Care Home: Kirkdale Nursing Home

What the care home does well The service does well in all outcome area groups, as a specialist nursing home service for older people with dementia. The provider is registered with the Charities Commission as well as with CQC. Relatives and staff speak very highly of the caring, supportive atmosphere and good design of the building. Clear and detailed records are kept in the home of how medicines are used. Staffing levels are impressive and appropriate for the needs of service users. There is excellent teamwork and high levels of skill and expertise within the staff group. The service is well run and well managed. The Board of Trustees is actively involved in the progress of the home. The service has achieved the Investor in People Award (IIP) and has dedicated staff champions in Infection Control and Dignity. The service is a valuable resource centre for the community, providing training and information for carers of people with dementia. It is committed to continuous improvement. It has won awards for its garden and its kitchen has been given the maximum 5 stars by the local environmental health authority for food hygiene. What the care home could do better: One to one supervision sessions with care staff need to be increased in frequency, to achieve the national minimum standard of 6 supervision sessions per year, including one appraisal. The manager needs to achieve registration with CQC as the registered manager for Kirkwood and complete her qualification in Leadership and Management at NVQ level 4. Random inspection report Care homes for older people Name: Address: Kirkdale Nursing Home Radcliffe Crescent Teesdale Estate Thornaby Stockton-on-Tees TS17 6BS one star adequate service 06/10/2009 The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Stephen Ellis Date: 0 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Kirkdale Nursing Home Radcliffe Crescent Teesdale Estate Thornaby Stockton-on-Tees TS17 6BS 01642611199 01642618899 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Tracey Maria Smales Type of registration: Number of places registered: Conditions of registration: Category(ies) : Cleveland Alzheimers Residential Centre care home 38 Number of places (if applicable): Under 65 Over 65 38 dementia Conditions of registration: 0 A maximum of 8 places can be used for people with dementia aged 50 . Date of last inspection Brief description of the care home Kirkdale is a modern, purpose built facility that is registered to provide personal and nursing care to thirty-eight older people with dementia. The home is single storey. The home is divided into two units, Lavender and Rosemary. Each unit has three lounge areas and a link lounge in addition to a dining room. Bathing and toilets are available on each unit. Bedrooms in the home environment are single in nature and meet the required amount of space. Bedrooms do not have en-suite facilities. Externally there are surrounding grounds and a pleasant enclosed Care Homes for Older People Page 2 of 10 0 6 1 0 2 0 0 9 Brief description of the care home garden/seating area for people that use the service. Car parking is available at the home. The home is on a bus route and close to Stockton town centre Care Homes for Older People Page 3 of 10 What we found: Good arrangements were found to be operating with regard to health and personal care. The care plans examined showed that a person-centred approach is taken. Care plans were well documented with comprehensive, detailed information, including risk assessments, nutritional assessments where appropriate and all of the activities of daily living. They were subject to systematic review and evaluation. Relatives and staff confirmed that people who use the service are treated with respect for their privacy and dignity. Typical comments included: The staff seem to be very caring, and you can talk to them, the atmosphere is warm and friendly. I am very happy with the care Dad receives, it is his home now, and I feel happy as I can be, that his needs are catered for and in his own way he is happy, thank you. The home has revised its policies and procedures concerning medicines and in April 2010 a PCT pharmacy audit awarded the home 97 for its medicines arrangements. Good practice was confirmed by the Pharmacy Inspector from CQC who participated in todays inspection (04/06/10): There is a detailed policy in the home covering all aspects of medicines management. This means that staff have up to date information on legal requirements and guidance. The home has control of the process of medication ordering at all stages of the process and copies of prescriptions were kept for medication which was supplied as part of the monthly cycle. Copies of the prescriptions supplied by the pharmacy mid month could not be found for two people. Disposal records were kept and good practice was observed with the recording of medication refused and destroyed. Medicine records contain very few gaps, and an audit of medication and records show that people were getting medication as prescribed. The folder containing medication administration record sheets also contained good protocols for when required medication; however, some updates were needed. Medication was stored securely and safely and good records were kept of fridge and room temperature, which assures staff that medication is safe to use. It was noted that the home is starting to implement the Gold Standard Framework for palliative care, which encourages service users and their relatives to discuss their end of life care and think about advance directives where appropriate. There are good arangements for social and recreational activities, including a full programme of events, activities, visiting entertainers, outings and relatives meetings. There are strong links with the local community. The individual needs and wishes of people who use the service are identified and respected, as reflected in the provision of physiotherapy services and complementary therapies. The person-centred approach to the provision of care respects the individuality of people and promotes choice and selfdetermination wherever possible. Recall and reminiscence is