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Inspection on 09/12/08 for Kerwin Court

Also see our care home review for Kerwin Court for more information

This inspection was carried out on 9th December 2008.

CSCI found this care home to be providing an Good service.

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

Kerwin Court 15/11/07

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

What the care home does well

The comprehensive pre-admission procedures at the home ensure that the people who use the services` needs and aspirations are fully assessed prior to admission ensuring that their needs can be met. The people who use the service are supported to take risks as part of an independent lifestyle. The occupational activities were well planned and structured to meet the needs of the service users. The home provides a safe and well maintained environment for the people who live there.

What has improved since the last inspection?

The home continues to provide good outcomes for the people who use the service.

What the care home could do better:

There were no Statutory Requirements or good practice recommendations made following this inspection.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kerwin Court Five Oaks Road Slinford Horsham West Sussex RH13 0TP     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sarah MacLennan     Date: 0 9 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Kerwin Court Five Oaks Road Slinford Horsham West Sussex RH13 0TP 01403799160 Telephone number: Fax number: Email address: Provider web address: dorothy.walker@birt.co.uk Name of registered provider(s): Name of registered manager (if applicable) The Brain Injury Rehabilitation Trust Type of registration: Number of places registered: care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 physical disability Additional conditions: The maximum number of service users to be accommodated is 23. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either. Date of last inspection Brief description of the care home Kerwin Court is owned and operated by the Brain Injury Rehabilitation Trust (BIRT) and is located on the outskirts of Horsham. The home is registered to provide care and accommodation for up to twenty-three younger adults. The aim of the home is to provide intensive rehabilitation therapy to service users who have medical / physical / behavioural / cognitive / functional deficits following an acquired brain injury. BIRT has a contractual arrangement in place with the Ministry of Defence (MoD), which allows a number of the homes beds to be utilised for service personnel. The home is arranged as one main building consisting of sixteen single occupancy bedrooms and two flats, Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 0 23 Brief description of the care home whilst there are five self contained independent living bungalows in the grounds (to the front of the main building). The home and bungalows are detached properties that have been purpose built and are set in their own grounds, a short distance from the local town of Horsham. There are well maintained gardens on three sides of the main house, that are easily accessible to service users. There is generous parking to the front of the main house. The town centre with its shops and access to bus and rail travel is approximately two miles away. Other local amenities are also within a short distance to the service. The range of fees charged is available from the home. Additional charges are made for toiletries and additional activities outside of the programme. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The Commission for Social Care Inspection has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This unannounced visit formed part of a key inspection and was carried out by Sarah MacLennan, Regulation Inspector. The acting / interim manager was present as the representative for the establishment. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager and any information that CSCI has received about the service since the last inspection. During this visit the inspector was accompanied by an expert by experience. An expert by experience is a person who has direct experience of using social care services, including carers, and visits a service with an inspector to help them get a Care Homes for Adults (18-65 years) Page 6 of 28 picture of what it is like to live in or use the service. The expert by experience spent his time speaking with the people who use the service. Observations fed back to the inspector by the expert by experience have been included within this report. A tour of the premises took place. On the day of this visit the inspector spoke with some people who use the service and some on-duty staff. Two people who use the service returned surveys. Some of the comments made to the inspector and made on the survey forms are quoted in this report. Observations of the interactions between staff and the people who use the service were also used to form the judgements reached in this report. The home completed an annual quality assurance assessment (AQAA) prior to the visit and care plans of people who use the service, staff recruitment and training records, health and safety check lists, activity records, policies, procedures, medication records and storage were all sampled on the day of this visit. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. We would like to thank the people who use the service and staff for their time, assistance and hospitality during this visit. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The pre-admission procedures at the home ensure that the people who use the services needs and aspirations are fully assessed prior to admission ensuring that their needs can be met. Evidence: Kerwin Court is a care home registered to provide care for up to twelve service users between the ages of 18 to 65 years. The aim of the home is to provide intensive rehabilitation therapy to service users who have medical / physical / behavioural / cognitive / functional deficits following an acquired brain injury. The inspector was informed that the pre-admission process starts with a comprehensive assessment undertaken by the Consultant Neuro Psychologist. This initially assessment sometimes includes input from the physiotherapist or the occupational therapist. Four service user care plans were seen and contained comprehensive and detailed preCare Homes for Adults (18-65 years) Page 10 of 28 Evidence: admission information. A multi-disciplinary referral meeting takes place every Monday to discuss potential admissions. The acting / interim manager confirmed that potential service users would be declined if necessary, if it were deemed that the home could not meet their needs. A copy of the pre-admission assessments that includes the goals of the admission is sent to the service user. A comprehensive care plan, risk assessments and admission plan are then set. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans, procedures and practices were in place to ensure that the health care needs of the people who use the service are met. The people who use the service are supported to take risks as part of an independent lifestyle. Evidence: The service user care plans and files were randomly sampled; four care plans and daily statements were looked at in detail. The service users had comprehensive care plans that covered all aspects of personal and social support and healthcare needs. The care plans are devised with service user involvement. They included details of service users preferences, details of risk assessment management and a service users lifestyle profile. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Following admission to the home, a multidisciplinary meeting is held with the service user and / or their family / representative. Care plans are reviewed at this stage, with all parties agreeing the goals and aspirations that the service user can achieve during their rehabilitation programme. Conversation with staff and examination of written records evidenced that the people who use the service were encouraged to be as independent as possible and to make their own choices, such interactions were observed. The care plans viewed reflected service users wishes and detailed how the home assists service users to make decisions about their lives. Samples of risk assessments were seen. The risk assessments were comprehensive and contained clear guidelines for staff to follow to minimise any associated risks. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service have individual activities programmes with opportunities for personal development and rehabilitation. They are supported and enabled to maintain and develop appropriate personal and family relationships. Evidence: The daily routines at the home reflect the need to promote independence, individual choice and freedom of movement. The people who use the service confirmed that they could choose what they wanted to do. Two completed service user survey forms were received prior to the inspection. Comments included we have a weekend planning group to see what we would like to do Saturday or Sunday. Feedback from the expert by experience included: with regard to social activities service users felt that most needs were met in a satisfactory manner, with the service Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: users having a fair amount of input into what was planned. The occupational activities were well planned and structured to meet the needs of the service users. Each service user had a weekly timetable. The timetables were randomly sampled and included activities within the home and within the local community. The expert by experience met with a group of service users in the communal dining area. Service users informed the expert by experience that there was always a good variety of food on offer, and that the catering staff always made sure that any dietary needs were met. The inspector observed service users eating lunch. The mealtime was relaxed and unhurried. Service users appeared to enjoy the meal. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care and healthcare support and assistance was seen to be provided, where needed, in a respectful and sensitive manor. Sound policies and procedures are in place for the administration and management of medications. Evidence: Staff spoken to were aware of the guidance and support required by the service users. The home has an in house specialist team including Consultant Neuro Psychologist, Clinical Psychiatrist, Occupational Therapist and Neuro Physiotherapist. The people who use the service were registered with a local GP and have access to other health care services. Daily statements are made on each service user, samples of which were seen at inspection. These statements related to the service user care plans and provided details of the people who use the services 24 hour day. The homes storage and recording of medication were seen and found to be in order. The home had a suitable policy for the administration of medication. The acting / Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: interim manager stated that all staff responsible for the administration of medication were suitably trained. During the visit, all interactions observed between staff and service users were polite and respectful. Stafff sought the permission of the people who use the service before entering their rooms. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All required policies and procedures are in place to ensure that the people who use the service feel their views will be listened to. Policies and practices are in place to protect the people who use the service from abuse and neglect. Evidence: The home had a simple and accessible complaints procedure; a copy is given to all the people who use the service in the service users guide. Two complaints had been received since the last inspection. Both of which are subject to an ongoing investigation by the acting / interim manager. No complainant had contacted the Commission with information concerning the service since the last inspection. All appropriate safeguarding adults policies and procedures were in place and readily available to staff. All staff spoken to were aware of these policies and procedures and their whistle blowing responsibilities. All staff had had training in the protection of vulnerable adults. In the AQQA, to demonstrate what the home does well, the Registered Manager stated that the home responds to concerns and complaints promptly. Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: All service users surveyed stated that they knew who to talk to if they were not happy. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and well maintained environment for the people who live there. Evidence: The inspector toured areas of the home. The people who use the service were able to access all areas of the home and grounds. The décor was domestic in nature and free from offensive odours. The location and layout of the home and bungalows are suitable for their stated purpose. The home and bungalows have been purpose built and were commissioned and registered in May 2007. All bedrooms (those in the main home including the flats) and bungalows are single occupancy and have en- suite facilities. Bedrooms are spacious and have been designed to accommodate service users who require the use of specialist equipment and wheelchairs. Service users spoken with said that they liked their bedrooms and that the communal Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: areas of the home were comfortable. The two people who use the service who returned surveys said that the home was always fresh and clean. In the AQAA, to demonstrate how the home has improved, the manager stated that a full-time maintenance person has been employed. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing arrangements in place on the day of the inspection were sufficient to meet the needs of the people who use the service. Evidence: The staff rotas were inspected and the staffing levels were found to be satisfactory to meet the needs of the current service users. The home maintains staffing numbers of five support workers in the morning, four in the afternoon and two at night. The head of care, deputy manager and clinical team are also on duty during the day. Staff and service users surveyed and spoken to felt there were enough staff to met the needs of the people who use the service. Recruitment of staff is carried out under the homes policy and procedure on Staff Recruitment that incorporates the equal opportunity policy and procedure of the home. Four staff files were seen and found to contain the required information and documents specified in paragraphs 1 – 9 of Schedule 2 of The Care Homes Regulations 2001 (as amended by The Care Standards Act 2000(Establishments and Agencies) (Miscellaneous Amendments) Regulations 2004). Samples of the staff’s training files were seen. Staff had received training in the Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: protection of vulnerable adults, food hygiene, fire, infection control, health and safety and moving and handling. Staff morale appeared high and the staff on duty appeared to enjoy their jobs. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who use the service benefit from the management approach at the home, which provided an open, positive and inclusive atmosphere. The acting / interim manager demonstrated a good knowledge and awareness of the needs of the people who use the service. Evidence: The home has an acting / interim manager in post and is currently recruiting for the post of Registered Manager. The acting / interim manager demonstrated knowledge and awareness of the service users needs, a sound grasp of her managerial responsibilities, regulations and legal requirements. An open and inclusive atmosphere was evident within the home. All staff and service users appeared happy, contented and relaxed with the inspection process. The atmosphere within the home during the visit was lively and cheerful. The manager stated that various quality audit systems were in place. These included Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: various service user and staff meetings and staff supervision. Clinical and financial audits take place and visits required under regulation 26 are carried out by the Registered Providers. Quality assurance questionnaires are distributed to stakeholders and are given to all service users upon discharge. The manager is aware of the need to maintain a safe environment for service users and staff. Required policies, procedures and safety checks were in place; samples of which were seen. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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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