Care Home: Kynaston Court

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What the care home does well People know the home could suitably meet their needs before they move in. They can also visit and stay for a while to check if they would like to live there. Kynaston Court is very friendly and homely. People living there say they are happy and that they get on well with and can talk to the manager and staff. Each person living at the home has a plan they are involved in making. Plans show what they like and their care needs and how staff should support them. People living at the home can choose what they do every day and to go out if and when they wish. Staff support them to keep in touch with their families and friends. They can choose all their meals and say they really like the food. Staff support people living at the home well with their personal care. They also ensure they have regular health checks and manage their medicines safely.The home offers a safe, well-kept and comfortable home. People living there say they like the lovely gardens and have their own things in their bedrooms. There are aids and equipment to help them move around the home easier. Staff receive training so they understand and know how to keep people living at the home safe and meet their special needs better. All staff are checked out before they start working at the home to help to make sure they are suitable. The home is well run and the manager and staff team work together. They are committed to giving individual and caring support to the people living there. What has improved since the last inspection? Some parts of the house have been redecorated to make the home look nicer and brighter for the people living there. Staff had more training so they would know how to deal with possible abuse of people living at the home and how to manage any difficult behaviours better. What the care home could do better: The ways the quality of the service is checked should result in a plan for the home to keep improving as people living there want and/or for their benefit. CARE HOME ADULTS 18-65 Kynaston Court Kynaston Court Hentland Ross-on-wye Herefordshire HR9 6LP Lead Inspector Christina Lavelle DRAFT REPORT: Key Unannounced Inspection 25th January 2008 1.30- Kynaston Court DS0000024720.V352901.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 Kynaston Court DS0000024720.V352901.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. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kynaston Court Address Kynaston Court Hentland Ross-on-wye Herefordshire HR9 6LP 01989 730678 01989 730664 kynastoncourt@msn.com 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) Mrs Monika Maria Swaine Mrs Brenda Carole Wetton Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users should be at least 30, and may be over 65 years of age. Date of last inspection 20th October 2006 Brief Description of the Service: Kynaston Court was built as a college of theology and was first set up as a care home in 1984. The provider Mrs Monika Swaine has been registered in respect of the home since 1987. The service was changed in 2006 from providing care primarily for older people to adults requiring care due to learning disabilities. The home is now registered to provide accommodation with personal care for up to eight adults with learning disabilities. The home’s statement of purpose states that the home’s layout and facilities are most suitable for people who are at least thirty years old and previously lived independently, or with family, and that people with severe aggressive or disruptive behaviours are not accepted. The home has a rural location in the village of Kynaston, six miles from the market town of Ross-on Wye. There are no facilities very close by, but a main bus route, shop/post office and two pubs are within about a mile. The property is a substantial, period house, which has large, well-maintained and accessible gardens with lovely views over open countryside. The accommodation is on the ground and first floors and there is a chair lift to access the upper floor. People living there have single bedrooms, six of which have en-suite facilities. There are two sitting rooms, a dining room and two bathrooms for communal use. The garden has a large patio and is a safe and pleasant area to relax in. Information about the home is provided in a service user’s guide and a book of photographs showing the accommodation available and staff. The current fee for the service ranges from £750 to £1250 a week depending on the assessed needs of individuals and as agreed between the provider and their funding authorities. Additional costs include for such as private chiropody, hairdressing, newspapers & magazines, personal toiletries, clothes and electrical appliances. Kynaston Court DS0000024720.V352901.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 is a key inspection of Kynaston Court and so all the Standards that can be most important to people living at care homes have been assessed. This visit was made without telling anyone at the home beforehand. Time was spent talking with two people living at the home about their care and lifestyle. One care worker was asked about the service, their role, training and support. The way the home is run and any changes since the last inspections were also discussed with the manager. Surveys were left at the home for staff and people living there asking for their views of the home. Surveys were also sent to one person’s relative and to three health or social care professionals involved with the home. Feedback received is referred to in this report. An AQAA (Annual Quality Assurance Assessment) was completed before this visit, as now required. This asks managers to say what they think their home does well and could do better, what has improved in the last year and about their plans to improve the service. It includes information about people living there, staff and other aspects of the home. Various records kept by the home were checked and the house looked around. All other information received by the Commission