Inspection on 30/05/06 for Boons Park

This inspection was carried out on 30th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Boons Park 23/01/09

Boons Park 20/02/07

Boons Park 18/10/05

Boons Park 05/05/05

Boons Park 17/12/04

Boons Park 13/05/04

Boons Park 02/10/03

Similar services:

Prinsted

Elizabeth House

Kenward House

Winthrop Hall

Life Works Community Ltd

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Boons Park Boons Park Toys Hill Road Toys Hill Edenbridge Kent TN8 6NP Lead Inspector Ruth Burnham Key Unannounced Inspection 30th May 2006 9:00 Boons Park DS0000023865.V295398.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 Boons Park DS0000023865.V295398.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. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Boons Park Address 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) Boons Park Toys Hill Road Toys Hill Edenbridge Kent TN8 6NP 01732 700202 Kenward Trust Mr Allen Belton Care Home 20 Category(ies) of Past or present alcohol dependence (20), Past or registration, with number present drug dependence (20) of places Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Residents with drug and/or alcohol dependency problems may also have a mental health difficulty. Total number of bedspaces must not exceed 20 Date of last inspection 18th October 2005 Brief Description of the Service: Boons Park is a large detached premises with accommodation arranged on 3 floors in the main building and accommodation is also provided in a barn conversion adjacent to the property, it is owned by Kenward Trust who provide a number of care homes for people with past alcohol and drug dependency in the South East. This home is located in a rural area near to a small hamlet. Accommodation is currently provided for 19 service users with past or present drug or alcohol dependency. The home has 15 single and 2 double bedrooms. There are communal rooms including a dining room, lounges, meeting and counselling rooms. The home is set in extensive grounds with off road parking for several cars. Staff accommodation is also provided on site. The home employs counselling and support staff who work a rota which includes a member of staff working at night on sleep in duty. In addition to these staff, there is a housekeeper and central administrative and management support at the local area office. Information about fees was not available at the time of the inspection, these will be included in the next inspection report. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection of the home during which the unannounced site visit took place on 30 May 2006 at 09:00. It was carried out by 1 inspector who was in the home until 14:15. During the visit a number of documents and records were examined, the deputy manager, some staff and service users were spoken with. Interaction between staff and residents was observed and case tracking was carried out through care plans and other records. A tour of the premises was also made. Other records were examined on 1 June 2006 at the head office of the Trust as part of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Care plans and risk assessments must provide adequate information and guidance for support staff to meet all care needs. Staff must be provided with adequate training for the tasks, which they perform, and to a level, which protects service users. Support staff should also have access to National Vocational Training. All complaints should be logged with records kept in line with the regulations. Volunteers should be checked through the Criminal Records Bureau. An effective quality assurance system should be in place including a regular report in line with the regulation. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 6 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. Boons Park DS0000023865.V295398.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 Boons Park DS0000023865.V295398.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-5 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who are considering undertaking the programme provided in the home are given detailed information about what they can expect on moving there. EVIDENCE: Two new residents were spoken with during the site visit and their records where examined, this confirmed that people who are considering moving to the home are provided with detailed information about how the service is run and what they can expect. All information is available in formats which are accessible to the service users. People who are thinking about moving to the project are visited wherever possible or contacted in their current situation when an assessment is made of their suitability for the programme, this is recorded and placed in the individual file along with a care management assessment which has been obtained wherever possible from the referring agency as a basis for the care plan. Wherever possible prospective residents are also encouraged to visit the home prior to admission. People who move into the home benefit from specialist help delivered through a therapeutic programme with support from qualified counsellors. They enter into a contract which includes the room to be occupied, personal support, specialist services and therapeutic interventions and any rules which may limit personal freedom. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home benefit from excellent support within the therapeutic programme, however their care and support outside this context may still be compromised by inadequate risk management. EVIDENCE: Service users spoken with praised staff, they said that they found them to be very supportive and understanding. There were 11 service users accommodated in the home at the time of the site visit. A great deal of work has been done since the last inspection to ensure that there is a care plan in every file, which is drawn up by the keyworker and counselling staff in consultation with the service user. There is better understanding about the purpose of the care plan in that it now provides clearer guidance to staff about how to meet the day to day care needs of people living in the home. People who live in the home confirmed that there is sufficient support where help is needed with daily living skills. Activity sheets are completed on a weekly basis, some discussion took place about the need to ensure that these records relate directly to the care plan to promote good care for service users outside of the Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 10 therapeutic programme. There was still some concern about a lack of understanding among staff who are recording care plans and risk assessments, these are still not being used by staff as part of their day to day guidance and do not generate clear guidance to