Care Home: Kenward House

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• Prinsted
• Elizabeth House
• Boons Park
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What the care home does well The home provides an excellent, structures and therapeutic rehabilitation programme for people with past drug and alcohol addictions. The home helps the residents regain their self esteem and supports them in taking further steps in their long term recovery. It helps them move on to the next stage and to reintegrate into their families and communities. The staff are well qualified and skilled in supporting people with addiction problems. They are strongly committed and work well as a team. The home understands the importance of good nutrition and provides excellent food services. Residents spoke highly of the food and one said, "The food is really nice, there`s plenty of choice and plenty of food - we`ve all put on weight". The organisation has clear direction and objectives. The home makes good use of community facilities and is well supported by the local community. In turn, the home supports events in the going on in the area. What has improved since the last inspection? A new manager has been appointed. He is very experienced in all aspects of drug and alcohol rehabilitation and holds recognised qualifications that are relevant to the post. There have been a number of environmental improvements and ongoing improvement work is still being carried out. When all the work is complete, all bedrooms will be single with en suite facilities, there will be more communal space and new office accommodation will be provided for the Trust and the home. Staff supervision procedures have been reviewed and revised to make them more robust and to give clearer structure. Staff training has increased and more staff are being encouraged to work to attain the National Vocational Qualification (NVQ) at level two or above. What the care home could do better: The home should reviewing the risk assessments for the interim stage of administration of medicines by staff to self administration of medicines by residents. As this procedure is an intermediate step between medicines being totally administered by staff and self administration of medicines it would be advisable to ensure that a risk assessment is in place for this particular procedure. Once the renovations and alterations to the home are complete and more residents are offered places at the home, consideration should be given to putting more staff on duty at weekends. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kenward House Kenward Road Yalding Maidstone Kent ME18 6AH     The quality rating for this care home is:   three star excellent 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: Wendy Mills     Date: 0 5 0 5 2 0 0 9 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. that people have said are important to them: They reflect the things 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 30 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.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 30 Information about the care home Name of care home: Address: Kenward House Kenward Road Yalding Maidstone Kent ME18 6AH 01622814187 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : angela.painter@kenwardtrust.org.uk Kenward Trust care home 48 Number of places (if applicable): Under 65 Over 65 0 0 past or present alcohol dependence past or present drug dependence Additional conditions: 48 48 The maximum number of service users to be accommodated is 48 The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category : Past or present dependence on alcohol (A) Past or present dependence on drugs (D) Date of last inspection Brief description of the care home Kenward House is owned and operated by the Kenward Trust. It occupies a large detached premise, which is a Grade II listed building. Currenty there is extensive renovation work being carried out. This will eventually provide more group and recreation rooms; upgrade all bedrooms to single, en suite accommodation; and provide new office accommodation for the Trust headquarters and the home. Once the work is complete it is likely that the home will reduce the number of service users to whom it offers places on the rehabilitation programme. Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home The stated objective of Kenward House is to provide programmes of rehabilitation for men who are recovering from alcohol and other drug dependencies in a Christian context that respects the individuals who share the accommodation. The Kenward Trust is the Registered Provider of this service and the headquarters of the Trust are on the same site as the home. The Trust has other registered homes, with the same purpose, in Kent. One of these has recently changed its registration in order to provide services specifically for women. The Trust also has several houses that provide supported living for people progressing from the rehabilitiaiton programmes in their registered homes. Kenward House is located in a rural area and access to public transport is approximately fifteen 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 counselling and support staff who work a rota which includes one member of staff sleeping in and an on call system. In addition to these staff there are others who deal with meal preparation, housekeeping, administration and supervision of residents in maintenance and horticultural activities. The weekly fees were given, at the time of inspection, as £525 per week. There may be extra charges should additional support needs be identified on assessment. Care Homes for Adults (18-65 years) Page 5 of 30 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: three star excellent 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: This visit was unannounced and formed part of the annual inspection process of the Care Quality Commission (CQC). The inspection was carried out in accordance with the Care Standards Act. The inspection process takes into account information we have gathered during this visit and information that we have received prior to the visit, such as the homes Annual Quality Assurance Assessment (AQAA) and notifications about events that affect the people who use this service, that are required under the Act; and the views of health and social care professionals who work with the home. The evidence we have gathered will result in the home being given a star quality rating. Care Homes for Adults (18-65 years) Page 6 of 30 During this visit we inspected important documentation such as care plans, policies