Inspection on 08/05/07 for Kenward House

This inspection was carried out on 8th May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Kenward House 20/12/05

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 Key Unannounced Inspection 8th May 2007 10:00 Kenward House DS0000023979.V334082.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 Kenward House DS0000023979.V334082.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. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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 48 Category(ies) of Past or present alcohol dependence (48), Past or registration, with number present drug dependence (48) of places Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 48 People with past or present drug or alcohol dependency who may also have a mental health difficulty. 20th December 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 and a modern 19 bed annex. 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. 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. Current fees range from £450 to £515 per week. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted by Gary Bartlett, Regulatory Inspector, who was in Kenward House from 10:00 a.m. until 3:30 pm. During that time the Inspector spoke with some residents, and some staff. Parts of the Home and some records were inspected. Some comment cards were received prior to the inspection from residents and health care professionals. Comments included: • “Provides a good environment for alcohol and drug dependant individuals to rehabilitate.” • “It keeps me safe.” The men spoken with had a high regard for the staff and the programme. The Manager and staff gave their full co-operation throughout the inspection. What the service does well: What has improved since the last inspection? The group work programme has been enhanced with the addition of Joint Step Work groups, Practical Life Skills groups and a variety of one-off groups. Medication storage facilities have been improved. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 6 A new annexe has been opened offering significantly better accommodation than previously. Existing facilities are being further improved with redecoration and refurbishment. The kitchen and second bathroom in The Barn are much improved. Portable electrical appliances are being tested annually Food hygiene standards are being better maintained. 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. The summary of this inspection report can be made available in other formats on request. Kenward House DS0000023979.V334082.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 Kenward House DS0000023979.V334082.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with enough information for them to be able to decide if Kenward House is the right place for them. Robust pre-admission processes ensure, as far as is practicable, the home can meet residents’ needs. EVIDENCE: The Manager said the Statement of Purpose is accurately descriptive of the aims, objectives, philosophy of care, services and facilities and terms and conditions of Kenward House. Copies of the Residents Guide are 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. The Manager has a clear understanding of the need to ensure, through a holistic pre-admission assessment, that Kenward House is an appropriate place for prospective residents. This ensures the project is best suited to the applicants and also protects the interests of the men already on the treatment programme. Emergency admissions are avoided in the interests of all concerned. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ individual needs are clearly recorded and reviewed through the care plan system. Residents have the opportunity to contribute their views and ideas about the services at the home. There are risk strategies and a very strong ethos of confidentiality to promote and protect residents’ welfare EVIDENCE: Each resident has an individual care plan that includes risk assessments. They are regularly reviewed and additional reviews are triggered by any change in a residents’ needs. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 10 A key staff member is allocated to each resident. Residents value this support. Appropriate assistance and advice with finances is given. The Manager described how, each weekday morning, there is a “Start of the Day” meeting with all residents and staff. Residents have the opportunity to make requests, ask questions and are reminded of the planned days activities. Residents’ choices are facilitated, where practicable, within the framework of the programme. A residents’ forum is held each month at which residents have the opportunity to contribute their views and ideas with regard to the services at the home. Residents are encouraged to develop relationships with external groups that could be maintained after the completion of their programme. There is a very strong ethos of confidentiality within Kenward House that underpins the service. The records seen are stored in a secure area when not in use. It was agreed counselling records remain confidential and would not be inspected. Residents said they are aware of the boundaries of confidentiality but also of the need and benefits of sharing experiences as part of group work. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 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. Kenward House offers residents the opportunity for personal development and enables them to partake in appropriate activities. Residents’ rights and responsibilities are respected. The residents enjoy the meals. EVIDENCE: The daily routines of the Home is designed to promote the residents’ rehabilitation and is an integral part of the programme for residents to develop and use practical life skills. The men spoken with confirm they have ongoing access to counselling services and therapies. It is evident that the programmes are presented in an effective, validated and professional manner. The group work programme has been enhanced with the addition of Joint Step Work groups, Practical Life Skills groups and a variety of one-off groups. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 12 Residents are strongly encouraged to adopt a routine work ethic as part of their rehabilitation. There is an education block on site and residents are able to participate in courses such as computer skills and basic literacy lessons. Some undertake training in horticulture. As Kenward House is providing an early stage rehabilitation programme it is not the remit of this project to place residents into employment. A weekly service is conducted at the home and residents are enabled to attend church if they wish. There are regular prayer meetings and bible study sessions. A staff member is employed to assist residents with their finances as required and has a detailed knowledge of the benefits system. Residents confirmed staff are courteous and respectful. Residents open their own mail, though this might be done with supervision if deemed necessary by risk assessment. Residents said they have plenty to eat and that the meals are of good quality. The menus seen are varied and balanced. Special dietary needs can be catered for. Hot and cold drinks are available throughout the day. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. 