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Inspection on 13/07/05 for Kenton House Nursing Home

Also see our care home review for Kenton House Nursing Home for more information

This inspection was carried out on 13th July 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The majority of the environment within and surrounding the home was good, providing the service users with an attractive and homely place to live, bedrooms and communal areas were brightly decorated and furnished. The arrangements for the induction of staff are good with staff demonstrating a clear understanding of their roles.

What has improved since the last inspection?

The home ensures that there are adequately trained staff in sufficient numbers to meet the service users needs at all times. Fire doors have been fitted with devices to ensure the health and safety of service users, staff and visitors. Prescribed medication is only administered to named service users. The manager confirmed that activities outside the home had improved, for example trips to the shops, pubs, theatres and country parks now take place. The manager informed the inspector the reason for a wash hand basin not being installed into a bedroom was the risk of injury to the service user or staff is too high.

What the care home could do better:

Individuals bedroom keys were hung up high outside the individuals bedrooms, this is poor practice and alternative arrangements must be made. The service users would benefit from a "user friendly" service users guide. Service users would benefit from the home ensuring dedicated drivers maintain educational and recreational activities, this will enable service users to access activities of their choice whilst ensuring staff levels remain adequate within the home. Decoration of the entrance hall would considerably improve one`s first impressions of the home, at the moment it does not reflect an accurate impression of the remaining areas within the home.