about the home since the last inspection was also considered. What the service does well: People know the home could suitably meet their needs before they move in. They can also visit and stay for a while to check if they would like to live there. Kynaston Court is very friendly and homely. People living there say they are happy and that they get on well with and can talk to the manager and staff. Each person living at the home has a plan they are involved in making. Plans show what they like and their care needs and how staff should support them. People living at the home can choose what they do every day and to go out if and when they wish. Staff support them to keep in touch with their families and friends. They can choose all their meals and say they really like the food. Staff support people living at the home well with their personal care. They also ensure they have regular health checks and manage their medicines safely. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 6 The home offers a safe, well-kept and comfortable home. People living there say they like the lovely gardens and have their own things in their bedrooms. There are aids and equipment to help them move around the home easier. Staff receive training so they understand and know how to keep people living at the home safe and meet their special needs better. All staff are checked out before they start working at the home to help to make sure they are suitable. The home is well run and the manager and staff team work together. They are committed to giving individual and caring support to the people living there. 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. Kynaston Court DS0000024720.V352901.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 Kynaston Court DS0000024720.V352901.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 this visit to the service. Good assessment and admission procedures are followed to ensure the home would suitably meet potential service users’ needs and they want to move in. EVIDENCE: The home has an appropriate statement of purpose and a service users’ guide to provide information about the home for potential service users and/or their representatives. The manager has also made up a scrapbook with photographs of the accommodation and staff to show anyone who may be interested in living there. It is planned to produce the guide in a pictorial and video format. The AQAA describes the home’s admission procedures, which include a detailed needs assessment undertaken by the manager that may involve several visits to obtain all the relevant information. This would be followed by introductory visits to the home including an overnight stay, when feasible. A three-month trial stay would then be arranged, during which their care plans are reviewed. At the end of this period review meetings are held with all involved parties to discuss the service to be provided and agree this and the fee in a contract. The care records of the person who most recently moved into the home were looked at and their admission discussed with the manager. It was confirmed the manager and senior visited several times at their previous residence, which Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 9 was the assessment unit of a learning disabilities hospital. During these visits they discussed the home, showed him the photographs and gave him a copy of their guide. The manager was given full access to care records and a copy of a community care assessment, which had been carried out by a care manager from their funding authority. The manager also completed the home’s own full needs assessment and attended their hospital discharge meeting. This person’s next of kin and an advocate visited to look at Kynaston Court, as it was not possible for him to make the journey to visit or to have an overnight stay. An assessment was also made by an Occupational Therapist to ensure the physical environment at the home was suitable and consequently extra grab rails had been fitted in their bedroom. One review meeting had already been held after six weeks and another was planned at the end of their threemonth trial period to discuss the suitability and continuation of the placement. The manager and staff are continually monitoring this person’s progress, whilst also considering compatibility with other people already living at the home. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 10 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 this visit to the service. Each person living at the home has a plan they are involved in making. Plans show their care needs and wishes and support they need to meet them. They can make choices and decisions in their daily lives and routines and whilst staff encourage independence they also take steps to minimise possible safety risks. EVIDENCE: Care records of two people living at the home were checked. They include their photograph, a full needs assessment at the time of admission, contact details, a personal profile, background information and a current care plan. The plans cover relevant areas of need such as personal & health care, mobility, social & cultural, communication, daily living skills and relationships. They specify their needs, objectives, action needed and who is responsible for it. Staff also make detailed daily reports about each person’s behaviour, mood, activities, events, etc. providing helpful information about their lifestyle and progress. They also record accidents, incidents and use behavioural analysis forms if necessary. