Care Home: Kirklands Care Home

Similar services:

• London Road Neurological and Specialist Care Unit
• Carlton Care Home
• Byars Care Home
• St Marys Nursing Home
• Bramble Lodge
• Parkmanor Residential Home
• Thornham Grove
• Hunter`s Lodge

What the care home does well Service users and their relatives said they feel cared for by a skilled staff team, they were always listened to and taken seriously and are enabled to live their lives as independently as possible. They feel that they have good meals and live in a well-maintained environment. There are good safeguards in place to protect vulnerable people and staff are fully trained and supervised in all aspects of their role. There is a registered manager in place that continues to work to improve the service through consultation with the service users and the development of a skilled workforce. What has improved since the last inspection? The manager has ensured that the statement of purpose has been updated to inform service users of the services provided. There is better organisation of medicines ensuring there is a suitable supply and service users receive their prescribed medicines on time. The manager has accessed suitable training for staff in managing difficult behaviours such as potential aggression, she has ensured that service users who may have behavioural problems are suitably assessed for any risk to themselves or others and that staff are informed through a care plan of how to meet their needs. CARE HOMES FOR OLDER PEOPLE Kirklands Care Home 2 Fairhaven Kirkby-in-Ashfield Nottinghamshire NG17 7FW Lead Inspector Mary O`Loughlin Unannounced Inspection 28th April 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kirklands Care Home Address 2 Fairhaven Kirkby-in-Ashfield Nottinghamshire NG17 7FW 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) 01623 723936 01623 723946 Nottinghamshire County Council Suzanne Michelle Dawson Care Home 29 Category(ies) of Dementia (14), Dementia - over 65 years of age registration, with number (14), Old age, not falling within any other of places category (29), Physical disability (5) Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered provider 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 to the home are within the following category: Old age, not falling within any other category - Code OP Dementia - Code DE Physical Disability - Code PD The maximum number of service users who can be accommodated is 29. 9th May 2007 2. Date of last inspection Brief Description of the Service: This is a Local Authority older persons care home offering 29 beds, with attached day centre facilities. The home is on two floors with vertical lift access to the first floor and all service users have single bedrooms. Grab rails and call alarms are sited around the home and there are assisted bathing facilities. The home is set within a secure enclosed garden and is sited in a residential area conveniently close to the town centre of Kirkby-in-Ashfield and close to public transport routes. A final consultation took place in April 2008 regarding the closure of the home, the manager told us that a new home will be built once a suitable site is secured and service users will be offered the opportunity to move into the new residence. Accommodation charges for those residents who are self funding would be £377.00 per week. A copy of the most recent inspection report is available in the home. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas were looked at. The main method of inspection used was called ‘case tracking’ which involved selecting the care plans of 3 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. The registered manager, members of staff, people who use the service and their relatives were spoken with as part of this visit. A partial tour was undertaken by the regulation inspector, which included looking at people bedrooms and communal areas of the home. The quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. What the service does well: Service users and their relatives said they feel cared for by a skilled staff team, they were always listened to and taken seriously and are enabled to live their lives as independently as possible. They feel that they have good meals and live in a well-maintained environment. There are good safeguards in place to protect vulnerable people and staff are fully trained and supervised in all aspects of their role. There is a registered manager in place that continues to work to improve the service through consultation with the service users and the development of a skilled workforce. Kirklands Care Home DS0000036318.V363643.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. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3-6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although people have the information to make an informed choice about moving into the home for short stays, they cannot be assured that their needs will be reviewed and met at subsequent admissions. Intermediate care is not provided EVIDENCE: Written information is provided for people who are interested in moving into the home in a document called the Statement of Purpose. For a recently admitted person for respite care, staff had obtained an assessment from the social worker and then completed their own assessment of the persons needs when they first provided respite care, subsequent stays Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 9 at the home did not record that any review had taken place and as a result the staff cannot always be sure what care a person should have. The care files did not clearly record the date of the most recent short stay. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7-8-9-10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: We looked at the care plans of a service user who was at risk of falling and saw that staff completed an assessment of the risk to safety with daily activities and then completed a plan of care that showed staff how to reduce the risk of the service user falling over. The service user told us that they were aware of the risk to them and work with staff to improve on mobility and reduce the risk whilst recognising personal choice to remain independent as far as possible. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 11 Accidents are recorded for any event that affects the health and wellbeing of the service users and we spoke to 2 relatives who told us that they felt staff were doing everything possible to reduce the possibility of people falling. Service users and their relatives are involved in their care planning with the staff, this ensures that the service user is receiving the type of care that they want and records identified that the plans are reviewed at suitable intervals to ensure that as changes occur staff are fully informed of how to meet the person’s needs. 2 service users told us how medical attention was immediate, “health improves quickly because staff are always on hand, there’s a family feeling here, if staff see a bruise they want to know how it happened” A relative told us “care is 110 here, staff are marvellous, we are always listened to, we have no concerns at all.” A service user said that his “key worker sets goals for him to achieve to increase his mobility which has improved his wellbeing enormously.” Staff are sensitive to the service users needs and show them respect and address their care in a dignified way, a service user described how “ the staff in this home never walk away from me however long it takes me to speak, they never get impatient and even though my speech is slow they always stay and listen to me” The staff manage the medicines at the home in a safe way, they record all medicines into the home and maintain good records of medicines administered and leaving the home to ensure there is no mishandling or missed doses. Service users told us they always receive their medicines on time. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12-13-14-15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. EVIDENCE: The practices of the home were identified as enabling service users to develop or maintain their skills, including social, emotional, communication, and independent living skills. Care plans showed us that individuals are supported to identify their goals, and each service user has a key worker to assist them to achieve their full potential We spoke to two service users who had been at the home for over a year, they had their own single room and a separate day room, which they had a computer fitted into, and were able to spend time on their hobbies and interests. They described how there was something to do every day if they wished to participate, it was their choice and there were plenty of things to Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 13 choose from ranging from in house activities such as arts, crafts and bingo, to opportunities to go on trips out to local events and short break coastal visits. We observed how the main lunchtime meal was delivered to service users and found that the dining room was spacious, well organised and seating is rotational for serving purposes so service users don’t always wait till last to be served. Staff were plentiful and assisting as required. Service users told us that they found the food to be “remarkably good” Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16-18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaint procedure, are protected from abuse, and have their rights protected. EVIDENCE: From examining documents and staff files we identified that the home is taking seriously any concerns that service users have and they work hard to ensure that staff are fully trained to ensure the protection of vulnerable adults. There are up to date procedures in place to inform service users of their rights, how to complain and what their opportunities are to have a voice in the way their care is delivered. Service users told us they were confident that staff listened to them and took their concerns or suggestions seriously and acted on them, they are surveyed each year on their perception of safety and security and we saw records of how they are consulted on how they were treated if they had to express concerns or complaints. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 15 Staff training records show that they receive training on how to protect people from abuse at their induction. They also receive training on how to safely respond to any aggression or potential aggression to ensure the service user is safe and treated properly. The manager has ensured that staff have completed training in how to uphold the service users dignity, having a zero tolerance to all forms of abuse and through training records we saw how each member of staff completes a questionnaire to check their competence in areas of protection such as ensuring that service users are able to complain without fear of retribution. There have been no complaints or safeguarding referrals since the last inspection. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19-26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that is appropriate to the specific needs of the people who live there. The home is a very pleasant, safe place to live. EVIDENCE: The accommodation has been maintained to a good standard it was pleasant and hygienic at the time of this inspection. Service users told us that repairs are taken care of immediately, one person said they had requested extra shelving and cupboards and the handyman fitted Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 17 these the same day. They said that the bathrooms and toilets are always clean and that their bedrooms were thoroughly cleaned. We saw that there was a good infection control policy in place and the manager was able to tell us and provide evidence of the involvement of external infection control specialists if there are any infections that may be a risk to other service users, this ensures that staff work to nationally recognised practices to prevent any spread of infection. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27-28-29-30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are enough qualified, competent and experienced staff to meet the health and welfare of people using the service. EVIDENCE: The staff records show that there is significant time spent ensuring that all new staff receive a thorough induction into their role, which includes the basic principles of the organisation and how to provide care for people according to recognised standards. The staff continue to receive training in the specific needs of the service users including how to care for people with Dementia, and how to address the needs of people who may lack capacity to make their own decisions. Staff are suitably supervised at appropriate intervals to ensure that any training needs are identified and dealt with which ensures people are in safe hands at all times. Service users told us there was always enough staff on duty to meet their needs and we have not received any concerns about staffing levels in the home. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 19 Service users relatives told us they were confident that staff were skilled in their jobs. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31-33-35-37-38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the service users. EVIDENCE: The home benefits from a registered manager that continues to update her skills in the needs of people using the service. Our inspection of the National Minimum Standards show that she has continued to develop the service, ensuring that staff receive training and that records are kept fully up to date. Through discussion the manager showed that she keeps up to date with changes in legislation which ensures that the practices in the home encourage Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 21 the involvement of the service users, ensuring that the service users receive a good standard of care and are fully involved in how the home is run. The systems in place to ensure quality are robust, evidence told us that when service users make suggestions at three monthly meetings a report is produced and displayed that details how their suggestions are being acted on. Service users confirmed that they are involved in how the home is run and are able to make changes, one person had recently suggested that the meal serving was made rotational to ensure the same people were not always last to get their meals, we saw that action had been taken as described in standard 15 of this report. Personal monies are not managed at the home but anyone needing to keep a cash float safely can ask the manager to keep it in the safe, we saw that cash floats have suitable accounting procedures in place that safeguard service users from any abuse. Health and safety practices are taken seriously; each member of staff receives training in health and safety at the start of their employment and continues to receive training in safe moving and handling, first aid and food hygiene practice. The management of fire prevention was examined and show that there are suitable safeguards in place that protect service users. Fire risks are suitably assessed and action plans are in place to address risks within the environment, making the home as safe as possible for the service users. Some policies examined did not show suitable review dates, which may not ensure that the practices of the home are reflecting all current guidance. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X 2 3 Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP3 Regulation 14(1)(a) Requirement You must ensure that each prospective respite service user has a suitable up to date assessment, which is recorded, in their care file to reflect any changes to how their care is delivered. Timescale for action 30/06/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. Refer to Standard OP8 OP9 OP26 OP37 Good Practice Recommendations Contact the falls team for advice on updating your falls risk assessment and subsequent care planning. Ensure that all hand written entries on medicine record sheets are signed and witnessed to reduce the risk of error. Obtain the Department of Health’s Essential Steps document to enable audit of the homes infection control practices. Ensure that policies reflect the date of the last review DS0000036318.V363643.R01.S.doc Version 5.2 Page 24 Kirklands Care Home taking place. Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kirklands Care Home DS0000036318.V363643.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!