Care Home: Kenway Court

What the care home does well Kenway Court has a warm and welcoming atmosphere. People living there have excellent opportunities to take part in educational and social activities both within the home and in the wider community. When people are considering moving into the home every effort is made to ensure that it is the right place for them. The accommodation provided for people is very spacious and designed to meet the needs of people who have disabilities. Environmental systems and equipment are provided to help people to be as independent as possible. The personal and healthcare support offered is very good. People`s needs are understood and planned for. Care is flexible to meet individual needs. People enjoy the food provided by the home. The facilities available enable people where possible to get their own snacks and drinks. People said that the staff at the home were very good. They said that sufficient staff were available, and that they did not have to wait a long time for care. What has improved since the last inspection? Staff at Kenway Court have continued to work in partnership with residents in providing them with further opportunities for activity and self determination. People have grown in confidence, and some residents are now part of groups to promote disabled access and awareness. In general the home is continuing to develop ways of involving people in the running of their home. At the last key inspection three small homes had merged into one at Kenway Court. Team building exercises have been undertaken to assist in the process of getting the three previous staff teams to work as one. The management of medication has developed, with people now having individual medication folders, and storage improved. What the care home could do better: Residents and staff need to have access to up to date and accurate information. This means that management need to be more proactive in reviewing and monitoring items such as the Service Users Guide, Statement of Purpose and complaints procedure. Staff need to consistently have the training and skills required so that they can understand and meet the needs of people living in the home. So that management can be assured that people living in the home receive consistent care from staff that they are familiar with, ways need to be found to reduce the level of agency staff used at Kenway Court. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Kenway Court Kenway Court 5 Kenway Southend on Sea Essex SS2 5DX     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: Vicky Dutton     Date: 0 8 0 6 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: Kenway Court 5 Kenway Kenway Court Southend on Sea Essex SS2 5DX 01702440750 01702440753 adminsouthend@livability.org.uk 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) : Livability care home 24 Number of places (if applicable): Under 65 Over 65 0 physical disability Additional conditions: Date of last inspection Brief description of the care home 24 Kenway Court is run by Livability, a national charity. The premises are new and purpose built. Kenway Court offers personal care, nursing care and accommodation for up to 24 people with a physical disability. The home is built to a very high specification and offers spacious private and communal accommodation. All bedrooms, or flatlets, are for single occupancy and very spacious. Each room has a large en suite area that incorporates a level access shower. Rooms also include also a kitchenette area that is equipped with a sink, toaster, kettle, microwave and refrigerator. Rooms are set up for wireless internet access. Kenway Court is equipped throughout with environmental systems and appropriate equipment to assist people who have disabilities. Kenway Court is situated in the Prittlewell area of Southend on Sea. There are local amenities close by. The home is well served by public transport and has three vehicles Care Homes for Adults (18-65 years) Page 4 of 30 Brief description of the care home available to assist people to access the local and wider community. Fees at the home are £1326.00 to £1493.00 per week. Fees depend on individual needs and funding arrangements. In addition to this people pay for their own personal requirements such as hairdressing, alternative therapies and sky TV. If people go on holiday using the homes transport after the first 20 miles there is a milage charge. A statement of purpose and service users guide are available. 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: 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: This was an unannounced key site visit. The previous site visit to the home took place on 5th July 2007. At this visit we (CQC) considered how well the home meets the needs of the people living there, how staff and management work to provide good outcomes for people, and how people are helped to have a lifestyle that is acceptable to them. The site visit took place over a period of seven hours. A partial tour of the premises was undertaken. Care records, staff records, medication records and other documentation was selected and various elements of these looked at to see how well these aspects of care and running the home are managed. Time was spent talking to, observing and interacting with people living at the home, and talking to staff. Care Homes for Adults (18-65 years) Page 6 of 30 The homes Annual Quality Assurance Assessment (AQAA) was sent in to us. This is a self assessment tool that providers are required by regulation to complete and send in to us. The AQAA was received by the due date, was fully completed, and outlined how management feel they are performing against the National Minimum Standards, and how they can evidence this. Before the site visit a selection of surveys with addressed return envelopes had been sent to the home for distribution to residents, relatives, involved professionals and staff. Unfortunately these were not distributed as requested before the site visit. We did however receive surveys from five people living in the home, two visiting professionals and four members of staff following the site visit. The views expressed at the site visit and in survey responses have been incorporated into this report where appropriate. We were assisted at the site visit by the manager and other members of the staff team. Feedback on findings was provided throughout the inspection. The opportunity for discussion or clarification was given. We would like to thank the staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: Residents and staff need to have access to up to date and accurate information. This means that management need to be more proactive in reviewing and monitoring items such as the Service Users Guide, Statement of Purpose and complaints procedure. Staff need to consistently have the training and skills required so that they can understand and meet the needs of people living in the home. So that management can be assured that people living in the home receive consistent care from staff that they are familiar with, ways need to be found to reduce the level of agency staff used at Kenway Court. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People considering moving into Kenway Court can be assured through assessment and consultation that the home will be suitable for them and meet their needs. Evidence: The home had a Statement of Purpose and Service Users Guide in place. The Service Users Guide dated from 2007. Both documents were out of date in terms of still referring to the previous organisation running the home. Neither document contained all the information required by Regulation. For example neither referred to the homes complaints procedure. At the previous inspection it was said that a service users guide in different formats was being developed. This has not happened. The manager showed that brochures were available about Livability and Kenway Court, these were brief but colourful and useful. Both gave people the opportunity to seek further information. On surveys people said that they had received enough information about the home to decide if it was the place for them. Everyone said that they had been asked about moving into the home. Care Homes for Adults (18-65 years) Page 11 of 30 Evidence: We saw, from looking at the files of two people more recently admitted to Kenway Court, that admissions to the home are based on detailed assessments and transitional arrangements. These include visits to and overnight stays at the home. The AQAA said that they, Welcome people to the home. Encourage new residents to visit/spend time with other residents and staff. People have a guided tour of the home and further visits are encouraged before a final decision is made. Home visits are undertaken to assess peoples needs and assess their suitability. Transitional arrangements are put in place and a key worker appointed prior to admission. These arrangements provide people with plenty of opportunity to ensure that the home will be suitable for them. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People know that their care needs are understood and planned for. People are encouraged to make choices and live as independently as possible. Evidence: People living at Kenway Court felt that the care and support they received was good, and reflected their individual needs. The home uses a computerised care planning and recording system called Saturn. The system provides a comprehensive package that allows all aspects of peoples personal, health care, social and cultural needs to be assessed, planned for and kept under review. Assessments, support plans, daily notes and other elements for three residents were viewed using the system. All staff can access these records so that they know what peoples care needs are and how they like things done. Staff spoken with had a good knowledge of individual peoples needs. All records viewed were well maintained and clear. Documentation allowed for people to contribute to their care Care Homes for Adults (18-65 years) Page 13 of 30 Evidence: plans. The manager said that every two months plans are printed of and reviewed and updated with the resident/family and key worker. The home are starting to develop individual person centred plans. Two staff have had training in this area, and are to cascade their knowledge to other staff. This work is at an early stage but two person centered plans viewed reflected individual personalities, and their detailed preferences and choices. The whole ethos at Kenway Court is to support people to to live their lives as independently and as flexibly as possible within a residential environment. A member of staff said, We try to let people live as they would if they were at home. They do lots of things here, and we try to encourage them to do what they can for themselves. Through records viewed, discussions and observations throughout the day it was very evident that people are encouraged to make their own choices in all aspects of their daily lives. Surveys said that people generally made their own decisions and could do what they wished to do each day, and at evenings and weekends. Care plans highlighted the need to offer people choices when giving personal care, for example helping them choose clothing. People came and went following their own routines during the day. One person said, No one puts any pressure on you, you are free to do what you want. Care records viewed and discussions with the manager and activity co-ordinator showed that although people are encouraged live their lives as freely as possible, risks associated with this are appreciated and assessed to ensure that people are cared for as safely 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. People will enjoy a lifestyle that suits their individual needs and preferences. Evidence: People living at Kenway Court have the opportunity to lead varied and fulfilling lives. At the previous key inspection this outcome group received a rating of excellent. Since that time further developments have been made. A keep fit trainer and reflexologist regularly visit the home. A shop has been developed that residents help to run. People have started to use social networking websites. Some residents have become involved with a local Disabled Action Group, and an organisational user involvement group has been set up at Kenway Court. Further developments such as a sensory room and soft play area are planned. On surveys activities were identified as a strength