Inspection on 16/11/05 for Kenton House Nursing Home

This inspection was carried out on 16th November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kenton House Nursing Home 17/08/06

Kenton House Nursing Home 13/07/05

Kenton House Nursing Home 26/01/05

Kenton House Nursing Home 28/09/04

Kenton House Nursing Home 24/03/04

Kenton House Nursing Home 08/07/03

Kenton House Nursing Home 04/03/03

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

CARE HOME ADULTS 18-65 Kenton House Nursing Home Beech Hill Headley Down Hampshire GU35 8NL Lead Inspector Tracey Box Unannounced Inspection 16th November 2005 10:00 Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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 Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kenton House Nursing Home Address Beech Hill Headley Down Hampshire GU35 8NL 01428 713634 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) Robinia Care Limited Mr Jowat Matiyenga Care Home 23 Category(ies) of Learning disability (23) registration, with number of places Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users must be at least 18 years of age. Date of last inspection 13th July 2005 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, a national company own Kenton, along with a number of care homes within Hampshire and other local authorities. 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, craft, cookery and a sensory room. The home has a hydrothapy pool. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over five and a half hours. The people living at Kenton House prefer to be referred to as service users, therefore will be referred as this throughout the report. Twenty one service users live at Kenton. The inspector witnessed good interacting between the majority of service users and staff who were participating in activities that service users seemed to enjoy, which included watching television, listening to music and spending one to one time with staff sitting close by. The inspector looked at records and asked staff for their views of working in the home. The manager showed the inspector the layout within and surrounding the home, which appeared clean and comfortable, providing a pleasant environment for the service users. What the service does well: What has improved since the last inspection? Individual’s bedroom keys are stored in a lockable cupboard, the senior person on duty has access to the cupboard, risk assessments are in place to support this practice. Service users benefit from the home ensuring a dedicated driver maintains their educational and recreational activities, this also ensures staff levels remain adequate within the home. The entrance hall has been redecorated, and the manager has requested the carpet in the entrance hall and the stairs be replaced. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 6 The inspector received verbal confirmation from the manager that Robinia Care Ltd have stopped claiming each Service users’ Disability Living Allowance (D.L.A.) to cover the cost of transport, this came into effect at the end of July 2005. 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 DS0000012131.V261973.R01.S.doc Version 5.0 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 Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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): 2 A comprehensive procedure for assessing the needs and aspirations of potential new service users is in place to ensure the service users and the homes needs are met prior to admission. EVIDENCE: The inspector looked at five service users files which included pre placement assessment forms which were completed by the service users’ family/representative, the service users social worker and the home’s manager. The information included educational and recreational wishes, likes and dislikes, profile of general appearance, medical and social history and comprehensive risk assessments for all activities. Service users are supported by family/representatives in the completing the assessment, this ensures as much information as possible is included in completing a full assessment. The manager explained that prospective service users are invited to spend a day at the home with their own care staff, if that is successful, the service user is invited to spend a night at Kenton House. The next stage of the assessment process involves the service user, their relatives and social worker meeting with the manager of Kenton House where they all discuss the assessment, and whether or not the service user wishes to live at Kenton, if the home is able to meet their needs. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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): 7 The systems for service user consultation are good with a variety of evidence that indicates that service users views are both sought and acted upon, which enables service users to make decisions. EVIDENCE: 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, arrange regular review meetings, form positive relationships with families, friends and outside agencies. One member of staff confirmed staff use a variety of ways to enable service users to make choices, for example, when choosing which clothes to wear, the staff member will arranging the options in front of the service user and prompt the service user to look and point to their choice. The same system is used when choosing to redecorate/ refurbish of areas within the home and where to go on holiday. One member of staff said the care plans are reviewed almost daily, any changes are discussed with the service user and agreed before any action is taken, signed documentation showed this practice occurred. Care plans and risk assessments are also reviewed at the service users six month review, where relatives/representatives, day placement representative Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 10 and social workers are invited if the service user wishes, the inspector saw five service users files which included detailed minutes from the reviews which included names of people who attended and what was discussed. Each service user has a timetable of daily activities, which is devised and agreed with them at their review. The home operates a keyworker system, which means each service user has a named member of staff who has specific responsibilities for the service user. A member of staff said “ I often spend one to one time with the resident I am keyworker to, we may spend time doing an activity, this promotes a relaxed atmosphere so that the service user feels able to communicate their wishes and we get to know one another.” The inspector saw staff communicate with service users in their preferred manner, as stated in their care plan. The manager explained “service users communicate in many different ways, usually a facial expression or body language informs us of whether or not the individual is happy or agrees with the outcome!” Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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): 12,15,17 Service users participate in activities appropriate to their age, peer group and cultural beliefs, promoting appropriate personal, family and sexual relationships. Dietary needs of service users are well catered for with a balance and varied selection of food available that meets individual’s dietary requirements and choices. EVIDENCE: The manager explained to the inspector that Service users are encouraged, in line with their care plan and risk assessments, to participate in social activities, both within the home and the community. Records of activities are recorded in the individuals care plan and daily records, these include daily activities such as physiotherapy, art, games, awareness of the world by looking at stories in newspapers/magazines, listening to stories on audio tape, cooking and nutrition, as well as visits to the cinema and shopping. The home employ an ‘activities coordinator’ who confirmed the activities are appropriate to the service users preferences. Staff record on a daily basis what each service user has participated in and whether or not the service user enjoyed or benefited from it, this information Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 12 then feeds into the service users review where a timetable of activities is discussed and devised. Care plans reflect the individuals cultural beliefs and individuals sexual preferences, the manager explained at present service users do not wish to partake in relationships, other than friendships outside the home. Should the need arise, service users would be fully supported and staff would follow the homes policy on personal and sexual relationships. The manager is aware of how to obtain support should it be required for any service user. The inspector witnessed the visitors book that detailed family and friends visits to the home. Staff reported there are no restrictions on visiting, unless stated in an individuals care plan. One service user has an advocate visit him at Kenton when he wishes. The inspector spoke with the chief as he was preparing the lunch in the kitchen, he used fresh ingredients including herbs, he said “ I add fresh herbs to enhance the flavours of the foods, as the majority of service users food is served liquidised to meet their dietary needs.” The inspector saw the stock areas and fridges were well stocked with fresh produce, the menu displayed a variety of nutritious meals, one of which is always vegetarian, as this is the preference of some service users. The inspector saw a record of individua’ls food intake, the chief said this helps him devise the menus according to popularity and waste. The results from the survey showed service users were very satisfied with the meals and the fact that they prefer eating in the dining rooms. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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): 19 Comprehensive procedures ensure service user’s physical and emotional health needs are met. EVIDENCE: 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. The inspector sampled five care plans, all included pre assessment paperwork, which included guidance of how to meet the individual’s physical and emotional health needs, and most recent visits to healthcare professionals this information was used to compile to individuals care plans and risk assessments. The home employ an physiotherapist who works with service users as per their care plans. The manager confirmed staff receive a variety of training to support service users, including, communication, awareness of disabilities, bereavement counselling and care planning. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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): 23 The home has satisfactory procedures for protecting service users’ form abuse. EVIDENCE: Staff follow comprehensive care plans and risk assessments for some service users who self harm, the inspector found the records to be eligible and complete, four staff confirmed the details in the care plan and risk assessments enable them to carry our their role effectively. Records show staff receive regular training regarding Strategy for Crisis Intervention and Prevention (S.C.I.P.) The manager confirmed he is not an appointee for any service user, the home safeguard service users ‘pocket’ money, the inspector checked three service users money along with the homes records, and found the amount stated on the record was the amount of money held. The manager confirmed he completes monthly audits of service users money to ensure all entries and withdraws are correct. The inspector saw the homes adult protection procedure, which includes the Department of Health “No Secrets” guidelines. The homes also have copies of Hampshire and Harrow’s guidelines for the Protection Of Vulnerable Adults. The inspector saw staff training records, which indicated training had been provided. Awareness of abuse and the correct procedures to follow is covered in the induction process of new staff. Staff confirmed they discuss issues surrounding abuse policy and procedures at their monthly staff meetings with their line manager supervisions, and confirmed their awareness of the procedure and where to find it should it be required. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 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 home presents as clean, hygienic and comfortable providing a pleasant, safe, homely environment for service users to live in. EVIDENCE: The home was clean, warm and no offensive odours were detected. Staff were observed cleaning, using appropriate protective clothing and products which were stored safely when not in use. Staffs said they have completed infection control training, and were aware of the home’s policies and procedures of hygiene issues. The inspector saw records of staff training and the chief confirmed he was up to date with food hygiene training. The home’s radiators and pipe work are safe ensuring that all potential hot surfaces are kept to low temperature. The garden appeared well maintained and is accessible to service users. A random selection of bedrooms were seen as the inspector toured the home and found them clean, bright and warm, furnished to the individuals taste and personalised. Some bedrooms had special adaptations to ensure the safety of the service user, risk assessments and care plans confirmed this. Other bedrooms were brightly decorated and had posters and the service users photographs on the walls, and other personal effects. The manager explained Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 16 service users are encouraged to furnish the room with personal belongings, furniture and pictures to make it feel like home. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 17 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): 32,34 Service users needs are met by staff who are well trained and supportive, however the manager must ensure there are sufficient numbers at all times. The home operates robust recruitment, induction, training and development procedures to ensure that ensure service user’s are not put at risk. EVIDENCE: During the morning of the inspection four staff were attending training from 09.30 until 12.30, cover for their absence was not arranged, reducing the staff numbers by half. All twenty three service users were at the home being supported by the remaining staff, two of which were trained nurses. Two service users were receiving one to one support as per their care plan and contractual agreement from social services. Four staff confirmed this is usual practice if attending training whilst rota’d to work, no cover is arranged, therefore the manager is required to ensure appropriate staffing levels remain at all times to ensure the health and welfare of service users is safeguarded. Six staff confirmed that “usually there are adequate staff on duty during the day, however during the evenings and nights we spend a lot of time cleaning and ironing, if the manager employed a domestic staff, that would help.” The manager confirmed the home is almost fully staffed, and listened to my feedback of the staffs concerns. The manager will research the possibilities of employing a member of staff to complete domestic chores in the evenings. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 18 The inspector sampled four staff files, which confirmed staff receive regular mandatory training, and specific training to meet individuals needs, such as Disability awareness, epilepsy, communication and SCIP, two staff confirmed the specific training has helped them to support individuals as they have learnt about the various syndromes and how best to manage certain situations and how to minimise situations occurring. Six staff confirmed they receive adequate training, and ample opportunity to participate in more. The staff confirmed they feel supported by their manager and benefit from regular supervisions and staff meetings, the inspector saw records which show staff receive regular supervisions, annual appraisals and various staff meetings that are minuted. The staff spoken with felt that the recruitment process within the home is very thorough. The inspector was able to sample four different staff records and found that they were detailed with the necessary checks taken to ensure staff are fit to work at the home. The manager confirmed that the home’s induction programme has been assessed against the Skills for Care Council induction standards. One member of staff told the inspector “This is my first job in the care sector, I feel that the training I have done so far has given me the skills I need to support service users who live here, some of the staff are working towards their National Vocational qualification level 2 and 3. 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, I don’t have to wait until a meeting or my supervision.” Staff explained “we work well together as a team, during staff meetings we talk openly and share ideas and support one another, this helps us meet the needs of all service users.” Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 19 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): 39 The systems for service users consultation are good, with some evidence that indicates service users views underpin all self monitoring, review and development by the home. EVIDENCE: Robinia have a service users forum, two service users from Kenton will attend a monthly meeting as representatives of the home to discuss various issues with other service users who live in homes owned by Robinia South. The home arranges an annual open day for families, social workers and anyone else service users want to invite, giving people the opportunity to visit the home and see how it is run. The inspector receives monthly reports as required under Regulation 26 of the National Minimum Standards (NMS). The manager showed the inspector the results from a satisfaction survey, which the provider distributes to service users, their families/representatives, social workers and staff on an annual basis. The majority of respondents were satisfied with the service Kenton provides, however the actual format of the questionnaire was not suitable for service users to complete without total support from family or staff. Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 20 Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 21 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 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kenton House Nursing Home Score X 3 X x Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000012131.V261973.R01.S.doc Version 5.0 Page 22 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 YA32 Regulation 18 (1)(a) Requirement The manager must ensure appropriate staffing levels remain within the home when staff attend training to ensure the health and welfare of service users is safeguarded. Timescale for action 21/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kenton House Nursing Home DS0000012131.V261973.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Hampshire Office 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 DS0000012131.V261973.R01.S.doc Version 5.0 Page 24 - 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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