staff on how to minimise risk to people living in the home. Staff drawing up these documents have still not had specific training in care planning and risk assessment although the Director agreed at the last inspection that additional training was needed to ensure that these standards are met. People who live in the home are consulted about life in the home through regular meetings. There is a resident’s meeting every four weeks where people are encouraged to raise any issues which may be causing them concern about the way in which the home is run. Minutes are recorded of these meetings which were examined at the visit. These demonstrated that staff and management promote and encourage the involvement of people who are living in the home and that action is taken where issues are raised by residents. People who live in the home can be confident that their confidentiality is maintained through systems and practice, which ensures that personal information is stored securely and is available solely to authorised and appropriate people. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 - 17 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home enjoy a wide variety of opportunities for recreation and personal development, their right are respected and choices are available. EVIDENCE: People who live in the home have opportunity to take part in a range of recreational and leisure activities, transport is available at set times to enable service users to pursue these during leisure periods. Trips are arranged to cinemas, bowling, walks and some group trips are arranged from time to time for those who share the same interests. Service users are encouraged to become involved in local churches; a local drop in centre and other local groups, libraries and the leisure centre. There is a notice board providing information about local events. Some entertainment is available in the home including a snooker room, darts and table tennis, An excellent leisure facility with a range of gym equipment has been opened since the last inspection, in converted garages. One service Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 12 user spoken with was particularly pleased with this and with the fact that the home had partially funded his membership at the gym in the nearby town. Family and friends are welcomed within the agreed restrictions of the therapeutic regime. In the same context visitors are welcomed and may be seen in private. Staff interaction with service users observed during the inspection was warm and respectful. People who live in the home may choose when to be alone or in company and, within the agreed therapeutic arrangements, they may choose when not to join in an activity. Service users have unrestricted access to the home and grounds and visitors have access subject to individual and collective consent. Residents spoken to said that the food is good and they are offered choice within the menu plan, meals are offered three times daily with snacks and drinks available at all times. Mealtimes are relaxed and take account of individual, nutritional needs. The inspector was able to have lunch with one of the residents and was impressed by the quality of the food provided. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 21 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live in the home are provided with access to healthcare support and are protected through safe medication systems. EVIDENCE: People who live in the home benefit from the support of a designated keyworker. Service users are provided with work clothes and often assistance is given to purchase other necessary items of clothing, people who need higher levels of personal support in their daily lives are helped to the level which they require. All service users are registered with the local GP and given an initial health check, access is also provided to opticians and dentists as required and specialist referrals are made where necessary. People who live in the home are protected through safe system for the administration and storage of medication in line with relevant guidance. Service users in this home only stay for short periods as a stage in their recovery. Staff have received training in bereavement and loss. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. People who live in the home feel free to offer comment or complaint and are listened to although inadequate records are kept. Inadequate checks on staff and volunteers could place people who live in the home at risk of harm EVIDENCE: People who live in the home said that they felt able to offer comment or complaint and that they were listened to. The complaints log was examined however, there had been no entries since June 2005, some discussion took place about the need to keep full and complete records of all complaints in line with the regulations. Service users are protected through a clear adult protection policy and all staff are checked through the Criminal Records Bureau however, these checks are not carried out prior to appointment and staff can be working for several weeks or even months without the response to the application having been received from the Bureau. This, and the continued failure to check all volunteers through the criminal records bureau could place people who live in the home at risk of harm. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 - 30 The quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The comfortable, clean and safe environment enhances the quality of life for people who live the home. EVIDENCE: Part of the main building and the barn annexe were toured during the site visit. There is currently only one person living in the Barn which has 4 bedrooms, a small living area, a ground floor bathroom and a first floor toilet with washing facilities, this resident also have access to all other communal areas. All the bedrooms have hand basins, people who live in the home are expected to keep it clean as part of their therapeutic programme, there is a housekeeper and a project worker who oversee and co-ordinate this activity providing support where needed. There has been considerable improvement in the Barn since the last inspection which now compares favourably with the main building in that furniture has been replaced, a new sink has been fitted in the bathroom and all areas were clean and tidy ensuring a reasonable quality of life for residents in a comfortable and safe environment. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People who live in the home are supported by an enthusiastic and dedicated staff team however their safety and quality of life may be compromised by inadequate training. EVIDENCE: People who live in the home can be confident that staff will understand them through the policy of the home to employ staff who have first hand experience of the challenges facing them. Staff are divided into therapeutic and support staff with a part time housekeeper and chef. Residents benefit from the support of therapeutic staff who are highly qualified and receive professional supervision provided on a regular basis. People who live in the home can be confident that staff are only appointed following rigorous recruitment procedures which include the gathering of detailed information about applicants through the application form, informal and formal interviews and the taking up of references with criminal record checks, appointments are only confirmed following a 3 month probationary period. Since the last inspection a new member of staff has joined the team and there are now sufficient support staff including adequate housekeeping hours to ensure that people who live in the home are adequately supported outside of Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 17 the therapeutic programme. Inadequacies in care planning and risk assessment indicate that there are still gaps in training for support staff, including statutory training. It was encouraging to see that one member of staff has successfully completed a 12 week safety course at the local college, however other staff have still not received training in moving and handling to the required level in spite of the fact that the Director was reminded at the last inspection that statutory training must be provided, this issue is outstanding from the previous 4 inspection reports. However some evidence was seen at the last inspection that service user’s safety is being protected in relation to fire safety, first aid and food hygiene through competence-based training from a qualified instructor. National Vocational Qualifications have still not been accessed for support staff . Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The quality of life and safety of service users has been improved since the last inspection however lack of an effective quality assurance system may compromise further improvement. EVIDENCE: The manager is currently undertaking the Registered Manager’s Award to broaden his skills in the management of the home and improve the service for the benefit of the people who live here. Additional management support is provided by the Director of Residential Services who visits the home regularly, regular reports in line with Regulation 26 are submitted monthly to the Commission However there is still no effective internal quality assurance system in place to ensure that standards are met and the quality of life and service for people who live in the home is continually improved. The management also agreed at the last inspection that shortfalls identified in the Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 19 last report in relation to statutory training, risk management, health and safety and infection control will be addressed to ensure that people who live in the home are protected from harm. It was good to find that some improvement has been made although further work needs to be done to achieve compliance with the previous requirements. Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 20 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 1 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 3 LIFESTYLES Standard No Score 11 3 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 3 3 x 2 x x 2 x Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 21 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. 1 Standard YA6 Regulation 15 & Sch 3 Requirement Timescale for action 15/07/06 2 YA9 13(4)(c) 3 YA22 22 Individual care plans must be drawn up for each service user which are kept under review and up to date with daily records maintained of the support provided. unnecessary risks to the health 15/07/06 and safety of service users must be identified with clear guidance to staff of how to manage these risks. Complaints should be handled in 15/07/06 accordance with laid down procedures and recorded in such a way as to ensure that service users receive appropriate feedback and a summary of complaints can be supplied to the commission containing action taken in response. The timescale for compliance with this requirement following the inspection in May 2005 was 30/06/05. This has not been achieved. An improvement plan specifying how the registered person intends to achieve compliance Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 22 with this requirement has been requested. 4 YA23 13(6) Volunteers should be checked through the criminal records bureau The timescale for compliance with this requirement following the inspection in October 2005 was 31/11/05. This has not been achieved. An improvement plan specifying how the registered person intends to achieve compliance with this requirement has been requested. 5 YA35 18(1c) & Sch 4.6 19(5)(b) 15/07/06 Records in relation to the qualifications and experience of staff should be available in the care home and all staff should be qualified to an adequate level in basic food hygiene, first aid, moving and handling, fire safety, health and safety and infection control. Staff must be qualified and competent to carry out the task they perform including care planning and risk assessment. access to the relevant NVQs should be provided. The timescale for compliance with this requirement following the inspection in October 2005 was 31/11/05. This has not been achieved. An improvement plan specifying how the registered person intends to achieve compliance with this requirement has been requested. 6 YA39 24 The home shall provide a report to the commission of the DS0000023865.V295398.R01.S.doc 15/07/06 15/07/06 Boons Park Version 5.2 Page 23 outcome of it’s quality assurance review and a monthly report in line with regulation 26. The timescale for compliance with this requirement following the inspection in October 2005 was 31/11/05. This has been partially achieved. An improvement plan specifying how the registered person intends to achieve compliance with this requirement has been requested. 7 YA42 13(4)(5) & 19(5)(b) Training for support staff must be provided in moving and handling, health and safety, infection control and handling medication. The timescale for compliance with this requirement following the inspection in October 2005 was 31/11/05. This has been partially achieved. An improvement plan specifying how the registered person intends to achieve compliance with this requirement has been requested. 15/07/06 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 Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 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 Boons Park DS0000023865.V295398.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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