of the home. One person said that staff were good at, Making sure I can do the things I like to do. There are two activity co-ordinators employed who between Care Homes for Adults (18-65 years) Page 15 of 30 Evidence: them provide a good level of cover and opportunities for people. The home has a large activity area with computers available. There is a wide range of equipment for people to use including musical instruments and a games console. Records viewed showed that monthly activities meetings are held where people can express their views about what they would like to do. We saw that individual desires are responded to. Three residents told us about a recent trip to Kew Gardens which they throughly enjoyed. We saw that trips to different shows or places of interest are arranged for individuals or small groups as requested. People make full use of the local community and amenities. The home have three minibuses to facilitate trips and community access. However, it was reported that there is a shortage of drivers which can limit their use. The manager is trying to encourage more staff to qualify to drive the buses. On a survey one person had commented under what the home could do better that, We could do with more drivers. Many people living at Kenway Court enjoy going to college to continue their education and develop new skills. One resident told us that they were looking forward to starting a pottery class in the autumn. People said that their friends and family could visit at any time. During the day people came and went. There are areas within the home where people can entertain visitors in private. During the day people promoted peoples independence and privacy. Each room has a do not enter sign that can be used when personal care is taking place. Some residents had chosen their own signs to indicate that they did not wish to be disturbed. People spoken with confirmed that there is no structured routine apart from that chosen by themselves. They said that they could rise and retire when they wished. People were observed coming down for breakfast at their own pace. A weekly activity timetable indicated what time people needed to be ready for in the mornings if going to different activities so that staff are aware of when to offer assistance. People said that they liked the food provided by the home, and are offered a good level of choice. Menus viewed and discussion with the cook showed that menus are planned around what residents like and that arrangements are flexible according to choice and needs. A drinks preparation area is available in the dining room so that people can help themselves to drinks or be assisted to do this at any time. Individual flats also have a kitchen area with facilities to store food and prepare snacks and drinks. The dining area is spacious, and lunchtime was a relaxed occasion. When people needed assistance to eat their meals this was done sensitively. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive good personal and healthcare support to meet their individual needs. Evidence: People living at Kenway Court are happy with the level of personal and healthcare support that they receive. One person said, They are all so kind, they give me just the help I need but dont smother me. Most residents require a significant level of help with all of their personal care needs. Support plans viewed gave staff good information as to how to support residents in ways that they prefer. Kenway Court is fully equipped with environmental systems and other aids to daily living. Rooms are very spacious to allow for individual equipment. People said that staff were available to them when needed no matter what time they chose to come in, go to bed or get up. Kenway court provides nursing care. Therefore there is always at least one qualified nurse on duty to monitor and attend to residents healthcare needs. Care records viewed showed that aspects of peoples healthcare needs such as nutrition and tissue viability are assessed and kept under review. We also saw that people are supported by staff to attend hospital appointments and go for routine health checks to the Care Homes for Adults (18-65 years) Page 17 of 30 Evidence: dentist, opticians and so on. People living at Kenway Court are registered with one doctors surgery. A doctor from the surgery visits the home on a set day (and other times if needed) each week to see anyone who needs it. On surveys two visiting professionals gave positive responses to every question about the home and felt that people were Very well supported. No one living at the home currently chooses to manage their own medications. We looked at systems and records available to see that this aspect of care is managed safely and well on their behalf. Medication is managed by trained nursing staff. The manager confirmed that these staff have received medication training from the pharmacist. We saw that systems were maintained in a safe and orderly way and that good records were maintained. Since the previous inspection individual residents medication profiles and audits have been introduced. Safe storage has been improved by the installation of an air conditioning unit. Care Homes for Adults (18-65 years) Page 18 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are cared for safely through procedure and practice in the home. Evidence: At the previous inspection we advised that the homes complaints procedure be reviewed so that people were aware of our (now CQC) role in complaints, and knew that they can take any concerns to the local authority who have a duty of care in this area. This has not been done. The complaints procedures on display in peoples rooms referred to a previous Regulatory agency. Although people on the day, and on surveys, said that they knew how to raise concerns and would feel comfortable in doing so with staff or management, they should have access to up to date information. Surprisingly given the enabling approach at the home, on five surveys three people felt that care staff and managers only sometimes listened and acted on what they said, another that they usually did. Management need to consider this and ensure that people always feel listened to. Since the previous inspection one person has raised