Inspection on 17/08/06 for Kenton House Nursing Home

This inspection was carried out on 17th August 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kenton House Nursing Home 16/11/05

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 Isolina Reilly Unannounced Inspection 17th August 2006 09:30 Kenton House Nursing Home DS0000012131.V305575.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 Kenton House Nursing Home DS0000012131.V305575.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. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 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.V305575.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 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 owns the service and employs Mr Jowat Matiyenga as the registered 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 lounge and dining room areas, numerous accessible bathrooms and well tendered gardens with easy access for wheelchair users. The communal areas are spread over two floors and staff facilities occupy the third floor. There are two passenger lifts and staircases to allow access to the second floor, a further staircase leads to the third floor. The home provides day service facilities including physiotherapy, music therapy, a sensory room, a craft room, horticulture and cookery areas. The home has a hydrotherapy pool. The provider makes information available about the service, including a statement of purpose and service user guide and the commission’s report to prospective residents on request. Copies of these documents are available at the home and may be sent out by post on request. The manager confirmed by telephone on the 29th August 2006, fees vary between individuals from £836.69 to £1,594.44 per week and there are no additional charges. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place over one day. The inspector looked around the home, viewed records and procedures, spoke with residents, staff and observed the interaction between them. The nurse in charge helped the inspector during the visit. The inspector was able to feedback to the organisation area manager and the two nurses. Communication with the service users was untaken with their key workers. This was necessary due to the service users limited verbal communication. Information has also been taken from correspondence with the home and monthly reports on how the service is doing, sent in by the area manager. The area manager confirmed that the home has not received a pre-visit questionnaire to complete. What the service does well: The service users made it known that they liked their home, the staff help was there for them when they need it. The home has a good system for assessing if it can meet the needs of service users before they come to the home. This includes medical and personal care needs. There are very good records in place that help staff to look after the service users as they wish to be looked after. The staff are caring, respectful and are mindful of peoples need for privacy and dignity. They encourage individuality and independence within the limits dictated by the service users needs. The staff support individuals to make decisions about their lives and service users are fully involved in planning their lives and care. There is an excellent attitude towards service users personal development expressing their own opinions and participating in activities as well as accessing the local community. The meals are good and take into account individuals likes and dislikes. The home has an open and good process in place for dealing with complaints, concerns and compliments. The staff team at the home is skilled and receive regular training to help them care for the residents. The home has a logical and detailed process for recruiting new staff. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 6 There are good systems in place for making sure that the service is run in a safe manor for residents. The residents indicated that they feel safe and comfortable at the home and their opinions are sought. The organisation has a good system in place for monitoring the quality of the service being delivered at the home. 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. Kenton House Nursing Home DS0000012131.V305575.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 Kenton House Nursing Home DS0000012131.V305575.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a good admission process that is well managed and prospective service users’ individual aspirations and needs are assessed. EVIDENCE: The service users indicated that they had been made welcome when they first came to live at the home and staff confirmed there is a very detailed and varied programme of visits before a potential service user decides to move into the home. The home last admitted a service use in 2003. The inspector tracked four service users’ records and each file contained a detailed assessment. The records showed individual aspirations, health and personal care needs, potential restrictions, choice, freedom, information on family and friends, their cultural and faith needs, physical and mental health care, treatments and methods of communication. Written assessments and relevant risk assessments on files were relevant and reflected care needs assessments completed by Adult Service’s care managers and health professionals including physiotherapy and occupational therapy assessments. The area manager explained that whilst the home is registered for twentythree service users it is planning to run at the current twenty. This is an Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 9 attempt to reduce the number of shares rooms on offer at the home providing much needed additional space for individual service users for the storing of their specialist equipment. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 10 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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has good systems in place that fully involves service users in decision-making, taking reasonable risks, assessing changing needs and meeting personal goals. EVIDENCE: The inspector observed one key worker working with the service user as he reviewed the individual’s care plan, using recognised body language and verbal prompts to ascertain the service user’s opinion. This was done in a respectful manor. The records seen for the four service users tracked were detailed, clear and relevant. The staff spoken with stated that the care plans have evolved over a period of time and they now found them a necessary tool that is easy to use when caring for individuals. Key information within the records was available in visual representations using symbols, pictures and colour. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 11 The care plans are reviewed monthly and amended as appropriate they involve the service user and this is recorded on the record. The home also holds formal six monthly detailed reviews with the service user where the relatives and carers along with health and social care professional are invited to contribute. There was evidence through out the day of relatives contacting the home to discuss care needs and other issues. The home has yet to implement Person Centred Plans (PCP) and the area manager stated that key staff are attending training run by the organisation on how to implement PCP. Two of the care plans detailed social and recreational time with their relatives and friends. Further records on social and recreational activities are held within the day care facility on site. These records were also detailed and reflected risk assessments and care instruction held on the main care plan. Physiotherapy, sensory and occupational therapy records are held separately and these are also reflected in the main care plan. Information had been up date across all records kept. The staff spoken with stated they assist service users to update their care plans are have a good knowledge of the individuals’ needs, aspirations and communication styles. One staff member said that the home was very flexible and providing an appropriate risk assessment and actions had been undertaken, recorded and followed the service users are able to follow their wishes. Risk assessment seen were informative and contained clear instruction to staff. They covered all aspects of support and personal care provided both in and outside the home. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 12 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, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is good at providing support for individuals to take part in age appropriate, peer and cultural activities with the home and access to the local community. They encourage appropriate personal, family and other relationships whilst respecting and empowering individuals rights and dignity. The service users enjoy varied balanced meals in a relaxed atmosphere. EVIDENCE: On the day of the visit, the inspector observed one service user enjoying their hydrotherapy session in the home’s pool and other service users enjoying music, arts and crafts. There are various facilities within the home and in the ground that include exercise and physiotherapy room, sensory room (white room) music room with a wide variety of musical instruments, art and craft room and chiropody room. The home has two dedicated staff that undertake activities and physiotherapy programmes working Monday to Friday. These staff are supported by visiting Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 13 physiotherapists and occupational therapist. There are a variety of activities both within the day centre facilities available on site and within the home itself. The activity support workers explained that they have themed activities and tie this in with day-to-day living at the home including meals and day centre activities. There are indoor and outside games, world and culture subjects, which are incorporated into art and craft sessions, outings, music and literature, and use of computers. The activities and therapy records were seen and found to be detailed and logged reactions of service user to the activity. The staff and area manager confirmed that several service users had been away on holiday some with family others within a small number of residents from the home. There was information on a variety of days out that service users had enjoyed. These included visits to Bird World, parks and theatres, Marwell Zoo, Bealieu Motor Museum, many shopping trips and pub lunches. The activity support workers and other staff confirmed that they had recently undertaken a large piece of work looking at individual service user’s clothing styles and likes and dislikes and had taken them shopping to choose their own clothes. It was observed that service users are relaxed when preparing and eating meals. The inspector observed service users being assisted with snacks, hot and cold drinks throughout the day. The staff and chef were aware of individuals’ preference regarding food. These include types and textures of food that were suitable for individuals. Three of the four care plans seen had a detailed up dated assessment for nutrition and speech therapy nutritional assessments. The home works on a four-week rota menu that is seasonal. The chef stated that meals are cooked from raw ingredients and vegetables and fruit was all bought in fresh. However, he felt there was a problem when it came to ordering different ingredients that were not on the organisation’s suppliers’ list. This he found frustrating when he is unable to make use of local fresh seasonal produce. This issue is known to the organisation and the area manager confirmed that they are trying to work out a solution. A copy of August’s menus were seen and found to be variable balanced and corresponded with individuals’ choices, likes and dislikes recorded in care plans. There were various health and safety procedures in place within the kitchen including colour co-ordinated chopping boards, cleaning rota, pro-biotic wipes for surfaces, gloves, temperature recording including probing of food, fridges and freezers. The cook confirmed Environmental Health Officer had visited in Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 14 recently. The report seen and the chef confirmed that cleaning identified had been undertaken. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 15 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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users’ health and personal care needs are being met ensuring are support is given in the way they prefer. The home medication practices, policies and procedures supports and protects service users. EVIDENCE: The inspector observed the service users respond positively to staff intervention and support. The service users able to respond indicated that they were comfortable with and liked their carer. Staff were observed being mindful of individuals’ privacy and dignity. Two service users indicated that they had chosen their own clothes and liked them. The staff confirmed that daily routines were flexible and were able to tell the inspector who liked to lie in and liked to stay up late. Personal and health care records on the four care plans tracked were detailed and included instructions on use of specialist equipment and relevant risk assessments are regularly reviewed. The level of independence was clearly documented and how to achieve individuality for the service user. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 16 Other therapies included in the care plans were occupational therapy, massage and reflexology. Regular assessments and exercises were recorded in the care plans from speech therapist. Other records seen included regular check ups at the doctors, consultants, opticians and dentist. The care plans and daily records at the day centre and within the home showed that service users’ lives and daily routines were varied, full and flexible. On the tour of the home it was noted that rooms had been personalised and personal effects including make up and other toiletries, which they had chosen for themselves. One of the service user indicated they enjoyed going shopping to buying their own new clothes. Staff and family support one service user to following their cultural and religious believes. Service users are supported to attend local churched and staff stated that the local church visits. Staff spoken with were aware of individuals’ preferences regarding religious preference. The staff and area manager confirmed that doctors visit the home and service users will attend out patient appointments. This was documented in the care plans seen. The area manager confirmed that service users have a choice of dentist but due to their special needs there is a visiting dentist, who has specialised in providing a dental service to physically disable people and many of the service users now use him. The staff were observed administering medication appropriately and there is a satisfactory medication policy and procedures. The home uses a blister pack system form the local pharmacist. The medicines were correctly stored in an appropriate cupboard that was clean and reasonably orderly in date and in sufficient quantities. There were no control medicines at the home on this visit. All residents need assistance with their medication. The records for receipt, disposal and administration were seen and found to be satisfactory. The home uses the ‘Medicine Administration Record Sheets (MARS) system for recording the administration of medication and medication received in the home. The carers and registered nurses spoken with stated they had received training in the safe handling of medicines and they regularly up date by completing a workbook and test. The area manager confirmed that she regularly assessed the staff when administering medication. Staff training records seen that confirmed this. An up to date copy of the British National Formulae (BNF) book was available in the office and another copy in the medicine trolley for reference purpose. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 17 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users, relatives and staff are confident that their complaints will be listened to, taken seriously and acted upon. Staff have a good understanding of Adult Protection issues that protects residents from potential abuse. EVIDENCE: The service users asked indicated that staff listened to their concerns. The staff spoken with confirmed this. The inspectors observed staff interacting with service users and dealing with their concerns and agitations. The staff were aware of the home’s complaint procedures and stated that they would support and encourage service users to have their say and voice their concerns. The home’s complaint procedure includes the various stages; the address for the Commission and complaints will be dealt within 28 days. An easy to read complaint procedure was available on the service users’ notice board and tapped audio and use of symbols versions were also available. The home has received three complaints since the last inspection these have been investigated by the home and resolved within the timescales. Appropriate records have been kept and the home’s logbook was seen. Complaints are monitored monthly by the organisation. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 18 The service users spoken with indicated that they felt safe at the home and the staff also confirmed this. The ten staff spoken with confirmed that they were aware of abuse and had received an initial instruction on induction about abuse but had not undertaken any formal training in abuse or protection of vulnerable adults. They were aware that any concerns should be reported immediately and stated that there was a clear and supportive ethos towards whistle blowing. The area manager confirmed that many of the staff were waiting to attend an abuse training. The home has been involved in one protection of vulnerable adults allegation. This has been appropriately reported to social services and the home has followed its procedure keeping appropriate records. The home has an up to date copy of the Hampshire County Council ‘Protection of Vulnerable Adults’ policy and procedure and it’s own policy and procedures reflecting the guidelines from Hampshire County council’s policy. There is a clear whistle blowing procedure and the home has encourages an open and fair ethos. The staff spoken with confirmed this. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home presents as a clean, homely, comfortable and suitable environment for the service users. The standard of the décor within the home is good with evidence of on-going maintenance. EVIDENCE: The senior nurse showed the inspector around the home, explaining that the staff involve service users in choosing the colour schemes in their own bedroom and in the communal areas. Since the last inspection, the home has been painted communal areas and corridors. The very large notice board in the hall way has been replaced and fitted at wheelchair user level. The service users spoken with indicated that they liked their bedrooms and the inspector observed that they had been personalised. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 20 There is a large mature garden and grounds surrounds the house accessible from various areas of the house. There are also several out building that house the day centre and other facilities. The home has maintenance on site and they are available to undertake repair and general maintenance as needed. Maintenance and repair logs were available on site. The staff spoken with felt there were sufficient toilets and bathrooms. The bathrooms and en suites consist of specialist equipment and hoists adapted to meet the needs of these clients. All communal bathrooms and toilets have liquid soap and disposable paper towels maintaining food infection control practices. The home has a supply of gloves and aprons that staff use when necessary. The staff confirmed that they have received training on infection control. There is easy access to the garden from the laundry room where there are industrial type washing machines and tumble dryers. There are various linen cupboards around the home and photos and colour co-ordinated information sheets to help staff in identifying which bed linen belongs in which room. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 21 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are supported by competent and qualified staff that undertake regular training. There are satisfactory recruitment procedures that ensure service users are not put at risk. However, staff numbers at certain times are reduced due to holiday, sickness and training. EVIDENCE: The inspector observed staff interacting with service user in a respectful manor. The staff were seen making themselves available, listening and interested in what the service users were doing and communicating. It was noted from the August and September 2006 staff duty rotas that there are normally two registered nurses on duty during the day and one on duty each night. There are eight carers on duty during the day and two carers awake and three sleeping each night. There are also individual one to one additional hours for named service users mainly at weekend and evening time. The home also employs people in the following roles; administration, activities co-ordinator and physiotherapist assistant, chef and kitchen assistant, laundry assistant, drivers, domestics and maintenance person. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 22 Staff spoken with felt that when all staff are available on each shift there are sufficient staff on duty to meet the needs of the service users. However, staff informed the inspector that there are times when staff on duty are taken away to complete training. The staff support very vulnerable service users who are not readily able to call for assistance and necessitate a staff team that is able to pre-empt their needs. The building is large and spread out over three large lounge diners during the daytime and four after 19:30 hours. Staff also informed the inspector that if staff are on holiday the home will not cover that persons shifts meaning that the care staff numbers are reduced. The area manager confirmed that this was routine practice and the registered nurses would undertake carers’ tasks when staff were not there as would the activities and physiotherapy assistant. However, this system does not allow for the nursing tasks that must be undertaken, or that service users would be left without their physiotherapy sessions and activities whilst the co-ordinator and physiotherapy assistant are undertaking carers’ tasks nor cover at the weekend, as these staff do not work during the weekend or evening. The area manager stated that this would be revisited in light of the frailty and vulnerability of the service users and the layout of the home. The area manager was surprised to hear that seven staff (four staff from one shift and three from another) undertaking National Vocational Qualifications course are leaving the floor to attending training from 09:30 to 12:30 hours once every fortnight. This is leaving the home very short of staff to meet all the service users needs and aspirations. However, the manager and nurses will fill in. The area manager stated that training sessions should have been split to minimise the impact. This was discussed with the area manager and senior registered nurse who agreed that the service user needs must come first and the home has responsibility to provide adequate cover, whilst staff are undertaking training. The area manager stated that staffing levels would be addressed as a matter of urgency, however, this requirements still remains. The staff spoken with stated that they received regular training and had a good knowledge of each individual. The area manager and registered nurse explained that all new staff complete an organisation induction on starting work at the home that meets the Skills for Care Council minimum standards for induction. This induction last for up to six weeks and is recorded in a workbook that is signed by the manager and staff member. The staff spoken with confirmed this. All the staff have completed the Learning Disability Awareness Framework (LDAF) induction and foundation course. Five staff hold or are in the process of obtaining a National Vocational Qualification in care level 2 and a further in level 3. Staff files seen on this visit confirmed this and the home has achieved 50 of its carers with a qualification in care. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 23 Four staff files seen held the necessary documentation including two satisfactory written references, identification, criminal record bureau and protection of vulnerable adult list checks prior to starting work. The staff and area manager confirmed that each staff member had their own copy of the General Social Care Council’s Code of Practice. Signed contracts of employment including terms and conditions were seen on the file. The home regularly checks the registered nurses identification number and registration with the nursing and midwifery council. However, the nurses and area manager confirmed that the organisation does not support them to maintain their registration. The organisation has an excellent ethos of carer support, personal development and training. However, this ethos does not extend to the registered nurses who have to undertake professional up date training in their own time and fund the courses themselves. The nurses are able to participate in carer training session but these are basic and may not cover clinical areas of expertise that requires up dating. The staff explained to the inspector the various training and learning they had recently undertaken these included epilepsy, makaton, specific hazards of oxygen, hydrotherapy, autism, communication level one and two, care planning, record keeping, personal care and values and standards. Other essential training undertaken includes health and safety, infection control, food hygiene, equal opportunities and diversity, first aid, moving and handling and fire safety. Two staff had received training in abuse and protection of vulnerable adults and one staff member had completed training in child protection issues but main of the staff had yet to attend training on abuse. Certificates and the home’s staff training matrix were seen confirming this. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 24 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a well run home where their view are listened to and their health, safety and welfare are promoted and protected. The home has a satisfactory quality monitoring system for reviewing and developing the home’s performance. EVIDENCE: The manager has the necessary experience and skills to manage the home well. The staff and area manager described the manager as approachable, fair and listened to their views and concerns. The manager holds a National Vocational Qualification (NVQ) registered manager’s award and is a registered nurse. The area manager confirmed that the manager regularly undertakes maintain his skills. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 25 The home seeks the views of the service users on a regular basis and these are recorded in the individuals’ files. Service user quality surveys are sent out by the organisation to assess quality of the service being provided. These are collated by the organisation and the area manager confirmed that she is waiting for feedback from this year’s survey. The manager completes a monthly performance monitoring report for the organisation and reviews policies and procedures annually. The area manager undertakes monthly monitoring meeting and generates a written report that meets the Care Homes regulations 2001, regulation 26 reports. The home has a Best Value file that includes all quality monitoring outcome and actions to be taken. The service users attend voice meting where their opinions are actively sought. Notes from these meetings were available. Staff confirmed that they attend regular meetings that are minuted. These minutes were available in the office. Further regular meetings held at the home include nurses, admin catering, health and safety and management meetings. The staff confirmed that they attend regular supervisions sessions and record seen confirmed this. The inspector was able to seen various up dated risk assessments for the environment, fire safety and activities. The service users indicated that they feel safe at the home and confirmed that the fire alarms are regularly tested. Individual service user’s evacuation plans were available in the service user files. They participate in regular drills and evacuations. The inspector viewed the records for fires safety maintenance, evacuation and most visual checks and found them to be satisfactory. However, it was noted that the visual check of fire fighting equipment (fire extinguisher) could not be found on this visit. The manager confirmed following the inspection by telephone that the visual checks records were available in a different place within the fire safety file. The manager organises and undertakes ‘in house’ training on fire safety and records were seen showed that staff had received the necessary training and participated in drills. The home has a satisfactory reference file for the Control of Substances Hazardous to Health (COSHH) with information leaflets for each chemical being utilised within the home and chemicals were securely stored. The home’s records for reporting injuries and incidents were appropriate. The incident records matched the Care Homes Regulation, regulation 37 reports. Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 26 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 X 2 3 3 X 4 X 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X X 3 X 3 X Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes 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. THIS IS A REPEAT REQUIREMENT FROM 22/11/05 2. YA32 18(1)(a) The responsible individual must ensure that the home is sufficiently staffed at all times to ensure that service users needs and aspirations are met. This includes holiday and sickness cover. 30/09/06 Timescale for action 30/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 28 Kenton House Nursing Home DS0000012131.V305575.R01.S.doc Version 5.2 Page 29 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.V305575.R01.S.doc Version 5.2 Page 30 - 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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