Care Home: Kirk House

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What the care home does well The home is very well run, with staff that are very well trained and supported. They know residents very well, and have a good relationship with them. The staff work well together, and enjoy working at the home. They provide good support for the people living there. The home is clean and well decorated, with plenty of space for residents to enjoy. Resident`s records provide staff with all the information they need to give good support. There are plenty of activities for residents to join in, with residents able to go on outings regularly. Staff involve them in the running of the home at every opportunity, and encourage them to become more independent, whilst at the same time, making sure that they are safe. There are good arrangements to ensure that residents are protected from abuse. Residents indicate that they like living at Kirk House, and enjoy the food and outings. What has improved since the last inspection? Not applicable as this is a new service. What the care home could do better: Staff deployment needs to be looked at and a risk assessment undertaken for those occasions when there is only one staff member present in the home. CARE HOME ADULTS 18-65 Kirk House 2 Lincoln Road Dorrington Lincoln LN4 3PT Lead Inspector Julie Western Unannounced Inspection 30th January 2008 10:00 Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kirk House Address 2 Lincoln Road Dorrington Lincoln LN4 3PT 01526 833569 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) www.homefromhome.com Home From Home Care Ltd Susan Jacqueline Wilson Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - Code LD. The maximum number of service users who can be accommodated is 11. 2. Date of last inspection Brief Description of the Service: Kirk House is situated on the main road at Dorrington next to the pub and 2 miles from the larger village of Ruskington which has a wide range of facilities including shops, pubs and a library. There is public transport into Lincoln and the home also has its own transport. It is registered for up to eleven residents with a learning disability and is managed by Home from Home Ltd. The home is a formerly privately owned, Victorian two-storey house, that has been modernised and extended to provide six bedrooms, all with en-suite facilities, a lounge, a dining room, kitchen and laundry on the first floor, accessible with stairs and a shaft lift. The ground floor, which is a mirror image of the first floor, has five bedrooms and is used for day care and respite care. Although the two services are staffed separately, residents can share the facilities and go on outings together. The home set in its own grounds with plenty of parking to the front and rear. Information about the home’s facilities is available in the office. Kirk House DS0000070579.V358934.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. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of Kirk House, and through undertaking a visit to the home. The fieldwork visit took place over 3 hours. The Registered Manager was not present during the visit, which was conducted with the assistance of the acting manager. The main method of inspection used was called case tracking which involved selecting people who live at the home, and tracking the care they receive through the checking of their records, discussion with the care staff and observation of care practices and interactions. A tour of the premises was conducted. Documents connected with the running of the care home were also inspected. The acting manager had completed a questionnaire before the inspection. On the day of the inspection one service user was being accommodated and there were two residents using day care. What the service does well: The home is very well run, with staff that are very well trained and supported. They know residents very well, and have a good relationship with them. The staff work well together, and enjoy working at the home. They provide good support for the people living there. The home is clean and well decorated, with plenty of space for residents to enjoy. Resident’s records provide staff with all the information they need to give good support. There are plenty of activities for residents to join in, with residents able to go on outings regularly. Staff involve them in the running of the home at every opportunity, and encourage them to become more independent, whilst at the same time, making sure that they are safe. There are good arrangements to ensure that residents are protected from abuse. Residents indicate that they like living at Kirk House, and enjoy the food and outings. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 6 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. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service have good information about whether the home in order to make an informed decision about whether the home is right for them EVIDENCE: There has been one admission since the service opened in October 2007. The acting manager outlined the processes to be followed for a new admission and on the day of the inspection the admissions manager and manager were visiting a prospective resident. The statement of purpose was comprehensive and clear and the acting manager said that they were in the process of developing a service user guide with pictures for residents to understand. All other admission documents gave full details of the admission process. The acting manager said that there was no restriction on the time allowed for trial periods and staff confirmed this. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give a very clear picture of residents’ needs. The staff group meets these needs with sensitivity and regard for residents’ privacy and dignity. EVIDENCE: The care plan contained concise but comprehensive information that accurately reflected the need of the resident. Staff members said they were easy to understand and quickly gave a profile of the residents’ needs, including triggers to behaviours and risk assessments on how to manage these. The care plan was regularly reviewed with the manager and staff. The current resident has a severe learning difficulty and is unable to take part in the review process but the views of parents/carers and other professionals such as placing authorities were sought. The resident and day care service user present on the day of the inspection were relaxed and cheerful and had a good relationship with staff members. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a wide range of activities for residents to participate in, led by the residents’ wishes. Meals are flexibly arranged to suit residents’ choices and preferences EVIDENCE: The timetable of weekly activities was in the resident’s care plan and preferences were clearly shown. Activities included swimming, horse riding and various outings to places such as Plqyzone in Lincoln. Residents have access to a 9-seater minibus. On the day of the inspection the resident and day care resident went for a re ride in the bus and a walk. The service is currently applying to the local college to be able to provide City and Guilds Lifeskills training for residents, to give them goals to achieve. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 11 The current resident is supported to have regular contact with relatives and regularly goes home for weekends. Records of contacts are kept in care plans. The acting manager said that each home in the organisation has responsibility for holding certain joint events and Kirk House would be holding future barbecues and garden parties in view of the large grounds they have. The staff members prepare all food for the residents, with their assistance on occasions. The kitchen and dining room are domestic in nature. Staff members assist residents to undertake cleaning and other domestic chores around the house; these are included on a daily planner. The menu showed that attention is paid to giving residents a healthy, wellbalanced diet with fresh fruit and vegetables. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans give a very clear picture of the resident’s needs. The staff group meets these needs with sensitivity and regard for the resident’s privacy and dignity. EVIDENCE: The current resident has autism with severe communication difficulties but does not take any medication and is fully mobile; healthcare and personal needs are therefore minimal. The medication procedure was described by the acting manager and staff spoken with said that they had received training in handling medication. Policies and procedures for medication handling and distribution were present. Staff members were seen to use a wide range of communication methods to gain both the residents’ needs and choices during the inspection. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clear and gives residents and their supporters the confidence that complaints and comments will be listened to. Residents are kept safe from harm by clear policies and procedures concerning safeguarding adults. EVIDENCE: Records show that there have been no complaints since the home opened in October 2007. The manager said that all staff had received training in safeguarding adults and staff confirmed this and staff spoken with confirmed this. The home uses the Local Authority guidelines for safeguarding adults. There are clear procedures for the recording and management of accidents or injuries. The manager said that all care staff are trained in restraint should it be needed. Any physical intervention is recorded in residents’ care plans. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Kirk House offers a very comfortable and homely place that is maintained to a very high standard, where residents can live in safety. EVIDENCE: Kirk House is a former private home that has been adapted to suit the needs of the resident; it has a homely atmosphere. The building is maintained to a very high standard both externally and internally; the maintenance manager, who was present on the day of the inspection, said that he regularly worked one day a week at the home. The resident’s room was well personalised and had an en-suite bathroom; all the other rooms were ready for accommodation and offered the same high standard of furnishing. The large kitchen, living room and dining room were spacious and airy and furnished to a high standard. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 15 The grounds were landscaped and laid to lawns, with a large trampoline and two large ponds that were well fenced for safety. The driveway was secured with an electronically operated gate. The home was clean and smelled fresh throughout. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff numbers are in sufficient quantity for them to be able to care for the residents. Staff members are suitably trained, qualified and competent. EVIDENCE: On the day of the inspection the home was staffed with two carers and the acting manager. There is a total of 11 staff members at present. At night there was only one staff member present in the building for the one present resident. Although it was unlikely that this would continue beyond April, when the arrival of the new resident would necessitate two staff members at all times, it was recommended that a risk assessment was undertaken until then, in the event of that staff member having an accident or illness, or attempted break-ins. Staff members confirmed that they are encouraged to obtain National Vocational Qualifications [nationally recognised awards] at level 2. Some staff recruitment and selection procedures, including CRB checks, were managed from the head office. The staff file seen contained all the necessary information required. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 17 Staff members spoken with had supervision regularly and records confirmed this. The last staff meeting was held on 16/01/08. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and the health, safety and welfare of the residents are promoted. The views of residents and their supporters are listened to. EVIDENCE: The manager of the home has been in the caring profession for 26 years and has been an enrolled nurse since 1983. She has been a manager since November 2006 and has managed Kirk house since it opened in October 2007. During the inspection the acting manager was seen to have a good working relationship with the staff and an open door policy was maintained. The home’s documentation is well organised. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 19 The acting manager said that regular monitoring visits were carried out by managers from the other homes in the organisation. The information from these visits is used to identify any actions required by the manager. Staff spoken with enjoyed working at the home; a student who had worked in other homes said this was the best she home had ever worked in and residents’ needs were well cared for. The acting manager explained how a monthly report was sent to the parents of the resident for them to comment on and return; any comments were recorded and acted upon where necessary. In this way the home could receive feedback on how it was performing. Maintenance and health and safety checks were not inspected in great detail but there was evidence of risk assessments and checks and a member of the maintenance team was present on the day of the inspection. Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X 3 X X 3 X Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? Not applicable 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 YA35 Regulation 18[1] Requirement A risk assessment must be undertaken while there is only one staff member on the premises, to protect the resident in the event of an accident or incapacitating illness occurring to the staff member, or an event such a break-in. Timescale for action 29/02/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Kirk House DS0000070579.V358934.R01.S.doc Version 5.2 Page 23 - 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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