Care Home: Prince George Duke Of Kent Court

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What the care home does well What has improved since the last inspection? The home has recently purchased new pressure relieving equipment; and some beds have been replaced with specialised nursing beds and mattresses. One wing of the nursing unit has been refurbished with new furniture, curtains and bed lien this is an ongoing process. A new lift has been installed and some of the rooms are to be upgraded to en suite this will also be an ongoing process. Staff training relating to the safe administration of medication and the disposal of medication has been improved, there are monitoring and auditing systems in place. Social activities are continuing to improve; there are more activities tailored to the more dependent people in the nursing unit and a second activities coordinator has been employed specifically for this purpose. There have been improvements in the documentation and investigations of any concerns and complaints; staff have also received in depth training relating to POVA and to whistle-blowing. There have been improvements in the relationship between the management and administration teams in the home and they now have clearer roles and responsibilities and they are working together in a cohesive team. What the care home could do better: The manager has stated that she will continue to improve staff training of staff by accessing free training and funding from the local authority and primary care trust. To continue with the refurbishment of the home to improve the environment for the people who use the service. To continue to cut down on the employment of agency staff to improve the continuity of care for the people who use the service. To continue to maintain the high standard of activities and social events and outings provided by the home. CARE HOMES FOR OLDER PEOPLE Prince George Duke Of Kent Court Shepherds Green Chislehurst Kent BR7 6PA Lead Inspector Sue Meaker Unannounced Inspection 09:30 22 & 29th May 2008 nd 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 Prince George Duke Of Kent Court DS0000010152.V363994.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. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Prince George Duke Of Kent Court Address Shepherds Green Chislehurst Kent BR7 6PA 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) 020 8467 0081 020 8295 3526 pgdokcourt@rmbi.org.uk www.rmbi.org.uk Royal Masonic Benevolent Institution Toni Louise Turner Care Home 78 Category(ies) of Old age, not falling within any other category registration, with number (78) of places Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Staffing Notice issued 21 January 2000 24 Beds for Nursing Care Date of last inspection 13th June 2007 Brief Description of the Service: Prince George Duke of Kent is a purpose built care home situated in Chislehurst in Kent. The care home is operated by the Royal Masonic Benevolent Institution who provide a range of services to meet the needs of older Freemasons and their dependents; as well as offering practical support to people who prefer to remain in their own homes; care is also offered in homes and sheltered accommodation throughout England and Wales. Prince George Duke of Kent offers residential care to a wide range of older people, some simply choose this lifestyle for their later years, others may be unable to manage in their own home due to failing health or a need for help with some day to day activities. The home also offers nursing care for older people with specific medical conditions requiring treatment that needs to be provided under the direction of a Registered Nurse. Prince George Duke of Kent was built in 1968 and is surrounded by gardens containing a large collection of rose bushes as well as many shrubs. A concrete path borders the garden, allowing residents with frames or wheelchairs to have uninhibited access. Part of the lawn is laid out for putting, which is enjoyed by the residents and their families and friends. The home provides accommodation for fifty residents in single bed sitting rooms and four double rooms (for couples) in the residential part of the home; and there are twenty- four beds for residents who require nursing care in the specialist-nursing wing of the home. Prince George Duke Of Kent Court DS0000010152.V363994.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 was an unannounced key inspection that took place over two days the 22nd and 29th o May 2008. The first day was spent touring the home and inspecting the environment; part of the day was spent in inspecting documentation relating to assessment and care planning; documents relating to recruitment, selection and staff training, documentation relating to health and safety, and documents relating to the administration of medication. The menu and activities programme were also inspected and discussed with the home manager and the activities co-ordinator. The second day was spent talking to residents who use the service, their friends and relatives and to the staff and management of the home. The home manager had provided a completed Annual Quality Assurance Assessment to the CSCI prior to the inspection taking place, this document is completed once during the current inspection year and gives an indication of what the organisation is doing to provide the best quality care for the people using the service. A number of questionnaires were received from people who live in the home, from relatives carers and advocates plus healthcare professionals who visit the home including GP’s, optician and district nurses. Generally the comments were of a positive nature; the questionnaires were complimentary and praised the level of care provided and the commitment of the staff and management of the home. All in all this was a good inspection and the home is maintaining it’s level