promoted by the use of objects, pictures and posters plus discussions and activities such as a 1940s themed tea dance. There is an award winning, well-used garden with raised borders, greenhouse and seating. There are sensory and tactile areas in the home, plus numerous lounge areas for different activities and uses depending on peoples preferences. Good use of different colours is made, including coloured toilet seats to some toilets with primary colour signage, helping to promote orientation and independence. There are good policies and procedures in place for complaints and the protection of service users. Staff are well trained in the protection of vulnerable adults, including deprivation of liberty safeguarding. Realtives described staff as being helpful and Care Homes for Older People Page 4 of 10 approachable about any concern or complaint. There are good safeguarding procedures in place, including protocols for inducting new staff and agency staff new to the home. The building is well maintained and clean. It is purpose built with an inner garden. Extensive redecoration and refurbishment has taken place. Many relatives commented very positively about the therapeutic atmosphere of the home, created in part by the design, facilities and decor of the home, and in part by the homes philosophy and practice of care. There are good arrangements for infection control and the laundering of clothes and bedding. The home has high ratios of staff to service users, reflecting the special needs of people who use the service. There are robust recruitment procedures and good arrangements for staff development and training. The home uses a high number of agency staff, but plans to reduce the extent of use by recruiting more permanent staff. It tries to use agency staff who are familiar with the home and has a protocol for inducting and briefing such staff when they commence work. The majority of care staff have achieved National Vocational Qualifications (NVQ) in Health and Social Care at level 2 or above and there is encouragement for care staff to enrol on NVQ courses. Student nurses are taken on placement at the home. The home has Dignity and Infection Control champions on its staff team. Comments from relatives and staff confirmed positive, caring outcomes for serice users, with relatives being invited to participate in the care plans, assessments of needs and reviews of progress. The home has the Investor in People (IIP) Award, which is an important, nationally recognised indicator of good quality assurance systems, helping to engage staff fully in the aims and objectives of the service. The service is well managed. The manager is not yet registered with CQC, but her application is in the process of being submitted. She has substantial management and professional experience in the field of dementia care and is a registered nurse. Both she and the deputy are working towards NVQ level 4 in Leadership and Management. The home is well supported by a Service Manager and Board of Trustees. Monthly Quality Assurance visits are carried out under regulation 26 and reports are made. Good arrangements are in place for other quality assurance checks and audits, including maintenance, care planning and health and safety. Formal staff supervision involving one to one supervision sessions needs to be increased in frequency. The national minimum standard is 6 supervision sessions per year including an annual appraisal. Staff comments were positive and complimentary about their experience of working at Kirkwood, describing a supportive and enabling atmosphere, with good care objectives and excellent teamwork. What the care home does well: The service does well in all outcome area groups, as a specialist nursing home service for older people with dementia. The provider is registered with the Charities Commission as well as with CQC. Relatives and staff speak very highly of the caring, supportive atmosphere and good design of the building. Clear and detailed records are kept in the home of how medicines are used. Staffing levels are impressive and appropriate for the needs of service users. There is excellent teamwork and high levels of skill and expertise within the staff group. The service is well run and well managed. The Board of Trustees is actively involved in the progress of the home. The service has achieved the Investor in People Award (IIP) and has dedicated staff champions in Infection Control and Dignity. The service is a valuable resource centre for the community, providing training and information for carers of people with dementia. It is committed to continuous improvement. It has won awards for its garden and its kitchen has been given the maximum 5 stars by the local environmental health authority for food hygiene. Care Homes for Older People Page 5 of 10 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 2. Care Homes for Older People Page 6 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 10 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, 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 31 9 The manager needs to 10/08/2010 achieve registration with CQC as the registered manager for Kirkwood and complete her qualification in Leadership and Management at NVQ level 4. The home is required to have a registered manager who is fit to undertake the role. 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 9 The protocols for medication given when required should be checked and updated to reflect the medicines currently being taken. Copies of prescriptions supplied mid cycle should be kept by the home . The prescription is the authority for staff to administer medication to the person. This also provides an opportunity to check that the handwritten entry is correct. One to one supervision sessions with care staff need to be increased in frequency, to achieve the national minimum standard of 6 supervision sessions per year, including one appraisal. Page 8 of 10 2 36 Care Homes for Older People Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: 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. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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