Care Home: Kitnocks House Nursing Home

What the care home does well Since the error has occurred and been investigated by Social Services the policy for the use of PEG`s has been reviewed and trained nurses are expected to read the policy and be satisfied they are competent to carry out the task. All trained nurses have been informed that under no circumstances are care staff allowed to set up PEG feeds and be involved in the administration of PEG feeds. What the care home could do better: The manager and other senior staff need to be more aware of the information surrounding any errors at the service, and take the necessary action to minimise any further risk to residents. Records of any actions taken including further training need to be in place and evidence available to show that staff have received the necessary training and what this consisted of, to keep residents safe.This would mean that residents can be confident that the right people are delivering their care and that the staff have the right skills, experience and qualifications. Polices and procedures need to be in sufficient detail so staff are clear of their responsibilities and roles. When staff have not worked to agreed polices and the expectations of their job roles the manager needs to review this and take appropriate action. When equipment is new but had advisory instruction such as to be serviced within a set timescale of production, consideration should be given to carrying out servicing or speaking with the manufacturer regarding the need to carry out a service.This would mean that residents and staff can be confident that the equipment they are using is safe. Inspecting for better lives Random inspection report Care homes for older people Name: Address: Kitnocks House Nursing Home Wickham Road Curdridge Hampshire SO32 2HG two star good service 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 assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. 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: Kathryn Emmons Date: 0 8 1 2 2 0 0 8 Information about the care home Name of care home: Address: Kitnocks House Nursing Home Wickham Road Curdridge Hampshire SO32 2HG 01489798244 01489799411 kitnocks@zoom.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Kitnocks House Limited care home 62 Number of places (if applicable): Under 65 Over 65 0 62 0 62 dementia dementia mental disorder, excluding learning disability or dementia mental disorder, excluding learning disability or dementia Conditions of registration: 62 62 62 62 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category ; Mental disorder, not falling within any other category (MD) Dementia (DE) The maximum number of service users to be accommodated is 62 Date of last inspection Brief description of the care home Kitnocks House is a care home providing nursing and accommodation for 62 persons with mental health difficulties, from the age of 18. It is situated in the rural area of Care Homes for Older People Page 2 of 9 Brief description of the care home Curdridge, between the local villages of Botley, Wickham, and Bishops Waltham. The registered provider is Kitnocks House Ltd. Kitnocks is a converted Edwardian building, originally refurbished and opened as a 32-bed nursing home in 1993. It was further extended in 1994 and in 2007 an extra 13 beds and communal areas were added. All bedrooms are single with the exception of 6 double bedrooms. There is a passenger lift. The home is set in large grounds. Flexi paving is provided so that the grounds may be accessed and enjoyed with minimal risks to service users. Residents must meet the National Health Service clinical eligibility criteria for continuing care before they can be admitted. The home?s weekly fees range from #750 per week to #1930. Care Homes for Older People Page 3 of 9 What we found: We visited the service in an unannounced capacity for six and a half hours to look at records and information in respect of a safe guarding adult referral. We did this because concerns had been raised regarding the care and procedure carried out for a resident who was receiving nutrition through a PEG feed (percutaneous endoscopic gastrostomy). We found that the task of setting up the feed and running it through a mechanical pump was carried out by a care assistant who was not trained to do this. We did not find any records to evidence training had been given even though the carer thought they had received some verbal training three years previously. It was confirmed by the registered Manager that no care staff had been trained to carry out the procedure and it was only trained nurses who could carry out the procedure. We were informed that a trained nurse had delegated the task to the care assistant.The resident became unwell due to the speed the food went through the pump and needed to go to hospital. The trained nurse did not inform the manager that this was due to the error with the speed the food was administered through the PEG. The manager and deputy matron confirmed that they were not aware that a trained nurse had delegated the task so had not taken any action to follow up the incident with the staff concerned. It was also raised as a concern that the pump used had not been serviced. We found that pumps are brand new and only used for one resident for no more than a year and then they are exchanged for a new one from the manufactures. The records for training in respect of the services PEG feeding policy were in place but it was not clear what training had comprised of and who had delivered this. What the care home does well: What they could do better: The manager and other senior staff need to be more aware of the information surrounding any errors at the service, and take the necessary action to minimise any further risk to residents. Records of any actions taken including further training need to be in place and evidence available to show that staff have received the necessary training and what this consisted of, to keep residents safe.This would mean that residents can be confident that the right people are delivering their care and that the staff have the right skills, experience and qualifications. Polices and procedures need to be in sufficient detail so staff are clear of their responsibilities and roles. When staff have not worked to agreed polices and the expectations of their job roles the manager needs to review this and take appropriate action. When equipment is new but had advisory instruction such as to be serviced within a set timescale of production, consideration should be given to carrying out servicing or speaking with the manufacturer regarding the need to carry out a service.This would Care Homes for Older People Page 4 of 9 mean that residents and staff can be confident that the equipment they are using is safe. 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 5 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 6 of 9 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 19 People must not be 20/01/2009 employed to work at the service unless they have the qualifications suitable to the work they perform and the skills and experience for such work. Residents need to have their care provided by people who are competent and qualified to carry out the tasks. This means that residents can be confident that they are receiving care from the right staff and risks to them will be minimised. 2 32 13 The registered persons must 20/01/2009 ensure that unnecessary risks to the health and safety of service users are identified and as far as possible eliminated. Registered persons need to ensure that the right staff are carrying out the right job roles which they are assessed as being competent to carry out and is within their qualifications and skills. This includes reviewing any Care Homes for Older People Page 7 of 9 incident where a resident has been placed at risk due to staff actions or suggested failure of any equipment. This means that residents can be confident that the organisation is taking action to minimise risks to residents. 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 Care Homes for Older People Page 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI 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: 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 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. 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