three – two star rating; the home is to be commended on the range of activities, social events and outings arranged and the enthusiasm of the staff, management and relatives who attain such a high standard of activities for their residents. The organisation is also to be commended for the high standard of the refurbishment of the dining room; this is now a light airy social space for the people who use the service to have their meals in a really nice space, overlooking the garden, the furniture and soft furnishings are of an extremely good quality. What the service does well: Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 6 The home provides a good service that meets the personal, health and social care needs of the people who use the service in a homely setting. The care needs of the people who use the service are identified in the first instance at the pre-admission assessment and then transferred to a personalised care plan making sure that care needs are met taking into consideration the wishes and preferences of the individual. The staff at the home have demonstrated that they are competent, experienced, trained and skilled in giving the appropriate level of care, support and encouragement to the people who use the service. The comments from the questionnaires support this view for example people who use the services have stated: • I am very satisfied with the care provided to me. • I would not stay here if I were not happy. • The staff are very caring and take good care of me. Comments from relatives, carers and advocates included the following• He had a very happy last few months….everyone showed respect, kindness and care…..it made my life easier…they gave him a wonderful 100th birthday party…we were 100 satisfied. • No we have no complaints at all. • The staff give comfort and assistance communicate very well with my relatives, nothing is too much trouble and the accommodation and facilities offered are excellent. What has improved since the last inspection? What they could do better: Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 7 The manager has stated that she will continue to improve staff training of staff by accessing free training and funding from the local authority and primary care trust. To continue with the refurbishment of the home to improve the environment for the people who use the service. To continue to cut down on the employment of agency staff to improve the continuity of care for the people who use the service. To continue to maintain the high standard of activities and social events and outings provided by the home. 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. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 8 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 Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4 and 5. (please note standard 6 is not applicable to this service) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents and their families receive information relating to the services: the home is able to provide including an opportunity to visit and be involved in the assessment process thereby determining whether the home is able to meet their assessed personal, health and social care needs. Service users are given a contract clearly stating the terms and conditions of their admission to the home and what standard of services they will receive. EVIDENCE: The management team take time to speak to prospective residents and their families prior to a place being offered to them; it was evident from questionnaires received that this is the case confirming that they received Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 10 information about the home before they moved in and relatives stated that they got enough information to enable them to make a decision as to whether the home could meet the needs of their relative. Prospective residents and their relatives are encouraged to visit the home and to spend time with the residents and staff and to stay for a meal if they wish. The residents, staff and management of the home are able to answer questions and address any concerns expressed at this time. Prospective residents are given a brochure and comprehensive guide giving details about the organisation and the services offered. All prospective residents have a comprehensive care needs assessment before admission; this is carried out by a trained member of staff who visit the person either at their home or in hospital receiving information from the person themselves, relatives, advocates and other health care professionals involved in their care. Questionnaires and residents spoken to confirmed that they were involved in the assessment process and that their wishes and preferences were taken into account; ensuring that they got the care and support they needed. Relative questionnaires and relatives spoken to said that they had contributed to the pre admission assessment and that they had been involved in the care planning process making sure that the home could meet the care needs of their relative. The assessment covers the persons individual health personal and social care needs and is necessary to ensure that the home is able to meet and detail how they will meet these identified needs however complex. All people who use the service receive clear information about the fees, the contract and the terms and conditions of their placement; the home’s business co-ordinator gives input ensuring that the person and their family of advocate understand the Statement of Terms and Conditions. Contracts are in the residents personal files held in the home’s main office, in a locked filing cabinet, accessible to the resident and their family members comply with the data Protection Act. The organisation is looking to provide the information in the brochure and resident’s guide in different formats to make it more accessible; it is also looking at ways to plan the prospective residents’ visit ensuring that they receive all relevant information appertaining to their placement at the home. The guide, Statement of Purpose and the brochure are updated annually ensuring that the information is relevant and up to date. The home manager is looking at the response times to initial enquiries to make sure that the pre admission assessments, visits to the home by prospective residents and other interested parties are undertaken as soon as possible; this is to be achieved by training more senior members of staff in how to assess the care needs of prospective residents. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents care plans ensure that their assessed health, personal and social care needs are met. The homes’ medication policies and procedures ensure that the resident’s rights are protected when dealing with medicines. Residents are confident that the home will respect their right to privacy. EVIDENCE: During the inspection both the nursing unit and the residential unit were visited; it was evident from these visits that a good standard of care and treatment is provided to help the people who use the service to maintain a full and enjoyable life ensuring that they have an individualised care plan tailored to their specific assessed health, personal and social care needs. Six care plans were inspected, two from the nursing unit and four from the residential Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 12 unit. All the care plans seen reflected the specific personal, health and social care needs of the individual and how these needs were to be met. The people who use the service, their relatives and advocates are involved in the care planning process and it was evident from questionnaires received that this was the case people who use the service said that they received the care and support they needed and that the staff listened to and acted on what they said. Relatives and advocates stated that the home met their relatives’ needs and were able to give the appropriate level of care and support that was agreed. The care plan documentation is good and endeavours to give an overall picture of the resident identifying the need, the goal/aim, action to be taken and a monthly evaluation. Care plans are supported by appropriate risk assessments relating to moving and handling, falls, nutrition, bathing, cot sides and pressure area care. The pre-admission documentation forms the basis of the care plan and a dependency profile completed at this time; this document is updated on a regular basis making sure a record is kept of the residents changing needs. There was evidence in the files of the care plans and risk assessments being reviewed monthly. People who use the service are supported and encouraged in making choices about their care and how they receive the care they need; they maintain their independence, choice and control over their lives and are enabled to choose their own GP, dentist, podiatrist. Physiotherapists, district nurses and dieticians visit the home on a regular basis usually referrals to these services are made by the GP; referrals to hospital consultants and subsequent follow appointments are arranged so that carers from the home are able to accompany residents if they wish. Staff are in the process of receiving specific training relating to appropriate, individualised care planning and there have been significant improvements to the way staff complete, review and update the documentation in the care plan. Both the nursing and residential units now have digital cameras for recording wounds and pressure area and new pressure relieving equipment and beds are now in situ thereby improving pressure area care. The clinical rooms and medication administration was checked on both the nursing and residential units. The home uses a monitored dosage system; MARS sheets are computer generated; medication labels should not be stuck onto the MARS sheet but written in by hand signed and dated with specific instructions for the safe administration of the medicine. If medication is not given the relevant code should be used and the reason specified on the back of the MARS sheet. The medication files contained the MARS sheets for individual residents on the unit along with a photograph, name, room number, date of birth and information relating to allergies. The file contained the signatures of staff trained to give medication, the homes’ policy and procedure and the Royal Pharmaceutical Society’s guidelines on the safe administration of medication. Both of the clinical rooms were well organised, clean and tidy, a record of fridge temperatures was maintained and medication trolleys were secured to the wall. Homely remedies are authorised for use by the homes’ GP this document is in the medication file and is updated annually, and is Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 13 supported by the organisations policy and procedure relating to the administration of homely medication and it is documented in a separated book. Some of the residents on the residential unit are able to self medicate; they keep their drugs in a locked drawer in their rooms, a risk assessment is completed and the amount of medication given is on a MARS sheet which the resident signs and records when medication is taken. The GP confirmed that the home always supports individuals to administer their own medication or manage it correctly where this is not possible. During a tour of the home and from speaking to the residents it was evident that there was a good rapport between them; the staff helped the residents in their care with sensitivity and compassion, staff were chatting with the residents throughout the day and helping them as unobtrusively as possible; they confirmed that the staff were kind and caring and that they received the care and support they needed, the surveys showed that the people who use the service felt that the staff listened to them and acted on what they said and that staff were available when they were needed. Relatives surveyed stated that they felt that the staff gave the support and care that was expected and agreed at the time of assessment, that they were involved in the care planning process and that their views were listened to and taken into account and that they were involved in annual reviews and that they were consulted by the staff if there were any changes or concerns about their relative’s care. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 14 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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Social activities are excellent, well organised, and creative and provide stimulation and interest for people living in the home. The home supports and encourages residents to stay in contact with family, friends and their local communities; by involving residents’ families in organising social events and in activities that they can enjoy as a family. Meals were nutritious and balanced and offer a healthy and varied diet for residents. EVIDENCE: People who use the service are supported and encouraged to have a full and varied lifestyle and they are encouraged to be as independent as possible by continuing to have responsibility for their finances and medication, obviously depending on the risk assessment and if the activity is appropriate to their capability. The people who use the service can choose what leisure and social Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 15 activities they wish to take part in and then the activity co-ordinators are there to plan and organise appropriate activities suitable for both the nursing and residential people in the home. Mealtimes are a social occasion where people are encouraged to enjoy their food in a relaxed comfortable environment. The catering company provide a wide and varied menu where people can choose what they would like to eat; the menu provides options for special diets, vegetarians, weight reducing, diabetic, low fat and with an accent on healthy eating. People who use the service who have swallowing difficulties or who are unable to chew properly are offered a wide variety of food suitable for their needs; as are people who require assistance to eat; observing lunch in the nursing unit it was evident that the staff were sensitive to their residents needs by helping them as unobtrusively as possible; residents responded to this level of assistance in a positive manner ensuring a good rapport is established; the home has a policy whereby individuals can choose to eat either in their own rooms if they do not wish to eat in the communal dining rooms. The residential dining room has recently been refurbished and is now a lovely light and airy space with nice furniture and soft furnishings and the residents are very appreciative of this lovely area. It was evident that routines within the home are flexible and the people who use the service confirmed that they were able to choose when they got up and went to bed; whether they had a bath or a shower and when they wanted this to happen; what activity they wanted to take part in, which social event they wanted to attend and when and where they wanted to eat; all this information was found to be documented in their individual care plans. People who use the service are encouraged to maintain contact with family and friends living in the community and it was evident that they were welcome in a the home at any reasonable time and visitors spoken to during the two visits confirmed that they were always welcomed, offered drinks and that they could order a meal to eat with their relative if they wished. The home has it’s own chapel where weekly services are held by the local church, people with other religious beliefs can have arrangements made whereby they can visit other local churches. Contact with the outside community is encouraged through relatives and with links made by the activity co-ordinators for example children from local schools who entertain and visit the people who use the service resident in the home. Activities, social events and outings, since the last inspection, have included the following:• An afternoon tea dance • Pre-dinner sherry party. • A visit to Lingfield Horse races • A trip to the seaside – Hythe in Kent. • Entertainers visiting the home at least once a month. • A Christmas party • Wine and cheese party for part of the Easter celebrations. • The annual May fair • 100th birthday celebration and other birthdays. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 16 To name but a few; in addition there are regular coffee mornings, tea dances and musical entertainment; other regular events include a weekly chapel service, scrabble, cards, quizzes, bingo sessions, countdown sessions, knitting circle, twice weekly shopping trips and a weekly news discussion. Craft, art, flower arranging, computer lessons and mini golf putting sessions, one to one conversation and reading sessions also take place on a regular basis. Residents meetings are held every two months, records of these meetings were seen at the inspection, and residents are invited to make suggestions for entertainment, activities social events and outings. The activity co-ordinator is to be congratulated on the wide range of activities, social events and outings offered; there is now an additional member of the activity team who is primarily concerned with providing appropriate activities for the peoples on the nursing wing which has proved to be an enormous help. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 17 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 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with and investigated in accordance with the homes’ policy and procedure and process ensures that residents, relatives and advocates can be confident that their concerns are listened to, taken seriously and acted upon. The homes’ Vulnerable Adults policy and procedure and staff training ensure that the people living in the home feel safe and protected from all forms of abuse. EVIDENCE: The home has a robust complaints policy and procedure copies of this document is in the service user guide, the information booklet given to the residents on admission and is prominently displayed around the home. Staff spoken to knew where to access the policy and stated that there was a copy in their handbook. Complaints are detailed in the homes’ complaints log and the date, nature of the complaint, the outcome is documented; any investigation undertaken is kept separately. From speaking to residents and relatives and from surveys received it was evident the they knew how to make a complaint if necessary; most stated that if they had any concerns they would go the care manager of their unit or the home manager and would feel confident that their Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 18 concern would be resolved satisfactorily. If the complainant is not satisfied with the outcome of the investigation of the complaint their concerns are then referred to the management of the organisation; where the complainant is able to make representation and discuss the outcome of any investigation The organisation has a clear policy and procedure relating to the handling of the financial matters appertaining to people who use the service; all staff receive a copy of this document and were aware of what will happen if it is breached in any way; this ensures that the people who use the service can be sure that their financial affairs are safeguarded and not open to abuse. The organisation has a Safeguarding Vulnerable Adults policy and procedure and staff undergo yearly mandatory training to cover abuse and POVA as well as Disclosure and Whistle-Blowing ensuring that staff are aware of how to prevent abuse happening and to enable them to recognise all types of abuse. The training also outlines the individual’s rights and how staff can respect those rights. The organisation ensures that the people who use the service have the right to vote and the freedom to choose; staff are encouraged to support and encourage the people who use the service to remain, active, independent and to maintain and enjoy their preferred lifestyle. The home’s management team have an open door policy for people who use the service, their families and advocates and staff so that concerns are dealt with before major problems arise. All staff have CRB clearance and POVA clearance prior to commencing employment. It was evident from inspecting minutes of residents, relatives and staff meetings, staff training records, the complaints log, the incident and occurrence book, details of accidents and documentation relating to POVA that the organisation has systems in place to ensure the safety of their residents and staff at all times. The management of the home is committed to providing more specialist training relating to POVA for all staff and to obtain information and skills gained from outside agencies in dealing with allegations of abuse. The home management team have received specific training relating to grievance and disciplinary procedures; and the team is also committed to implement an advocacy policy and procedure so that they can provide an in house advocacy service for the people who use the service ensuring that they always have a voice. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents in the home are provided with a well-maintained, safe, clean and comfortable, homely environment; giving them access accommodation and facilities tailored to their personal and social needs EVIDENCE: The people who use the service are encouraged to treat the home as “Their Home” and to enjoy their life not endure it. The home is clean, well maintained and visitors and residents commented on the lack of unpleasant smells. In the nursing unit pressure relieving equipment and specialist equipment to meet their individual care needs. There are adapted, assisted baths, and toilets have grab rails and high and low seats ensuring that people fell safe enough to use them independently. The home has a selection of adapted wheelchairs that have been allocated to individuals following an Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 20 assessment from the Wheelchair Service. The home has hoists and various slings for the safe transfer of people who use the service; there is also a emergency call system within the home and all bedrooms, bathrooms, toilets and all communal areas have a call bell to summon help if needed; it was evident that staff responded very quickly to any call bell and that they resolved any difficulties quickly, efficiently and with sensitivity. The homes’ fire alarm system and emergency lighting system are in good working order and maintained to a high standard as evidence by the inspection of the relevant health and safety records. The lounges and corridors are spacious, well decorated and furnished to a high standard; the nursing unit has it’s own lounge, dining room and quiet room; the main dining room for the residential unit has been recently refurbished to an extremely high standard and is a really lovely space. There is a good team of domestic staff who keep the home clean and hygienic ensuring that all equipment is kept clean and in good working order. Taff are trained to dispose of laundry following a comprehensive policy and procedure relating to laundry the home is hoping to improve the laundry facilities to enable the safe transfer of clean and dirty laundry. The home has clear policies and procedures to dispose of clinical waste and use a macerator and sluice cleanser. It was observed that staff use protective clothing, aprons, gloves and goggles where appropriate; visitors are encouraged to use a hand gel when entering the building and encourage hand-washing thereby ensuring infection control. The home has a beautiful garden with a putting green and lovely flowerbeds, the home has recently purchases new wooden garden furniture and large umbrellas to enable more people to enjoy the garden in the good weather. A new lift has been installed; a new en-suite room has been added since the last inspection and there are plans to create more en-suite bedrooms and to refurbish the entrance hall and main lobby at the front of the building. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 21 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has efficient and effective systems for recruitment, training, supervision and appraisal, ensuring that the residents’ assessed health, personal and social care needs can be met. EVIDENCE: The rotas seen confirmed that the correct numbers of staff were on duty in both the residential and nursing units. The staff teams on both units appear to be stable; it has also been noted that the use of agency staff continues to reduce thereby giving a greater continuity of care; the management team is continuing with their rigorous recruitment campaign and a number of staff are currently completing their induction to skills council standards, and some are commencing their NVQ 2 qualification. Currently the home employs nine first level registered nurses, forty- six care staff and eight ancillary staff. Residents confirmed that they received the care and support they needed that he staff listened to them and acted on what they said and what they wanted and that staff were available when they needed them. Relatives stated that the staff gave the support and care to their relative that was expected and agreed; and that they felt the staff had the right skills and experience to look after people properly Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 22 All staff are subject to a rigorous section procedure, personnel files seen confirmed that staff had been given an in depth interview with a test where written answers were given; two references were on file, as was evidence of CRB and POVA checks being done prior to employment being offered also prospective staff members were required to complete a health questionnaire. The aim of the homes’ management team is to make sure that they recruit the right person for the job ensuring that they can build a team of good quality care staff. The home management team have developed a recruitment and selection policy and procedure with a clear criteria to ensure that the right person for the right job is selected; ensured that all documentation is in place before employing staff and they have also improved the interview procedure and questioning. The management team have undertaken specialist disciplinary and grievance procedure training and now shift leaders and RGN’s are invited on to the recruitment panel. Each member of staff has their own training record and training passport; the home has a comprehensive annual training plan and a reasonable budget for outside trainers to come into the home. NVQ qualifications are in line with the standard and all staff are encouraged to participate in this training. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 23 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 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has efficient and effective systems for recruitment, training, supervision and appraisal, ensuring that the residents’ assessed health, personal and social care needs can be met. The health and safety policies and procedures ensure the safety of the people who use the service, their relatives and advocates and the staff and management of the home feel safe and protected at all times. EVIDENCE: Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 24 It was evident from discussions with people who use the service, their relatives and advocates and the staff of the home that the management and administration team work effectively and efficiently to run the home. There is a new manager in post and a deputy has been recently appointed; the home manager has both managerial and nursing experience with a sound knowledge of the day to day running of the home, she is also a qualified nurse. The home manager maintains high standards and keeps clear records; she communicates policies and procedures to staff and ensures that they are followed; she also ensures that that staff have appropriate training, identified during staff supervision and annual appraisals, and training records are monitored. Staff confirmed that they have regular supervision and an annual appraisal, this is documented in their individual personnel files, evidence of this documentation was seen during the inspection. Staff have regular meetings and feedback from the home manager and staff said that the manager listens to them, acts on their concerns and values their suggestions and ideas; relatives said that the manager and her team are approachable and are always ready to listen and resolve any concerns they may have about their relative. It was evident that the home manager has the ability to manage and monitor staff and is supportive and is known to be firm but fair. Records inspected showed that the home complies with current health and safety legislation identified in the National Minimum Standards. Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 3 X 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 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 3 3 3 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 X 3 Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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 Prince George Duke Of Kent Court DS0000010152.V363994.R01.S.doc Version 5.2 Page 28 - 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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