Inspection on 05/05/05 for Boons Park

This inspection was carried out on 5th May 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Boons Park 23/01/09

Boons Park 20/02/07

Boons Park 30/05/06

Boons Park 18/10/05

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 Toys Hill Road Toys Hill Edenbridge Kent TN8 6NP Lead Inspector Ruth Burnham Unannounced 5 May 2005 09:30 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 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 Stationary 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 H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Boons Park Address Toys Hill Road Toys Hill Edenbridge Kent TN8 6NP 01732 700202 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Kenward Trust Mr Allen Belton CRH Care Home 20 Category(ies) of Alcohol depend past/present (20) registration, with number Drug dependence past/present (20) of places Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents with drug and/or alcohol dependency problems may also have a mental health difficulty 2. Total number of bedspaces must not exceed 20 Date of last inspection 17 December 2004 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. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by one inspector who was in the home from 9.30 a.m. to 1.30 p.m. during which time 7 service users, 2 members of staff and a Director of the Trust were spoken to. A number of records were examined. What the service does well: What has improved since the last inspection? What they could do better: Staff must have access to up to date information about service users needs or risks which could affect their welfare. There must be enough staff on duty to ensure that service users are provided with access to recreational activities and staff support. Complaints must be handled and recorded in such a way that service users are confident that their concerns are listened to and will be dealt with appropriately. Staff must be provided with adequate training for the tasks which they perform or to a level which protects service users. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) 2 Service users arriving at the home for the first time are potentially put at risk by the lack of pre admission information. EVIDENCE: Admission and assessment procedures were discussed and records were examined. Not all individual files contained pre admission assessment information and a new service user was due to arrive on the day of the inspection about whom none of the staff on duty had any information and no documentation could be found. The registered manager was on leave and one of the Directors of the Trust arrived during the morning to cover the home. Whilst he was aware of the new admission he did not have access to any pre admission needs assessment to brief staff about the incoming service user. No evidence could be found that a care management assessment had been obtained from any referring agency upon which to base the individual care plan. The service user would therefore have to go over ground already covered to provide necessary information rather than being welcomed by staff who understand his background and important information such as health care needs may be overlooked. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) 6,7&9 Service users benefit from excellent support within the therapeutic programme however their care and support outside this context is compromised by the lack of information available to staff. EVIDENCE: Service users spoken to praised staff, particularly staff involved in counselling and group work. Criticisms were about low staffing levels and feeling let down and anxious when counselling sessions were cancelled or staff were not available at other times. There were 9 service users accommodated in the home at the time of the inspection. Only 1 care plan had been completed in individual files. Staff other than counselling staff who were spoken to did not use a care plan as a basis for their practice, they completed activity sheets on a weekly basis which did not relate to any care plan, this fails to promote consistency of care for service users. Risk assessments were not being used by staff as part of their day to day guidance and they were not being updated when incidents or accidents occurred. Two recent accidents had not resulted in risk assessments being carried out or recorded therefore staff did not have specific guidance to minimise risk of harm to service users in those areas in the future. The format Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 10 used for risk assessments is completed following admission and those seen had not been reviewed or updated. Discussion took place with staff and management about the reason for care plans, risk assessments and day to day recording processes. There is a need to ensure that systems used generate and maintain a cohesive working document for each service user which reflects their changing needs and provides staff with up to date guidance to enable them to provide ongoing and consistent support, not only within, but also outside of counselling and group sessions where the greatest amount of service users’ time is spent. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15,16&17 Life in the home provides a variety of opportunities, rights are respected and choices are available. Boredom for service users becomes a problem when staffing levels are too low. EVIDENCE: Service users spoken to were critical of opportunities available to them during leisure time and said that their biggest problem was boredom. The bank holiday weekend before the inspection had been particularly difficult with no planned activities to engage service users. Transport is available at set times to enable service users to pursue activities 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; attendance is facilitated at the local drop in centre and other local groups, libraries and the leisure centre. There is a notice board providing information about local events. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 12 Some entertainment is available in the home including a snooker room, small gym, darts and table tennis, service users commented that some equipment needed repair. Whilst the inspector takes note of the fact that some of the complaints reflect the particular needs and difficulties experienced by service users in this category rather than any failure on the part of the service provider, inadequate staffing levels validate some of their criticisms. 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. Service users 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. Service users were happy with the food provided and are offered some 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 has eaten with service users at previous inspections and was impressed by the quality of the food provided. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) 20 The home has made great improvements in relation to medication administration however lack of training could compromise the safety of service users in this area. EVIDENCE: Service users safety has been improved in that medication is now stored, administered and recorded in line with relevant guidance. However not all staff who administer medication have received accredited training in medication. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) 22 Failure to implement consistent and effective procedures for handling complaints has led to service users feeling that they are not always listened to. EVIDENCE: Discussion with service users revealed a number of areas where service users felt that their complaints had not been addressed; an example where this view was borne out was the leaking roof in the workshop. No record could be found of this complaint although staff agreed that the issue had been raised as long ago as 6 weeks. No action has been taken as yet to resolve the problem. There is an opportunity to raise complaints at a monthly residents forum which is minuted. However recording processes are somewhat muddled and evidence could not be found of investigation or feedback to service users where concerns had been expressed. The complaints book had not been used since 2003. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 standard(s) The environment was not inspected at this visit and no judgement has therefore been made. EVIDENCE: Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 The safety of service users is compromised by the continued failure to comply with some statutory training requirements. EVIDENCE: It was encouraging to talk with a member of staff whose life story evidenced the success of the work of the Trust. Employing staff who have first hand experience of the challenges facing service users makes a positive contribution to meeting their individual and collective needs. It remains difficult to make an accurate judgement about staff training and development as records continue to be stored centrally rather than at the home. Discussion with staff indicated that there were some gaps in training, specifically in relation to statutory training. Staff on duty during the inspection did not hold up to date basic food hygiene certificates or first aid certificates. Training in moving and handling had not been provided, the Director was reminded that statutory training must be provided, this issue was outstanding from the previous 2 inspections. However following the inspection evidence was provided that service user’s safety is being protected in relation to fire and food hygiene by providing competence-based training through a qualified instructor. Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected at this visit therefore no judgement has been made. EVIDENCE: Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 2 x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 1 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Boons Park Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 19 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 2 Regulation 14& Schedule 3 15& Schedule 3 13(4)( c ) Requirement Staff should have access to individual pre admission assessments of needs prior to admission Individual care plans must be drawn up for each service user which are kept under review unecessary risks to the health and safety of service users must be identified and eliminated within the context of an effective risk management system to include up to date individua and environmental risk assessments. Adequte numbers of staff should be available to ensure that suitable activities are available for recreation during leaisure periods. Staff who administer medication should be provided with accredited training Complaints should be handled in 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. Timescale for action By 30/06/05 By 30/06/05 By 30/06/05 2. 3. 6 9 4. 14 16(2)(n)& 18(1) By 30/06/05 5. 6. 20 22 18(1)( c ) 22 By 30/06/05 By 30/06/05 Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 20 7. 35 1 8(1)( c ) & Schedule 4.6 Records in relation to the Action plan qualifications and experience of By staff should be available in the 30/06/05 care home and all staff should be qualified to an adequate level in basic food hygeine, first aid, moving and handling, fire safety, health and safety and infection control. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Boons Park H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection The Oast, Hermitage Court Hermitage Lane Maidstone Kent 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 H56-H06 S23865 Boons Park V225146 050505 Stage 4.doc Version 1.30 Page 22 - 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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