and procedures and staff files. We talked to the six of the people who use this service, two members of staff and the manager of the home. We made a tour of the home and made direct and indirect observations throughout the visit. The people who use this service said that the staff and manager are very supportive and are really helping them in their recovery. They said they like the atmosphere in the home and that the countryside location is good. The people that use this service said that they would like to be referred to as, Residents. Therefore, this is the term that has been used to refer to the people who use this service throughout this report. No requirements were placed as a result of this visit. The residents, the staff and the manager are all thanked for the welcome they gave and their help throughout the inspection process. The quality rating for this service is 3 Stars. This means that the people who use live in this home experience and excellent service. What the care home does well: What has improved since the last inspection? What they could do better: The home should reviewing the risk assessments for the interim stage of administration of medicines by staff to self administration of medicines by residents. As this procedure is an intermediate step between medicines being totally administered by staff and self administration of medicines it would be advisable to ensure that a risk assessment is in place for this particular procedure. Once the renovations and alterations to the home are complete and more residents are offered places at the home, consideration should be given to putting more staff on duty at weekends. Care Homes for Adults (18-65 years) Page 8 of 30 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 30 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 10 of 30 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 home provides prospective residents and their supporters with good information about the home. This allows them to make an informed decision about entering the rehabilitation programme. Thorough pre-admission assessments are made to ensure that the programme can meet the needs of the residents. Evidence: The home has a clear Statement of Purpose and Service User Guide. The Service User Guide has been revised and updated since the last inspection. The Service User Guide clearly sets out the rights and responsibilities of the residents whilst living in the home. Those entering the rehabilitation programme enter into a written contract that includes the room to be occupied, personal support, specialist services, therapeutic interventions and rules that may limit personal freedom in the interests of promoting recovery. This is very important to the therapeutic process as the residents need to be committed to participating in their own recovery and adhering to the zero tolerance of Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: drugs and alcohol. The Kenward Trust, the registered provider of this service, also had a website, DVDs and brochures that give information about the services provided by the Trust. Three care plans were examined in detail. There was good evidence that a thorough pre-admission process had been followed. There were comprehensive assessments on file as well as well as written guidelines about health needs. Prospective residents are invited to come to the home for a pre-admission visit. Once a person comes to live at the home there is an induction where the rules, and the reasons for the rules, are carefully explained. Extra support is given during this period by staff and existing residents. The residents confirmed that they had either been able to visit the home or received visits from the manager prior to coming to live at the home. They said that they fully understand their rights and responsibilities whilst living there and that they found that having clear rules from the beginning of their stay was very helpful. They were also very positive about the support and encouragement they are able to give each other. Care Homes for Adults (18-65 years) Page 12 of 30 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. The home gives the people who use this service plenty of opportunities to make informed decisions. This helps them take responsibility for their own rehabilitation. Evidence: The therapeutic process and the rules of the home are made very clear to people before they make a decision to join the rehabilitation programme. However, once on the programme there is an expectation that rules are followed. These rules restrict some choices in the interests of achieving the twelve step process of conquering addiction. Some of these restrictions include not being able to have a televising in a bedroom and an expectation that residents will attend a faith and hope group and Bible study as part of the programme. The Kenward Trust, the registered provider is a Christian organisation but does not demand that residents profess a faith of any sort, only that they keep an open mind about spirituality. The men we spoke to said that they had found these groups helpful and had learned a lot in the Bible study groups. They understood the need for restrictions and said that they welcome the structure Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: that the rules provide. One said, I had no structure before I came here, all I was interested in was finding the next drink and it affected everything I did and everyone I knew. Now I have a purpose in life and there is plenty of choice within the limits. Another said, I understand the rule about television, if you have it in your room it stops you from mixing with the others here and then you can stay in your room watching TV and miss out a lot by not taking part (in the programme). There are many aspects of life in the home where there is plenty of choice about what to do and what to eat. There are plenty of leisure opportunities both in the home and in the local community. In the home there is a billiards room, a computer, a television room, a gym and and education room as well as outside space for work and leisure. During the day the programme is structured but in the evenings there is more time to choose what to do. The first four weeks of the programme are seen as a probationary period. During this time visiting is restricted and the men are accompanied if they have to attend any appointments outside the home. Later in the programme clients are supported to attend meetings such as Alcoholics Anonymous (AA). The staff from the home provide transport for these appointments and meetings but do not attend the appointment or