Inspection on 27/09/06 for Kendler House

This inspection was carried out on 27th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Kendler House 06/07/07

Kendler House 18/01/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Kendler House 57 Haddington Road Stoke Plymouth PL2 1RR Lead Inspector Tina Maddison Unannounced Inspection 27th September 2006 10:00 Kendler House DS0000061892.V300536.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 Kendler House DS0000061892.V300536.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. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Kendler House Address 57 Haddington Road Stoke Plymouth PL2 1RR 01752 550479 01752 265228 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) Small House Homes Limited Vacancy Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Aged 16 - 35 One Service Users named elsewhere with Emotional, Behavioural difficulties. 18th January 2006 Date of last inspection Brief Description of the Service: Kendler House is a terrace property that is situated in a residential area of Stoke in Plymouth. It is situated close to local amenities and bus routes. This home is owned by Small House Homes Ltd. Kendler House is registered for four people who have a learning disability. The home aims to teach the service users independent living skills with a view to the service users living on their own in the community. The house contains a fully self contained flat. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day. Prior to the inspection a pre inspection questionnaire was completed and returned by the Manager. Four service user survey forms were returned, and one relatives survey form. One survey form was sent to the local General practitioner but was not returned. Two survey forms were sent to Care Managers but were not returned. Two service users were spoken with during the inspection, one at length. Two members of staff were interviewed during the inspection. A tour of the building was undertaken and the bedrooms of two service users were seen with permission of the service users concerned. What the service does well: Kendler House staff and management provide a structured and supportive environment to the four young men living there. Independence is promoted in all areas to possibly enable the service users to live independently with some support in the future. The service users have complex emotional and behavioural needs and these are fully met in a skilled manner by staff at the home. Comments that were received from service users and their families included: “Excellent care is provided by trained and sympathetic people.” “The home has a nice feel about it”. “The home is absolutely perfect 100 ”. There was only positive feedback received from the service users who felt that sanctions when applied were explained to them and they felt that the use of these to help their behaviour was fair. Records and documents relating to the care of the service users were found to be regularly reviewed and updated. They were informative and comprehensive. Health and safety issues are a priority in the home and risk assessments are in place for all activities inside and outside of the home. A new Manager, Daniel Welch, has recently moved to the home from another in the group and this transition appears to have been successful and has not caused disruption to the service users or staff. Service users gave positive feedback about staff, and it was evident that there are good relationships between them. Any incidents concerning the service users are well managed and documented. Staff are well trained and feel supported by the organisation and Manager. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kendler House DS0000061892.V300536.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 Kendler House DS0000061892.V300536.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): 1,2,3,4. Quality in this outcome area is good because service users can be assured that Kendler House will meet their assessed care needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Kendler House has a statement of purpose and service users guide that is offered to service users. These documents are comprehensive and informative. Some updating is needed to reflect the recent change of manager. The most recent admission was twelve months ago and there have not been any new service users admitted to the home since the previous inspection. All service users had pre admission assessments undertaken by the Manager prior to admission, and these documents evidenced consultation with the service user, families of the service users and involved health and social care professionals. These pre admission assessment documents are produced by Small House Homes to facilitiate the pre admission assessments. The Manager stated that care is taken with any new service user to the home to ensure that the prospective service user will be compatible with the existing service users who live at the home. Service users are offered a visit to the home and are able to stay for a trial overnight stay or visit for a meal prior to admission. Kendler House DS0000061892.V300536.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): 6,7,8,9. Quality in this outcome area is good because service users are enabled with support from staff at Kendler to be as independent as possible with daily living tasks. Risks and choices are appropriately balanced at kindler. This judgment has been made using available evidence including a visit to the service. EVIDENCE: Each service user had an individual placement plan. These plans contained details of all the assessed care needs of the individual and how these would be met at Kendler House. Some of the service users at kindler House at times display behaviour that challenges the service. Strategies were found to be in place in the placement plans to enable staff to manage these behaviours. There are contracts that are signed and agreed by the service users regarding acceptable behaviour and clearly explain house rules and boundaries and the reasons for these. It was clear from examination of placement plans and from observations made during the inspection that staff respect the service users right to make decisions, and provide information, assistance and the communication support that they need to make informed decisions and positive choices about their lives. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 10 It was observed during the inspection that staff worked with the service users in a respectful and enabling manner, and sought their opinions regarding daily living tasks. Restrictions on freedom are detailed in the placement plan, and are documented as agreed by Care Managers, as are use of sanctions all of which were found to be appropriate to encourage positive choices from the service users. Staff were made aware in the placement plans to remain consistent when working with the service users, as for people who have autism this is very important. The Manager and staff are aware of equality and diversity issues, and are currently working with one of the service users regarding his negative views towards Asian women. Observation of these strategies confirmed them to be effective. All placement plans contain goals set and are regularly reviewed to monitor progress towards these. It is hoped that most of the young men at kindler will go on to live in a supported living arrangement in the future, and goals are made to help them achieve this aim. Service users are encouraged to manage their own finances with support from staff. Service users spoken with during the inspection said that they thought the staff helped them make positive choices and encouraged them to be as independent as possible. Service users are encouraged to take part in household chores and undertake the cleaning of their own rooms, and do their own laundry. Minutes evidenced that Service user meetings are regularly held. Risk assessments were found to be in place for all activities outside of the home and were comprehensive and informative. Risks and individual choices were found to be appropriately balanced. Kendler House DS0000061892.V300536.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): 11,12,12,14,15,16,17. Quality in this outcome area is good because service users are encouraged to be as independent as possible and participate in all aspects of life at Kendler House. This judgment has been made using available evidence including a visit to the service. EVIDENCE: All the service users living at Kendler House have the opportunity to use the school/College that is run by Small House Homes. Here they can learn independent living skills and work is undertaken with them regarding appropriate behaviours. Other activities available include visits to the city centre, bowling and cinema. Service users spoken with commented that they thought the range of activities available was good and they enjoyed these. All service users enjoyed individual holidays this year in accordance with their interests and wishes. One service user said he went on a fishing holiday that he really enjoyed. All activities are risk assessed and documented as to how staff will manage the activity safely. A weekly activity planner is displayed for each service user so they know what is planned for the week ahead. Family relationships are encouraged, and it was seen in records that service users are enabled to visit their families, and send cards and letters. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 12 Service users are able to have a key to their bedroom if this is appropriate. It is agreed with the service users that they do not have access to the staff office, and this is understood and respected by the service users. The service users are encouraged to eat healthily which sometimes staff commented is a struggle, as the service users do enjoy their takeaway meals! The service users are encouraged to plan, shop and prepare their meals. Meals taken are recorded individually. Kendler House DS0000061892.V300536.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): 18,19,20. Quality in this outcome area is good because service users’ physical and health care needs are met at Kendler House. This judgment has been made using available evidence including a visit to the service. EVIDENCE: The service users at Kendler House are mainly independent with their personal care and only require prompting to complete self care tasks such as shaving and showering. Service users confirmed that they are able to be as independent as they wish regarding personal care, and are able to make their own choices within reason and agreed structures regarding daily routines and their choice of clothes. Physical and emotional Health care needs had been documented, regularly reviewed and it was documented how individual health needs were to be met. There was recorded evidence that the service users have access to a General Practitioner, Dentist, optician and the learning disability services. Kendler House has a comprehensive policy and procedure regarding the ordering, storage and administration of medication. Staff spoken with were aware of these. Medication was found to be appropriately stored in the home. Records regarding the dispensing of medication were found to be correct. There were details of possible side effects for staff to read and all homely remedies are obtained on prescription. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 14 Medication training is provided to staff. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 15 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): 22,23 Quality in this outcome area is good because service users can be confident that their concerns and complaints will be listened to, taken seriously and acted upon. This judgment has been made using available evidence including a visit to the service. EVIDENCE: Kendler House has a clear and effective complaints procedure, and service users spoken with during the inspection said that they felt confident that they could complain if they needed to and that their complaint would be listened to and acted upon. Complaints and concerns were recorded and it was also recorded how these complaints and concerns were resolved. The Commission for Social Care Inspection has received no complaints regarding Kendler House in the last twelve months. The home has robust procedures in place to respond to any suspicion of abuse or neglect. Physical and verbal aggression from service users is clearly understood by staff. Physical interventions are only used as a last resort and are recorded. Staff are trained in physical interventions and non physical interventions. Any verbal or physical aggression is logged. Staff commented that in the event of verbal or physical aggression from the service users they use de escalation techniques and follow guidelines in the placement plan. Most staff had attended protection of vulnerable adults training, and child protection training. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 16 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): 24,25,26,27,28,30. Quality in this outcome area is adequate because Kendler House is conveniently located, generally well maintained, clean, warm and bedrooms are personalised. Some improvement to the décor would further improve the environment. This judgement has been made using available evidence including a visit to the service. EVIDENCE: A tour of the home was undertaken by the inspector, who was accompanied by a service user. Kendler House was found to be clean and warm on the day of the inspection. The service user said that he liked his room although he did not want the inspector to see it as he thought it was too untidy. He liked where the home is situated as it is near to shops, transport and leisure facilities. He said that sometimes he thinks that the house is too small when everyone gets stressy, but this did not happen very often. The house is an end terrace Victorian building that is spacious and generally well maintained. The house would benefit from the downstairs carpet being either thoroughly cleaned or renewed. The Manager said that there are plans for the home to be painted inside. There is a small courtyard area to the rear of the property that service users said they used in the summer. The house has a lounge and separate dining area. All bedrooms are single rooms and have access to their own bathrooms. One of the bedrooms is in a self Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 17 contained flat at the top of the house that has its own kitchen, lounge and bathroom and kitchen. The house would not be suitable for anyone with mobility difficulties due to the steep stairs. The laundry area was well organised and very clean. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 18 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): 31,32,33,34,35. The quality in this outcome area is good because care staff numbers on duty at all times meet the service users care needs, and there is a robust recruitment procedure that offers protection to the service users. The staff team are skilled, committed and caring. This judgment has been made using available evidence including a visit to the service. EVIDENCE: Kendler House was adequately staffed on the day of the inspection with enough staff on duty to meet the service users care needs. Staff confirmed that they had job descriptions and were clear about their roles and responsibilities and that of the other care workers. Staff were observed throughout the inspection to interact with the service users and each other in an informal and respectful manner. Staff records evidenced that there is an induction procedure for staff. The home has a recruitment procedure. The records of four members of staff were examined, and it was found that all had a copy of application forms, CRB check, medical references, proof of identification and a copy of terms and conditions of employment. One file did not contain two references or proof of a CRB check. The manager confirmed that these references had been applied for and chased, and a CRB check had been applied for. Until these were received and found to be satisfactory, then the member of staff was not working alone or unsupervised. From examination of records and discussion with staff it was evident that the company offers a good range of training opportunities, including health and Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 19 safety, NVQ training, breakaway techniques, medication administration and handling, food hygiene, and physical intervention. Supervision is offered on a regular basis, as confirmed by supervision notes. Staff said that they found the formal and informal supervision very helpful and supportive. New staff on their probation period are offered supervision once a fortnight. Staff rotas were available, and evidenced that there is 3-4 care staff plus a manager on duty on weekdays, and at weekends there are 5 care staff on duty as one service user is staffed on a 2:1 basis when outside of the home. Other service users are staffed on a 1:1 basis when outside of the home. At nights there are two waking night staff and one sleeper on duty. Staff spoken with said that they thought the staffing levels were appropriate to meet the service users care needs. Service users also commented that they thought there was always enough staff on duty. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 20 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): 37,38,39,42. Quality in this outcome area is good because Kendler House is managed by a skilled and competent Manager who has the respect and confidence of the staff team. The health, safety and welfare of residents are promoted and respected. This judgement has been made using available evidence including a visit to the service. EVIDENCE: There has been a change of Manager since the previous inspection, and the role is now being undertaken by Daniel Welch, who was previously the Registered Manager for three years at another home within the company. He is currently undertaking the registration process. Mr Welch has vast experience working successfully with service users who have a learning disability and behaviours that challenge services. Mr Welch holds the Registered managers award and is qualified to NVQ level 4 in care. A quality assurance system had been developed by the company. There was evidence that six monthly questionnaires regarding the care offered at the home had been sent to parents and families and also service user questionnaires. Service users confirmed that any concerns that they have are Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 21 acted upon. All questionnaires that had been returned contained positive remarks regarding the quality of care offered at the home. The Manager is aware of infection control issues, and the home now has a revised infection control policy, and precautions to deal with incontinence including a sluice, individual washing machines and tumble dryer. There is a procedure for dealing with soiled clothes and bed linen. All health and safety checks were found to be up to date. The company vehicles were appropriately serviced and insured. Temperature control thermostats were not in place on the hot water outlets but monthly temperature checks are undertaken. Windows above ground floor level have restricted openings. Fire prevention records evidenced that tests are regularly undertaken on appliances and fire drills had taken place recently. Risk assessments have been undertaken on all safe working topics. Accidents, injuries and physical interventions have been appropriately recorded. Notifiable incidents have been reported to the Commission for Social Care Inspection. Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 22 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 2 2 3 3 3 4 3 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 4 3 x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 3 x Kendler House DS0000061892.V300536.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard YA1 Good Practice Recommendations The homes statement of purpose and service users guide should be updated to reflect the change in management and the quality assurance system. The carpets on the ground floor of the home should be thoroughly cleaned or replaced. The home would benefit from being repainted inside. 2. 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