Inspection on 20/12/05 for Kenward House

This inspection was carried out on 20th December 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Kenward House 08/05/07

Kenward House 05/07/05

Kenward House 28/02/05

Kenward House 15/12/04

Kenward House 04/02/04

Similar services:

Prinsted

Elizabeth House

Boons Park

Winthrop Hall

Life Works Community Ltd

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

CARE HOME ADULTS 18-65 Kenward House Kenward Road Yalding Maidstone Kent ME18 6AH Lead Inspector Gary Bartlett Announced Inspection 20th December 2005 09:30 Kenward House DS0000023979.V261550.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 Kenward House DS0000023979.V261550.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. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Kenward House Address Kenward Road Yalding Maidstone Kent ME18 6AH 01622 814187 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) Kenward Trust Paul John Davis Care Home 32 Category(ies) of Past or present alcohol dependence (32), Past or registration, with number present drug dependence (32) of places Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 32 People with past or present drug or alcohol dependency who may also have a mental health difficulty. 5th July 2005 Date of last inspection Brief Description of the Service: Kenward House is owned and operated by the Kenward Trust. It occupies a large detached premise, which is a Grade II listed building. The accommodation is arranged on 3 floors with 2 additional mezzanine floors. There are 24 single rooms, 17 of which are not fitted with washbasins and 7 of which fall below registration requirements in terms of space. These factors have been carried over from the previous registration. In addition to the main house there is a further residential unit, The Barn” on the same site. The Barn is a detached premise with accommodation for 8 people on 3 floors. There are 4 single and 2 shared bedrooms, not all of which are equipped with washbasins. One bedroom falls below registration requirements in terms of floor space. According to its aims and objectives, the Home provides programmes of rehabilitation from alcohol and other drug dependencies in a Christian context in a safe environment that respects the value of the individuals who share the accommodation.Kenward House is located in a rural area and access to public transport is approximately 15 minutes walk away. There are extensive grounds, part of which is used for a horticultural nursery. There is staff accommodation on the site.The Home employs staff who work a rota which includes 1 member of staff sleeping in, on call. There are further members of staff available elsewhere in an emergency. In addition to these staff there are others who deal with meal preparation, housekeeping, administration and supervision of residents in maintenance and horticultural activities. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Kenward House from 9.30 a.m. until 5.40 pm. During that time the Inspector spoke with some residents, and some staff. Parts of the Home and some records were inspected. No comment cards were received prior to the inspection. The men spoken with had a high regard for the staff and the programme. Comments included: • “I would recommend Kenward House to any one serious about getting clean.” • “Trust is a major part of the programme and I trust the staff implicitly.” The Manager and staff gave their full co-operation throughout the inspection. What the service does well: Staff were committed to helping residents complete their programme. Effective staff recruitment systems ensured only appropriate people worked at the Home. Kenward House was proactively managed and there was a continuous review of policies and practices with a view to giving an optimum service to the men. Robust and comprehensive pre-admission processes continued to ensure, as far as was practicable, the Home could meet residents’ needs. Residents were made fully aware of the rules and individual responsibilities of the programme. The Home was effective at maintaining confidentiality. The range of educational, recreational and social activities offered enriched residents’ lives and there was good liaison with health care professionals and other concerned agencies. Good support was given to men moving on from the programme. Adherence to the health and safety measures that had been implemented for the duration of the building works effectively protected every one on the premises. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Kenward House DS0000023979.V261550.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 Kenward House DS0000023979.V261550.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): 1, 2 and 5 Sound systems were in place for prospective residents to decide whether Kenward House was the right place for them. Robust pre-admission processes ensured, as far as was practicable, the Home could meet residents’ needs. EVIDENCE: The Manager said the Statement of Purpose was accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Kenward House and copies of the Residents Guide were provided for each resident. The men spoken with said they had been made fully aware of the rules of the programme prior to coming to Kenward House. Every resident was also provided with a signed contract that clearly indicated roles and responsibilities. The Manager had a clear understanding of the need to ensure, through a holistic pre-admission assessment, that Kenward House was an appropriate place for prospective residents. This ensured the project was best suited to the applicants and also protected the interests of the men already on the treatment programme. A senior staff member at The Barn spoke of the need to take account of group compatibility when assessing prospective residents. In view of this comprehensive assessment process, emergency admissions were commendably avoided in the interests of all concerned. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 9 Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 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, 8, 9 and 10 Residents’ individual needs were clearly recorded and reviewed through the care plan system. Residents had the opportunity to contribute their views and ideas with regard to the services at the Home. There were risk strategies and a very strong ethos of confidentiality to promote and protect residents’ welfare EVIDENCE: Each resident had an individual care plan that included risk assessments. They were regularly reviewed and additional reviews would be triggered by any change in a resident’s needs. A key staff member was allocated to every resident. Residents commented favourably on the value of their support. Appropriate assistance and advice with finances was given. The Manager described how, each weekday morning, there was a “Start of the Day” meeting with all residents and staff. Residents had the opportunity to make requests, ask questions and were reminded of the planned days Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 11 activities. Residents’ choices were facilitated, where practicable, within the framework of the programme. A residents’ forum was held each month. At these meetings residents had the opportunity to contribute their views and ideas with regard to the services at the Home and the House Rep was voted in for the following month. Residents were encouraged to develop relationships with external groups that could be maintained after the completion of their programme. There was a very strong ethos of confidentiality within Kenward House that underpinned the service. It was agreed counselling records remained confidential and would not be inspected. Residents mentioned they were aware of the boundaries of confidentiality but also of the need and benefits of sharing experiences as part of group work. The records seen were stored in a secure area when not in use and were kept in a manner that was in accordance with current data protection legislation. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 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): 11, 12, 16 and 17 The service was effective in offering residents the opportunity for personal development and in enabling them to partake in appropriate activities. Residents’ rights and responsibilities were respected. The men enjoyed the meals. EVIDENCE: The daily routines of the Home were designed to promote the residents’ rehabilitation and the Manager described how it was an integral part of the programme for residents to develop and use practical life skills. The men spoken with confirmed they had ongoing access to counselling services and therapies. It was evident that the programmes were presented in an effective, validated and professional manner. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 13 Staff spoke of how residents were strongly encouraged to adopt a routine work ethic as part of their rehabilitation. There was an education block on site and residents were able to participate in computer courses; basic literacy lessons. Some undertook training in horticulture. As Kenward House was providing an early stage rehabilitation programme it was not the remit of this project to place residents into employment. Residents were enabled to attend church if they wished to and a weekly service was conducted at the Home. There were regular prayer meetings and bible study sessions. A staff member was employed to assist residents with their finances as required and had a detailed knowledge of the benefits system. Due to the nature of the service provided at the Home, it was acceptable that the Home departed from Standard 16.3 in that bedroom doors were not fitted with locks, except for those of the long stay older persons at Kenward. The Manager said that each bedroom had a lockable facility. Residents said staff were courteous and respectful. It was said that residents opened their own mail, though this might be done with supervision if deemed necessary by risk assessment. It was clearly stated in the conditions of residence that pets could not be permitted at the Home. Residents told the Inspector they had plenty to eat and that the meals were of good quality. The menus seen were varied and balanced. A staff member described how special dietary needs could be catered for. Hot and cold drinks were available throughout the day. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 14 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 The Home provided appropriate support for residents’ physical and emotional needs to be met. EVIDENCE: The Manager described how the Home worked closely with the local surgery, with whom all residents were registered and it was intended that all residents would have a medical examination within 48 hours of arriving at the Home. The Manager spoke of the importance that the Home attached to enabling residents to be as independent as possible in managing their health care and described how residents’ health was monitored. A staff member was heard to be very supportive in a resident’s request to have an appointment with a G.P. of their choice. The Home operated a monitored dosage system for residents’ medicines. A staff member was seen to be diligent in checking the contents of cassettes recently received from the pharmacist were correct. The Manager described how residents were encouraged to have responsibility for managing their medications as part of the rehabilitation process. Staff closely monitored this and constantly assessed the associated risks. Medication storage and records were not inspected on this occasion. There were no controlled drugs at the Home. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 15 Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 16 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 A complaints procedure was readily available to residents who felt their views were listened to and treated with due seriousness. There were robust systems to protect residents from abuse. EVIDENCE: There was a clear and effective complaints procedure which residents said they were aware of. They felt confident that if they had any concerns they would be listened to and acted upon by staff. The Home kept a record of all complaints, of the investigation and of what action was taken by the Home. These records were monitored regularly. There were policies and procedures designed to safeguard residents from abuse which were regularly updated and accessible to all staff. Staff were expected to attend training courses in the management of challenging behaviour. Residents described how they were supported in managing their benefits. Where cash was held on behalf of residents, detailed records were kept. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30 Residents’ quality of life had been enhanced through continued improvements to the environment. Significant improvement would be made with the completion of the planned new build. The poor condition of the second bathroom in The Barn could compromise residents’ health and safety. EVIDENCE: The parts of the Home inspected were warm, generally clean and free from unpleasant odours. Good progress had been made on the building of the new twenty-bed unit that would have modern facilities to improve the standard of accommodation. Existing facilities were also still being improved with further decoration and improved lighting. The kitchen in The Barn was being refurbished to a high standard and it was planned to refit the second bathroom. This was very necessary to improve infection control and provide a safer environment. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Kenward House has an effective and well supported staff team. Robust recruitment processes ensured only appropriate people worked there. EVIDENCE: Residents commented favourably on the staff skills and understanding, saying they were approachable and there was always a staff member available. There was an evident bond of trust. Comments included: • “The staff here can’t be bettered.” • “The staff here are dedicated to helping us with the programme.” • “The staff are always there to help.” The files of two staff members were inspected and both complied with the Regulations and Schedules. Prospective staff were required to complete an application form, attend a formal interview and provide written references. They were invited to visit the Home prior to the interview. Applicants’ identity and employment histories would be checked. A formal interview system would be used that recorded the questions and answers given. POVA and Criminal Records Bureau checks were requested for all staff and volunteers working at the Home. A risk assessment was always undertaken in instances where the Home employed persons with a criminal record and took into account their integrity through an honest declaration of offences. There were systems for the monitoring of equal opportunities. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 19 Staff had job descriptions that defined their roles and responsibilities and it was evident that the staff understood when it was appropriate to involve others with more expertise. The Manager stated that volunteers worked within clearly defined parameters. All employed staff were required to undertake a comprehensive induction programme. The Manager said that whilst the staff group predominantly had qualifications in counselling skills and personal care was not generally given, the Home continued to encourage NVQ training where appropriate. The Manager monitored staff training needs. To this end, it was acknowledged the training matrix needed to be updated. The Manager explained that all staff received supervision/appraisals and this was recorded and kept on staff files. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 and 42 The Home benefited from a Manager who was well qualified and had high expectations of the service to be delivered. The Home regularly reviewed aspects of its performance through a programme of self-review and consultations, which included the opinions of residents. Residents’ welfare would be better promoted by improved food hygiene standards within the kitchen and by regular testing of portable electrical appliances. EVIDENCE: It was clear the Manager was dedicated to the aims and objectives of Kenward House and in establishing it as a centre of excellence. It was apparent from discussion with residents and staff that the Manager gave a clear sense of direction and leadership. The Manager demonstrated a commitment to developing his own and other staffs expertise. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 21 The Manager described how residents were asked to complete a questionnaire at the completion of their programme and a service satisfaction survey was conducted every 6 months. Residents had been told about the planned inspection and invited to speak with the Inspector if they so wished. The necessity for the Trust to do monthly visits and produce reports required under Regulation 26 was again discussed as it had been at the inspection conducted on 28 February 2005. Policies and procedures were reviewed on a regular basis. Current maintenance certificates were inspected and seen to be satisfactory. Improvements to the electrical installation of the existing premises were being made in tandem with the building of the new extension. Portable electrical appliances had not had an annual test as required, thereby potentially placing people at risk. Records of routine fire safety systems checks were seen. A more effective monitoring system was being introduced. The Manager was aware of the necessity to ensure all staff had undertaken fire training/drills at the frequency recommended by Fire Safety Officers. A new and well-equipped kitchen was in use. An Environmental Health Officer had inspected the kitchen on 12 December 2005 and their report listed several requirements and recommendations. Whilst these were being addressed, it was concerning that some kitchen staff continued to disregard food hygiene standards even though an announced inspection was in progress. The Manager stated retraining of the staff concerned and monitoring of practices would be a priority. Commendable awareness of health and safety relating to the building works was seen. Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 X 3 X X 2 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Kenward House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 4 4 2 3 3 2 X DS0000023979.V261550.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA30 Regulation 12(1), 13(3)(4) Requirement “The registered person shall make suitable arrangements to prevent infection, toxic conditions and the spread of infection at the care home”, in that the second bathroom in The Barn must be made good An action plan is to be received by CSCI by the given timescale. Visits must be undertaken and reports provided as required by Regulation 26. An action plan is to be received by CSCI by the given timescale. “The registered person shall ensure that unnecessary risks to the health or safety of service users are identified and so far as possible eliminated” in that all portable electrical appliances must be tested annually by an appropriatly trained person. An action plan is to be received by CSCI by the given timescale. The registered person shall make suitable arrangements to prevent infection,toxic conditions and the spread of infection in the care home in that food hygiene regulations must be adhered to. DS0000023979.V261550.R01.S.doc Timescale for action 25/01/06 2 YA39 26 25/01/06 3 YA42 13(4) 25/01/06 4 YA42 13(3) 25/01/06 Kenward House Version 5.0 Page 24 An action plan is to be received by CSCI by the given timescale. 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 Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Kenward House DS0000023979.V261550.R01.S.doc Version 5.0 Page 26 - 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. 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