meeting. The residents said that the staff are very good at supporting them to make choices. One resident said, When you first come here its very different but the staff are great at letting you know what you can do. The care plans and Service User Guide provide good written evidence that the residents are supported to make informed decisions and to gain as much independence as possible. Care Homes for Adults (18-65 years) Page 14 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides plenty of work, leisure and personal development opportunities. This promotes the self esteem and independence of the people who live there and helps their recovery. Evidence: The home offers a very well structured, six month rehabilitation programme that includes therapeutic sessions, education, spiritual support, community participation, counselling and leisure activities. There is plenty to do throughout the day and into the evenings. The home has a separate annexe where educational activities take place. A literacy and numeracy tutor visits the home and helps the residents to improve their skills in these areas. One said, Im taking every opportunity to do things, I go to the gym, Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: Bible study education sessions - lots of things - its helping me a lot - keeping busy stops me from thinking about my past too much and getting down. As part of their rehabilitation the residents have a structured work programme. They all undertake duties around the home. There are extensive grounds and a plant nursery and the residents said that they really enjoyed spending time working outdoors in the fresh air. Residents are supported to take part in activities in the local community. They can go swimming, bowling and visit leisure centres or the library. They can become involved in local church activities if they wish and also contribute to activities that help the nearby community. There is plenty to do in the home. Residents are expected to keep their own rooms clean and do their own laundry. There is a billiards room, a gym, a television room and a small lounge with a computer in it. There are other communal areas throughout the home but, at present, the home is undergoing extensive renovation and some of these areas were not accessible on the day of this visit. Family and friends are welcomed to the home but there are some restrictions within the agreed therapeutic programme. These restrictions are clearly explained in the Service User Guide and when contracts are signed. Food services at the home are excellent. The home recognises the importance of good nutrition and regular meals as part of the recovery process. The residents said that the food is very good. One said, Theres always a good choice of food and plenty of it. Another joked, Ive have only been here a few weeks and Im on a diet already because Ive put on so much weight. Another spoke more seriously of being very ill and underweight due to his addiction and said that now he steadily getting up to his proper weight. The home has a large dining room and there was a relaxed atmosphere at lunchtime. The registered manager told us that there is a very good budget for food and the chef works with the the management team to plan meals. The care plans showed that there is good nutritional monitoring. This is especially important for those new to the home as they have often been very ill and not been having regular meals before coming to the home. Special diets are catered for although no-one at the home needed a special diet at the time of this visit. Care Homes for Adults (18-65 years) Page 16 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home positively promotes an holistic approach to health that gives the residents the best possible chance of recovery. Evidence: Conversation with the manager and staff showed that they have a very good understanding of holistic care. The home aims to meet all aspects of the health needs of the residents. This includes supporting the physical, emotional, mental, social, spiritual and financial well being of each resident. The rehabilitation process is in line with the, Twelve steps to recovery, programme. It lasts for six months and aims to provide a clear structure, plenty to do and support for all aspects of health. The home works in close partnership with Community Drug and Alcohol teams, care managers and local health Authorities. Staff work to the Drug and Alcohol National Occupational Standards (DANOS) to ensure best practice in care and rehabilitation. Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: There is a written plans of support for each resident. Care plans are important documents because they are one of the means by which the residents can tell that they will be supported in a way that will help their recovery. Also, the plans are a source of reference information for staff who need to ensure they assist people in a consistent and appropriate way. Three care plans were examined. These were up-to-date and in good order. They contained comprehensive information about health needs and records of health care appointments. All the residents are registered with a local General Practice (GP). We were told that the home has changed GP following feedback from residents. We were told that the new GP has a good understanding of rehabilitation and mental health. An initial general health check is arranged with the GP as soon as possible after a resident joins the programme. Discussion with the manager and staff showed that good holistic health care is actively promoted in the home. Often residents come to the home in poor health due to their past lifestyles and good nutrition is seen as one of the key factors in helping them regain their health. The residents all said that they now have good appetites and that they are eating well. They also said that they felt much better for being in a country environment where there is plenty of fresh air. One said, You can feel the difference, the air smells so much fresher, it gives you an appetite. The care plans showed that specialist appointments, such as opticians, hospital consultants and chiropody, are made and kept. Transport is provided for these appointments but staff do not attend the actual appointment unless requested to do so by a resident. This protect confidentiality and helps the residents take responsibility for their own health. The home puts a strong emphasis on counselling and health education. There are regular counselling sessions both in groups and on a one-to-one basis. A faith and hope group gives the residents a chance to develop their