CARE HOME ADULTS 18-65 Kenton House Nursing Home Beech Hill Headley Down Hampshire GU35 8NL Lead Inspector Tracey Box Unannounced 13/07/05 9:30am 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. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Kenton House Nursing Home Address Beech Hill, Headley Down, Hampshire, GU35 8NL 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) 01428 713634 Robinia Care Limited Mr J Matiyenga CRH 23 Category(ies) of LD - 23 registration, with number of places Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users must be at least 18 years of age Date of last inspection 26.01.05 Brief Description of the Service: Kenton House is a care home providing nursing care and accommodation for twenty three younger adults who have physical and learning disabilities. Robinia Care Ltd owns the service ( along with a number of care homes within Hampshire). Mr Jowat Matiyenga is the registered home manager. The home is situated in a rural residential area on the outskirts of Headley Down, and comprises of five single and nine double bedrooms, four longe/dining room areas, adequate bathrooms and well tendered gardens with easy access for wheelchair users. The living/communial areas are spread over two floors, staff facilities occupy the third floor, a passenger lift and staircase to allow access to the second floor, a further staircase leads to the third floor. The home provides day service facilities for physiotherapy, horticulure, music therapy a sensory room and cookery, the a craft room was being re decorated. The home has a hydrothapy pool. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over four and a half hours. Jowat Matiyenga, the manager, supported the inspector. Twenty two people live at Kenton House and prefer to be referred to as Service users. The inspector witnessed good interacting between service users and staff who were participating in activities that service users seemed to enjoy, including listening to dance music and staff spending one to one time sitting close by. The manager showed the inspector the layout within and surrounding the home. The inspector looked at records and asked staff for their views. What the service does well: What has improved since the last inspection? The home ensures that there are adequately trained staff in sufficient numbers to meet the service users needs at all times. Fire doors have been fitted with devices to ensure the health and safety of service users, staff and visitors. Prescribed medication is only administered to named service users. The manager confirmed that activities outside the home had improved, for example trips to the shops, pubs, theatres and country parks now take place. The manager informed the inspector the reason for a wash hand basin not being installed into a bedroom was the risk of injury to the service user or staff is too high. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 6 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. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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 Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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) This standard was not assessed on this occasion. EVIDENCE: This standard was not assessed on this occasion. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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) 6,9 Comprehensive care plans and risk assessments are in place for all service users, however the manager must ensure they are reviewed regularly, with service users involvement. EVIDENCE: The care plans and risk assessments state the individual’s assessed needs however, this must be reviewed on a regular basis or as needs change to reflect these changes. The inspector was assured this practice would improve. One relative said “The home used to hold care planning review meetings twice a year, this practice has not continued.” The manager must ensure service users benefit from this opportunity to meet with all parties concerned with their welfare. The manager informed the inspector the reason for a wash hand basin not being installed into a bedroom was the risk of injury to the service user or staff is too high, a risk assessment was carried out and was seen by the inspector. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 10 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) 13,16 Links with the local community are limited. Contact with family, friends and representatives is apparent and encouraged. Some practices within the home demonstrate that individual choices are promoted. Service users would benefit from formal procedures being implemented to encourage service users to have control over their lives. EVIDENCE: The home owns three vehicles, however a driver is not always available, thus reducing service users educational and recreational opportunities. One relative requested on their comment card that the inspector contact them, they informed the inspector of “Lack of funding has resulted in a reduction in day activities for my son, it is not the homes fault but a driver is not always available, especially at weekends to enable social activities to take place with sufficient staff support.” The inspector witnessed the visitors book which detailed family and friends visits to the home. Staff reported there are no restrictions on visiting, unless stated in an individuals care plan. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 11 The inspector witnessed individuals bedroom keys hanging up high on a hook outside the bedroom door, the manager stated the service users do not use their keys, the inspector required all keys to be removed to reduce the risk of service users being locked in their bedrooms, as they will not be able to get out. All service users must be informed of this. The manager confirmed keys would be removed and stored in an appropriate place by the senior staff on duty. The inspector witnessed positive interaction between service users and staff, this was also stated on one relatives feedback comment card received by the inspector. The manager explained two service users (who represent the home) attend a “service user forum” which is held at “The Grove” day centre, the manager is working with the service users to devise a productive line of communication between service users within the home. The inspector received one comment card which indicated that the service user “Wish to be more involved in decision making within the home.” Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 12 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) 18,20. Service users receive personal support in the way they prefer and require and are protected by the homes policies and procedures for dealing with medicines. EVIDENCE: The care plans and risk assessments states how the individual wishes to receive their personal support, however, they must be reviewed on a regular basis or as needs change. The inspector was assured this practice would improve. One service user comment card indicated that the service user agreed that they were well cared for by staff that treated them well and respected their dignity. Daily records comment on individuals daily activities, physical and emotional health and behaviour, records of visits to outside agencies, such as doctor, dentist, optician are kept on the individuals file, this enables the home to monitor and track the information recorded. Staff administers all service users medication using a monitoring dosage system, staff informed the inspector all service users prefer staff to store and administer their medication. The inspector saw the homes comprehensive policy and procedure, and a record of all staff trained to administer medication. The care plans included risk assessments for medication. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 13 Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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. The home has a comprehensive complaints format suited to the individuals needs, however, procedures to ensure service users views are listened to and acted on could be improved. EVIDENCE: The complaints procedure was displayed in the entrance hall, and was devised using pictures and words. One service sure comment card received by the inspector indicated that the service user was aware of whom to speak with if they wear unhappy. The inspector spoke with the manager and staff, who confirmed the way they ensure service users views are listened to is to communicate in the style and pace appropriate to the individual, spend one to one time with service users, and by forming positive relationships with families, friends and outside agencies. The home could improve this further by regularly formally reviewing the needs of the service user. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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) These standards were not assessed on this occasion. EVIDENCE: These standards were not assessed on this occasion. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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. Appropriately trained staff ensure individual and joint needs of service users are met. EVIDENCE: Throughout the inspection, staff listened to the service users, and responded appropriately to meet the individuals’ and joint needs. One service user appeared upset, a member of staff enabled the service user to go outside where she could see and hear the wind chimes hanging in the trees, the service user appeared calm and relaxed. In the afternoon service users seemed to enjoy an activity in the garden with the staff team. One member of staff who had recently started working at Kenton, stated they had completed induction training and Learning Disability Award Framework, which included training on, policies and procedures of the home, learning disability, physical disability, epilepsy, communication and adult protection. One staff member said “ I feel I have adequate training in order for me to carry out my job, I can just ask if I want training.” Staff files were sampled and certificates confirmed mandatory training had taken place. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 17 One member of staff said “I feel we have adequate staff on duty to meet the needs of the service user.” The manager confirmed staffing levels are adequate, the inspector saw the duty rota which also confirmed this. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 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 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) 42. The home promotes and protects the health and safety of the service users and staff. EVIDENCE: The home has risk assessments in place to ensure the health, safety and welfare of all living, working and visiting the home. The home has clear policies and procedures in place to enable staff to follow, the inspector asked one member of staff where the accident book was, they showed me. The inspector witnessed good food hygiene practices within the kitchen, appropriate clothing was worn, food was stored correctly at the correct temperature according to the temperature chart. Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 19 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 x x x x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 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 x 2 x x 2 x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kenton House Nursing Home Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 20 NO 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 6.10 Regulation 15 2 (b) Requirement The service user plan is reviewed with the service user involving others as agreed at the request of the service user, or at least every six months The provider supports service users to integrate into the community with staff support as required Bedroom keys must be removed from hanging up outside bedrooms to protect service users from potential abuse. Risk assessments must be completed for service users who do not have their own room key. All parts of the care home are kept reasonably decorated Timescale for action 13/8/05 2. 13.2 13.4 16 (2) (m) 13 (6) 13/8/05 3. 16.3 14/7/05 4. 19.9 23 2 (d) 13/9/05 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 Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.doc Version 1.30 Page 21 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Kenton House Nursing Home H54 S12131 Kenton Hse V231648 130705.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!