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 11 The home has an appropriately person centred (PC) approach to care planning and so aims to involve people living at the home as far as possible in drawing up and reviewing their plans. PC plans should also focus on personal goals and enabling individuals to identify and meet their goals. People currently living at the home are all over seventy years of age however and so their plans mostly reflect their personal and health care needs, as they are less likely to develop a more independent lifestyle and new skills. Whilst this may be so staff at the home encourage their independence and they can be self-determining and live the lifestyle they choose. Care reviews also reflect any progress, for example one person is now happier to go out and interact more with other people. Plans are appropriately reviewed at least six monthly and as needs change. All staff discuss care management issues with people living at the home if they can. Formal reviews meetings are also held during and at the end of trial stays when care managers and any other relevant people are invited and are part of the reviewing process. The home also involves their families and advocates. Individuals risk assessments had also been carried out. They primarily identify any safety risks to themselves and other people and include such as smoking, bathing and moving & handling. Again because of age and frailty there is a limit to how far risk assessments could be part of supporting an independent lifestyle, although issues such as road safety, safety out in the community and management of their own finances are covered. There are also behavioural plans in place for some people and although the home will not accept people with severely aggressive or disruptive behaviours staff have receive training in positive techniques to manage challenging behaviours and aggression. It is evident staff understand and are dealing with some difficult behaviours well. In respect of equality & diversity the home’s information documents, AQAA and care planning supports the view that staff understand and always consider any cultural, gender and disability differences. They would consult people living at the home so that suitable arrangements are made to meet their preferences. Two examples of this were noted and another person had an occupational therapy assessment so the home could provide grab rails and a special chair in their bedroom to promote their mobility and comfort. The manager has also attended a training session on the new Mental Capacity Act and it is mentioned in the service users’ guide that a best interest assessment may need to be made if anyone living at the home was not able to give their informed consent for such as medical treatment. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 12 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 this visit to the service. People living at the home are enabled to go out in the community and take part in any activities they want to and staff respect their chosen daily lifestyles. Staff support them to keep in touch with their families and friends and ensure that they have wholesome and healthy meals, which they choose and like. EVIDENCE: All three people living at home are aged over seventy and two have physical health and mobility problems. This clearly affects their ability and wish to take part in activities and go out and be part of the community. Work placements & college courses are not appropriate, although opportunities for attending day services have been explored and one person has tried one out. Each person is encouraged however to go out in the community and take part in appropriate activities as much as they are able and want to. Staff also have time to spend with individuals at home and aim to encourage them to socialise and be as active as they can be. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 13 One person has a daily newspaper and visits Ross-on-Wye three times a week. He is very happy with this arrangement and spends the time in town shopping with staff and at a bookmakers, where he is now known and has made friends. He also spends a lot of time in the gardens working with the home’s gardener. The home clearly offers an individualised service and enables the people living there to lead their chosen daily lifestyle. There are no set routines and staff work around them and their needs and wishes entirely, which two people living there confirm. The AQAA states social interactions could be improved when more people are admitted and another aim is to develop individual activity schedules. However plans already specify their interests and how they like to spend their time and any support needed from staff to facilitate them. People living at the home are supported to maintain contact with their families and friends. Their plans detail their personal contacts and relationships and show the home also keeps in touch and updates them when important things happen etc. One plan includes that staff will transport the person to visit his family and friends regularly. They live a good distance away but he has agreed and is happy with this arrangement. He also telephones his social worker and friends regularly and staff escort him to the post office with letters. Regarding food provided by the home an individual record of the meals people receive is kept and a daily menu board displayed. This indicates a good variety of mostly traditional meals. People living can choose their meals and two say the food is very good, one describing it as fantastic and they can have whatever and whenever they want. One person has a cooked breakfast every day and makes his own hot drinks in the kitchen and another person has their own fridge and kettle in their bedroom. Mealtimes are flexible and people choose whether to eat alone or in their bedroom or dining room. All staff share cooking and aim to use fresh ingredients and vegetables etc to provide a healthy diet. One person will only eat a very limited range of food and staff are making efforts to ensure their diet is as wholesome as it can be. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 14 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 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. People living at the home are being well supported with their personal and health care. Their medicines are managed safely in the home on their behalf. EVIDENCE: Plans include the assistance and/or guidance each person living at the home needs with their personal care and hygiene. Two people confirm they have the support they want and staff respect their privacy and individual preferences. Care records detail medical histories and any current health problems. The home arranges introductory visits to the local GP practice when new people move to live at the home so their condition and medication can be assessed and reviewed. Staff then support and enable them to have routine health care checks such as chiropodist and dentist and preventative input e.g. flu injection and well person checks. Specialist input is sought and obtained as needed. Records are kept of all health care input and any physical checks carried out by staff whenever necessary, such as for weight and food input. Plans include instructions to staff in relation to physical health, such as elevating legs and an epilepsy plan. Body charts are also completed for any injuries/marks etc. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 15 Regarding medication prescribed for the people living at the home appropriate policies & procedures are in place for their management by the home. There is additional guidance on the use of homely medicines and when medicines may be given “as required”. None of the current residents is assessed as being able to self-medicate and all staff are designated to administer their medication. They have therefore undertaken a safe handling of medicines training session as is required. Medication was seen to be stored safely in the home and staff maintain appropriate records of all medicines kept, administered, received and disposed of when no longer required. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 16 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 this visit to the service. People living at the home are enabled to express their views and feel that they can raise concerns with staff and know they would be dealt with. Staff also understand their responsibility to follow relevant procedures to protect them. EVIDENCE: Kynaston Court provides a written complaints procedure and the people living there and/or their representatives had been given a copy. Two people confirm they can talk to the manager and staff and feel confident their views would be listened to and any issues raised would be dealt with properly. No complaints had been made to the home or the Commission since the last inspection. There are also policies & procedures in relation to abuse and adult protection. They include a copy of Herefordshire’s multi-agency procedures for protection of vulnerable adults (POVA) so that staff would know where and how to refer any incidence or suspicion of abuse and/or neglect of people living at the home externally. The manager and care worker spoken with are both clear about their responsibility for the welfare, safety and protection of people living at the home. Staff had attended training sessions on abuse, POVA and for positive management of challenging behaviours and protocols are in place as needed. Two people are supported by the home to manage their personal allowance. They have their own bank accounts and cash cards and they all have cash kept at the home to spend as they wish. Records are kept of all transactions and when checked show cash spent on their behalf is signed by them and staff with receipts kept. All their financial records are regularly audited by an accountant. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 17 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 good. This judgement has been made using available evidence including this visit to the service. Kynaston Court provides a well kept and comfortable home that suitably meets the needs of people living there. Staff also ensure the accommodation is kept clean and safe and promote good infection control for their health and welfare. EVIDENCE: Kynaston Court is in a fairly isolated rural location, although two people living there say this suits them and both enthused about the lovely countryside and gardens. The lanes around the home are quiet and there is a local shop/post office, church and pubs within a mile for those able to walk or be wheelchaired. Staff use their cars to provide transport into Ross town and for other outings. The overall impression of the environment is spacious and comfortable and most of the house was visited and found to be warm, fresh, clean and tidy. The accommodation is suitably furnished, fitted and equipped, with arrangements in place for ongoing maintenance and improvements. Some redecoration has Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 18 been carried out since the last inspection and it is planned to replace some of the communal furniture this coming year. There are ramps and grab rails around the home and a chair lift, bath hoist, aids & adaptations provided to assist people with mobility difficulties. There is also an emergency call bell system. The bedrooms are furnished and equipped to meet individual’s needs and one person who chooses to take meals in their room has their own fridge and dining table. Staff support and encourage them all to personalise their rooms and use them as their private space if they wish. One person loves the home’s cats and they too spend time in their bedroom. There is a policy & procedures for infection control and all staff have received training on the prevention of infection and management of infection control. Protective gloves and aprons are provided for staff and there are suitable laundry facilities and arrangements in place for the disposal of soiled waste. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 19 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, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including this visit to the service. People living at the home receive support from experienced, trained staff with the knowledge and skills necessary to meet their needs well. Good recruitment procedures help to ensure only suitable staff provide care for their protection. EVIDENCE: The staff team comprises the manager and five care workers, as there are only three people living at the home currently. This small and stable staff team can provide sufficient cover for the home and offer flexible & individualised support to people living there. The staff team seem committed and clearly work well together to meet the purpose and aims of the service. They say they have good support from management. Staff meetings are held and their views are listened to and they receive formal individual supervision regularly when their work performance and skills are reviewed and appraised with records kept. All staff have an action plan for their identified developmental and training needs. All staff are experienced in care, most having worked with people who require care due to age related frailty, but some also in learning disability services. They complete the LDAF induction programme, which is an accredited course Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 20 for staff working with people who have learning disabilities. They then move onto an NVQ (national Vocational Qualification) in social care, which three had already achieved and two will complete in due course. The whole team had also attended training sessions on topics including autism, dementia, epilepsy, person centred planning and positive responses for management of challenging behaviours. Thus providing knowledge to help them understand the special needs of people living at the home and skills to provide better support. Regarding recruitment the records of the newest staff member were checked. Their application appropriately includes proof of identity, a full employment history and a statement about their health. An enhanced criminal record check (CRB) and two written references had appropriately been taken up and the manager reaffirmed that new staff would not start work at the home without these necessary checks being taken up and considered satisfactory. One care worker confirmed that when she applied for a post at the home she had been invited to meet people living at the home and staff before having an interview. She went through the home’s induction programme with the manager and also completed LDAF. New staff are then expected to complete a probationary period at the home that is reviewed at 3 & 6 months before their appointment is confirmed and they are issued with a job description and contract. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 21 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 this visit to the service. The home is well run with a positive management approach that helps ensure people living there receive caring, individualised support. A system is in place to monitor and review service quality, but should result in a plan for the home to continually improve as people living there and significant others want. Safe working practices protect people living at the home and promote their welfare. EVIDENCE: The manager (Mrs Brenda Wetton) has thirteen years experience working with people with learning disabilities and has been a registered manager in several care homes. Mrs Wetton has achieved an NVQ 4 qualification in social care & management and a Diploma in Adult Psychology. She is also an NVQ assessor and a moving & handling trainer and completed a lot of other relevant training e.g. supervision & development, effective customer care, dementia awareness, epilepsy, autism and for the positive management of challenging behaviours. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 22 Management arrangements within the home are appropriate and although the manager says she has a “hands on” approach there is sufficient time available for the management tasks. The home also employs a senior support worker and staff report they receive good support from the provider, who has many years experience in the care of older people. It is evident that the home is run around the needs and wishes of people living there and that staff understand their needs and are committed to providing a good home and service for them. The home operates a system to monitor and review all relevant aspects of the service through quarterly audits. Questionnaires are sent regularly to people living there and their representatives asking for their views of the home. This should provide the information necessary to assure the quality of the service. It should result in an action plan for the service’s continual development, which is based on the views of people living there and other stakeholders. Regarding safety within the home environment and how the welfare of people living and working there is promoted the information obtained during this visit and/or from the AQAA confirms as follows: • • • • • • • The fire safety system is serviced annually as required. The required tests & checks on the fire safety system and equipment are carried out at the specified intervals. Fire drills are being arranged regularly. The heating system & electrical appliances are tested/serviced regularly. Checks on water temperatures are carried out regularly. The home has COSHH & other risk assessments in place. Accident and incident records are maintained. There were no safety hazards seen in the environment during this visit and the evidence overall indicates due attention is paid to maintaining health & safety in the home, to protect and promote the welfare of residents and staff. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 23 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 24 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 persons meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered provider must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the registered provider to consider carrying out. No. 1. Refer to Standard YA39 Good Practice Recommendations The home’s quality assurance and reviewing system should result in an annual plan for the continual development of the service, based on the views people living at the home (and relevant stakeholders) and/or for their benefit. Kynaston Court DS0000024720.V352901.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 Kynaston Court DS0000024720.V352901.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. 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