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 home provides appropriate support for residents’ physical and emotional needs to be met. EVIDENCE: The Manager described how the home works closely with the local surgery, with whom all residents are registered. It is intended that all residents have a medical examination within 48 hours of arriving at the Kenward House. The Manager spoke of the importance that the home attaches to enabling residents to be as independent as possible in managing their health care and described how residents’ health is monitored. The Home operates a monitored dosage system for residents’ medicines. Residents are encouraged to have responsibility for managing their medications as part of the rehabilitation process. Staff closely monitor this and constantly assess the associated risks. Medication storage facilities have been improved. The medication records seen are appropriately completed. There are no controlled drugs at the Home. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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. 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 complaints procedure is readily available to residents who feel their concerns are listened to and treated with due seriousness. There are robust systems to protect residents from abuse. EVIDENCE: There is a clear complaints procedure which residents are aware of. They feel confident that if they had any concerns they would be listened to and acted upon by staff. The Home keeps a record of all complaints, of the investigation and of what action was taken by the Home. These records are monitored regularly. The Pre Inspection Questionnaire completed by the Manager indicates there has been one complaint since the last inspection and this was partially substantiated. There are policies and procedures designed to safeguard residents from abuse which are regularly updated and accessible to all staff. Staff are expected to attend training courses in the management of challenging behaviour. Residents described how they are supported in managing their benefits. Where cash is held on behalf of residents, detailed records are kept. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new annex provides comfortable and well-equipped accommodation. Residents’ quality of life is being enhanced by improvements to other parts of the home. EVIDENCE: Since the last inspection, a new annexe has been opened offering significantly better accommodation than previously. The parts of the Home inspected were warm, clean and free from unpleasant odours. One room in the annexe is suitable for use by a person with mobility difficulties. However, the Manager recognises that there is not current safe access to the building for a wheelchair dependent person, nor could they readily have access to other parts of the home or the education block. Consequently, and quite rightly, this room will not been used until these issues are resolved. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 16 It is planned to provide a detox service in the future and a bedroom has been designated for this. There was some discussion as to whether the CCTV in that room is appropriate and if the room provides a safe enough environment for someone in detox. Existing facilities are being further improved with redecoration and improved lighting. The kitchen in The Barn has been refurbished to a high standard and the second bathroom is much improved. The men pointed out that the water pressure at the shower is too low. Damage to The Barn lounge ceiling caused by a water leak needed to be repaired. Residents and staff commented that repairs were not always carried out quickly. Due to the nature of the service provided at the home, it is acceptable that the Home departs from Standard 16.3 in that bedroom doors in the old building are not fitted with locks, except for those of the long stay older person at Kenward. The bedrooms in the new annex have locks that can be operated from inside the room. Each bedroom has a lockable facility. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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. 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. Kenward House has an effective and well supported staff team. Robust recruitment processes ensure only appropriate people work there. EVIDENCE: Residents speak favourably on the staff skills and understanding, saying they are approachable and there is always a staff member available. There is an evident bond of trust. Comments included: • “They go the extra mile for you here.” • “It’s a top level programme, the staff are top level, give all they can and with love.” Prospective staff are required to complete an application form, attend a formal interview and provide written references. They are invited to visit the Home prior to the interview. Applicants’ identity and employment histories would be checked and a formal interview system used. POVA and Criminal Records Bureau checks are requested for all staff and volunteers working at the home. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 18 A risk assessment is always undertaken in instances where the home employs persons with a criminal record and takes into account their integrity through an honest declaration of offences. There are systems for the monitoring of equal opportunities. Staff have job descriptions that define their roles and responsibilities and they understand when it is appropriate to involve others with more expertise. All employed staff are required to undertake a comprehensive induction programme. The Manager said that whilst the staff group predominantly have qualifications in counselling skills and personal care was not generally given, the Home continues to encourage NVQ training where appropriate. The Manager monitors staff training needs. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 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 Home benefits from a Manager who was is qualified and has high expectations of the service to be delivered. The Home regularly reviews aspects of its performance through a programme of self-review and consultations, which includes the opinions of residents. EVIDENCE: The Manager continues to be dedicated to the aims and objectives of Kenward House and in establishing it as a centre of excellence. It is apparent from discussion with residents and staff that the Manager gives a clear sense of Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 20 direction and leadership. The Manager demonstrates a commitment to developing his own and other staffs expertise. Residents are asked to complete a questionnaire at the completion of their programme and a service satisfaction survey is conducted every 6 months. The Pre Inspection Questionnaire indicates that servicing and maintenance of equipment is up to date and is undertaken regularly. Portable electrical appliances are now being tested. An Environmental Health Officer had inspected the kitchen on 30th February 2007 and their recommendations had been implemented. Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 X X 3 X Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP24 Good Practice Recommendations It is strongly recommended the use of CCTV in the bedroom designated for a future detox programme should be reviewed as should the safety of that room for such a service. It is strongly recommended access for wheelchair dependent persons is improved before they are accommodated at Kenward House. It is recommended the water pressure at the shower in the second bathroom in The Barn should be improved. 2. 3. OP24 OP27 Kenward House DS0000023979.V334082.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V334082.R01.S.doc Version 5.2 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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