emotional and spiritual well being. There are group health education sessions where the practical side of maintaining good physical health is discussed. A large, comfortably furnished room is set aside for meetings and educational sessions, as well as an annexe to the building that is used for education purposes. There was good evidence in the form of posters, flip chart pages that the men had worked on and other heath education materials, on the walls of these rooms to show that regular and focused work is being done to promote all aspects of good health. Residents said that they find these sessions really helpful. Care Homes for Adults (18-65 years) Page 18 of 30 Evidence: The home carries out random drug and alcohol testing. This is made clear in the information clients are given prior to coming to the home and in their care plans. The residents spoken to were all aware that there is zero tolerance of drugs and that a positive test may mean that they home will terminate their contract immediately. This is because any use of drugs and/or alcohol is considered to be detrimental to the rehabilitation process and unfair to the other residents who are working hard remain free of substance misuse. There are strict rules about the management of medicines in the home. Although no resident is permitted to keep medicines in their rooms due to the risks this could present to themselves and other residents during their recovery period, they are encouraged to be independent and responsible in taking their medicines. Those residents who are able, collect their medicines daily from the office where they are stored. As this procedure is an intermediate step between medicines being totally administered by staff and self administration of medicines it would be advisable to ensure that a risk assessment is in place for this particular procedure. There are sound systems for the management and administration, including risk assessments for other procedures and individual residents. All staff administering medicines have received appropriate training. Care Homes for Adults (18-65 years) Page 19 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has sound safeguarding, complaints and concerns policies and is proactive in the way it seeks the views of the residents. This means that the concerns of the clients are listened to and acted upon. Evidence: The home has sound policies and procedures for handling concerns, complaints and safeguarding. These are clearly explained in the Statement of Purpose and the Service User Guide. The procedures are explained again during the induction period. The home holds a meeting every morning when concerns, complaints and safeguarding are one of the daily agenda items. Any issues arising are noted and dealt with immediately after this meeting. In addition there are one-to-one sessions where residents can talk over any concerns and other group sessions. Also, each resident has a key worker and is encouraged to share any concerns with his key worked if he feels this is appropriate. Staff said that the residents are also encouraged to make comments about the service and to share concerns with staff if they wish. The staff spoken to said they try to deal with concerns as they arise so that a resident does not have to get anxious waiting for for something that is worrying then to be sorted out. Care Homes for Adults (18-65 years) Page 20 of 30 Evidence: The residents said that they have no complaints and that there is always someone to talk to if they have any worries. One said, We can talk to any of the staff or the manager if we have any worries but Ive no complaints at all, they really support us here and we support each other as well. The home has changed to a different GP since the last inspection following comments made by previous residents. Staff spoken to clearly understand safeguarding procedures and are clear about reporting mechanisms. They said they would have no hesitation in reporting concerns if it was ever necessary. Care Homes for Adults (18-65 years) Page 21 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained, clean and comfortable, and has a welcoming atmosphere. The home provides a relaxed, safe and pleasant place in which to live and recover. Evidence: The home is a very large manor house, set in extensive grounds, in the Kent countryside. The home has been used as a residential home for over forty years and has a welcoming and relaxed atmosphere. The size of this home, the large grounds and the relative isolation make it ideal for this stage of rehabilitation. The Trust has other homes that are nearer local communities and some residents move on to these at a later stage of their recovery. In addition to the main building there are a number of other buildings in the grounds. There is a plant nursery, an education unit and a new administration block for the Trust. At the time of this visit a substantial renovation programme was nearing completion. The work has included provision of a new administration block for the Trust, new office accommodation for the home manager and staff as well as additional group rooms, recreation areas and single en suite bedrooms. In addition, a new, environmentally friendly, boiler has recently been installed. Care Homes for Adults (18-65 years) Page 22 of 30 Evidence: The work has been ongoing for some time but both staff and residents said it has been well managed and has not caused disruption to the rehabilitation programme. Whilst the work has been going on the home has taken in less residents. On the day of this visit, there were eight residents living in the home. All were accommodated in single, en suite rooms and there was a comfortable television lounge, a large group room, a large and airy dining room available for their use A tour of the home was made. All areas were found to be clean, clutter free and comfortable despite the ongoing building work. The housekeeping have managed to keep the house clean and comfortable and the catering staff have continued to provide an excellent meals service throughout this time. As part of the rehabilitation programme, the residents are expected to keep their own rooms clean and contribute to the household chores around the home. Residents spoken to said that they enjoy this as it gives them a sense of purpose and belonging. Despite the ongoing work, the home was clean and comfortable on the day of inspection. The housekeeping and catering staff are commended for the way they have managed to keep up standards during the inevitable disruption caused by the building and renovation programme. The homes quality assurance self