographs are available of the whole staff team and other people who regularly visit the home. One service user was observed putting up a photograph of a member of staff who was going to be on duty later that day. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 22 The National Minimum Standards recommend that over 50 of care staff are trained in National Vocational Qualification (NVQ) level 2. There are currently 75 of care staff trained to this level at the home, which exceeds the standard. This award is useful because it helps staff develop good care practices and their skills in working with people who live in a residential care home. Before new members of staff are employed at the home a number of checks need to be carried out to make sure that all members of staff working at the home are suitable to care for vulnerable service users. Files were seen for three new members of staff and seen to contain all the relevant checks and documentation showing that the recruitment process followed protects the people that live at Kingswood Lodge. The appointed manager is responsible for making sure that care staff have the skills they need to support the residents who live in the home. Information was given in the annual quality assurance assessment (AQAA) that all new staff receive the appropriate introductory training, which gives them the basic competencies they need to be able to work without direct supervision. Care workers need to undertake a number of training courses that develop their skills in caring for the people that live in the home. A staff training matrix has been developed which identifies the training that each member of staff needs to achieve. There are very few gaps in this record indicating that most staff are currently up to date with training that is necessary for them to perform their role as a carer. In addition the competency of the whole staff team is being assessed to ensure that they can effectively apply the skills that they have gained whilst undertaking training courses. Staff meetings now take place for all care staff to help better communication between everyone involved. The appointed manager has started to supervise all members of staff to give them the opportunity to discuss care practice and to identify and develop their skills for caring for the people who live in the home. Staff who completed a survey said that they regularly meet with the appointed manager to discuss how they are working. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 23 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 37 – 39 and 42 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from the management style of the home which is open. Service users health, safety and welfare is promoted. EVIDENCE: The appointed manager has been employed at the home for six months. He has previously told us that he has twenty years experience of working with adults with a learning disability and eight years in a management role. He has achieved NVQ 4 in Care and the Registered Managers Award. These awards are recognised by the commission to be useful because they help people who Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 24 manage residential care services to have the competencies that are necessary to do so. The registered home owner told us that we will shortly receive the appointed mangers application be to registered with us as the homes manager. Staff, who were spoken to were very positive about management style of the appointed manager. One professional was very complimentary about the skills that the appointed manager brings to the home. The service now has a manager in place who has the skills to address the long term issues at the home and move the ethos of the home forward with the service users a the centre of what the home does to support them. For the home to run in the best interests of the service users it is important to have a system in place which regularly obtains the views of service users and visitors about the standard of care that they receive from the home. Evidence was seen that questionnaires were sent out to service users and their representatives in April and May 2009. A report has been written that gives a summary of the responses and any action taken. In addition to this the appointed manager has started to monitor systems used in the home to make sure that they are effective. However, this needs to be extended to include medication administration sheets, as previously mentioned in the report. The home has told us that there are no people living at the home subject to a deprivation of liberty authorisation under the Mental Capacity Act 2005. In each service users care plan there is a checklist to assess whether the person is currently being deprived of their liberty by any care practices at the home. At the last inspection there was concern that the home was not well maintained. However, at this visit, spot checks showed that there are regular checks and servicing of equipment used in the home. There is a weekly health and safety audit and no risks to service users health or safety were observed during the inspection. As mentioned previously staff training matrix identifies that most staff are trained in the necessary areas. Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 25 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 3 2 2 3 3 4 X 5 3 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 3 26 3 27 3 28 3 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Version 5.2 Page 26 Kingswood Lodge DS0000028918.V376178.R01.S.doc 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. Standard YA20 Regulation 13 (2) Requirement Timescale for action 22/08/09 2. YA37 8 (1) (a) The medication administration record must be audited regularly by a competent person, to ensure that is being completed correctly. This will ensure that service users receive their medication as prescribed by their GP. The registered provider must 29/07/09 submit an application for a person to manage the service. This is so that a person, who has been assessed as competent to do so by the Commission, manages the service RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 27 Kingswood Lodge DS0000028918.V376178.R01.S.doc Version 5.2 Page 28 Care Quality Commission The Oast Hermitage Court Hermitage Lane Maidstone Kent ME16 9NT National Enquiry Line: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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