assessment (AQAA) confirmed that all health and safety checks have been carried out and are up-to-date. The residents said that they find the home very comfortable. One said, Id like to stay here forever, you can smell the clean air doing you good. Another said, The way the home is - in the country - nice surroundings - the whole package - makes it easier to be away from my family and to deal with my addictions. Care Homes for Adults (18-65 years) Page 23 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels, staff training and staff recruitment procedures are all very good. there is excellent team working and staff morale is good. this means that the residents are supported by a cheerful cohesive and knowledgeable staff team. Evidence: There were three support staff on duty on the day of this visit. In addition the manger was on duty and there was domestic and catering support. Due to the building work, there were only eight residents in the home at this time and these staffing levels were sufficient to meet the needs of the residents. The staff deliver a busy programme that includes group counselling, one to one sessions, group learning sessions and supported work programme. However, they do not often have to provide personal care, other than assistance with the management and administration of medicines. At weekends there is only one member of staff on duty but one of the support workers lives on site is on call, as is the manager. Residents say that they very well looked after. They said that the staff are kind, understanding and really supportive. They also said that the night staff are very helpful. One said, At night it sometimes seems worse and theres not so many people around to talk to, the night staff are great then, theyll sit and talk you though whatever it is thats bothering you. Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: Three members of staff were spoken to in private. They said that staffing levels meet the needs of the residents. They said that they work well as a team but that more staff at weekends would be an advantage. The manager said that he will soon be moving to live on site and that, once the refurbishment is complete and more residents are taken in, more staff will be rostered on at weekends. A sample of staff files was examined. These showed that a good level of training is undertaken and that there is a wide age and skill range amongst the staff, some of the staff having been through the programme themselves. Approximately eighty percent of the staff hold the National Vocational Qualification (NVQ) at level two or above. Other members of staff hold counselling qualifications and all staff work to the Drugs and Alcohol National Occupational Standards (DANOS). Staff competencies are checked against these standards. Staff records show that statutory training in areas such as fire safety and infection control, have been completed. The home has established regular staff supervision but found that there was a lack of structure for this. Therefore, they are restarting the supervision programme. There is a new policy and procedure and two meetings have been held to discuss the way forward. It is hoped that the new format for supervision will be in place by the end of June this year. The home also uses outside supervision for some staff. Staff spoken to were clear about their roles and responsibilities. There are comprehensive job descriptions on file. There are rigorous recruitment policies and procedures in place. There is a standard application form that asks for detailed history about past employment history and qualifications. Criminal Records Bureau (CRB) checks have been carried out and written references obtained and checked. There are informal and formal interviews for prospective staff and good records are kept of these. Appointments to the staff team are only confirmed following a three month probationary period. Care Homes for Adults (18-65 years) Page 25 of 30 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed. There are clear objectives and sound quality monitoring systems. The views of the people who use this service are respected and acted upon and the home is run in their best interests. This gives them the best chance of recovery. Evidence: The home is part of the Kenward Trust, a Christian organisation, that seeks to support those with drug and/or alcohol problems and to promote their recovery from these problems. Although it is a Christian organisation, people of all faiths are welcomed to the home. Spirituality is promoted as part of the twelve step recovery programme but no resident or prospective resident is expected to convert to Christianity, although some do. The Trust is very clear about its aims and objectives and ethics. There are sound quality assurance systems. The Trust Headquarters are on the same site as the home and representatives of the Trust visit regularly and talk to the residents and staff to seek their views. Complaints and concerns are reviewed on a Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: daily basis and comments about possible service improvements are encouraged and acted upon appropriately. The home has sound health and safety policies and procedures. Protective work clothing is provided for residents carrying out work around the home and risk assessments are in place for any such work. No health and safety hazards were noted during a tour of the home and the builders and home staff are commended for their high standards of safety during the renovation process. The Trust oversees the running of the home. Regular quality monitoring visits are made in accordance with Regulation 26 of the Care Standards Act. There are monthly budget and managers meetings so best practice in care and financial management can be shared. Since the last inspection the registered manager for the home has left and a new manager has been appointed. He is currently in the process of registering with the Commission. The manager is well qualified for the post. He holds the National Vocational Qualification (NVQ) in management and care at level four and the Diploma in Addiction Management from Canterbury University. Previously, the manager was the registered manager for another home in the Trust. Staff speak highly of him, they say he has an open door policy and is very approachable. Care Homes for Adults (18-65 years) Page 27 of 30 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 28 of 30 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 29 of 30 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 30 of 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!