a specific issue with us, (CQC.) This was managed through the home and social worker. The home had recorded seven complaints since the previous key inspection. It was not possible to fully confirm how well these were investigated, managed and outcomes recorded and acted upon. Complaints are logged in a book as a brief record, but all other information relating to them is held on file. the manager talked through the incidents and confirmed that Care Homes for Adults (18-65 years) Page 19 of 30 Evidence: appropriate actions had been taken. In the previous year management have demonstrated their knowledge and understanding of safeguarding, and have made three referrals to the adults safeguarding team. These have related to resident to resident incidents. The home have fully co-operated with the agency investigating and managing these concerns. Although a training matrix was not available the manager confirmed that they and the assistant manager are both trained to train the staff in safeguarding. Staff have also attended external training relating to this. The manager said that the last two staff would be attending external training a few days after the inspection. Staff training records viewed showed that staff had been trained in safeguarding. Given the safeguarding referrals made and information received on notifications it is clear that some people living in the home can have behaviours that challenge staff. It was highlighted at the previous inspection that staff have not done any training that would help them in understanding and managing behaviour. This training need is still outstanding. The manager said that they hoped to arrange some in house training soon. Although no firm arrangements were in place it was stated that the assistant manager had attended a one day training course, a DVD training pack was being reviewed to see if it was suitable, and that a manager from another home was experienced and may be able to do some training with staff. Care plans viewed did recognise behaviours and give staff guidance as to how to manage situations. Care Homes for Adults (18-65 years) Page 20 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. People live in a comfortable home that is highly suited to meet their needs. Evidence: Kenway Court is purpose built to meet the needs of people who have a disability. It is situated in a residential area, with local amenities close by, and the town of Southend also quite close. The home is built to a very high specification and provides comfortable, spacious and well equipped accommodation for residents. People spoken with enjoyed living in the home. One person said, My room is great and I am very comfortable here. Another person spoke about enjoying the outdoor space and how they have been involved in developing the garden over the last year. A visiting professional said that Kenway Court, Provides excellent living accommodation. Each resident has their own flatlet which is a large bed sitting room incorporating a kitchen area. Everyone also has their own large en suite with a shower. There is plenty of room for peoples equipment and possessions. All rooms are equipped with environmental systems to assist independence. All rooms also have a wireless Internet connection facility. In addition to each room having an en suite area there are also three large assisted Care Homes for Adults (18-65 years) Page 21 of 30 Evidence: communal bathrooms. Communal toilets are available in appropriate areas. Communal space is good with rooms available for a variety of purposes. At the site visit the home appeared fresh and clean. A suitable laundry area is available. One area of the laundry is set up with domestic equipment so that residents could do their own laundry tasks if they wished. Training records showed us that staff have undertaken training in infection control. Suitable protective equipment such as gloves and aprons were available throughout the home. Care Homes for Adults (18-65 years) Page 22 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by caring and trained staff. Evidence: People spoke highly of the staff at Kenway Court. The staff are great, I love them all, and, They are all very kind were three of the comments made. During the day we saw that staff had a very good understanding of peoples needs, and worked with them in a kind, caring and friendly manner. On surveys staff had a positive view of their role. One person said, As a new starter to Kenway and a care home environment I am impressed by the commitment to the quality of care for all the residents. Equally care staff are informed and educated to a high standard. Another said that the home, Offers an excellent high standard of care and opportunities to all residents. On surveys and in discussion staff felt that they had good training opportunities. When we looked at training records we saw that although there are good skills from past training across the staff team, training, other than basic core training, seems to have decreased since the previous inspection. A number of staff have not completed disability awareness training or epilepsy training. A number of residents have communication difficulties and staff have not had relevant training in this area. Challenging behaviour training has already been mentioned. The AQAA said that the Care Homes for Adults (18-65 years) Page 23 of 30 Evidence: home hoped to improve over the next twelve months by having More resident specific training, i.e Epilepsy awareness and inclusive communication. The home have achieved a good level of staff attaining National Vocational Qualifications (NVQ) in care. It was confirmed at the site visit that out of 29 permanent relief or bank staff 20 have achieved an NVQ, at various levels from 2 to 4. A further two staff are working towards their NVQ 2. The home has been in a position recently when it had to make some staff redundant. As a result of this they lost housekeeping, administrative, laundry and general hand hours. This has had an impact on the home. For example reduced handyman hours may affect people attending college etc. as a part of their role was to drive people to these activities. The loss of housekeeping and administrative hours mean that these tasks must be delegated elsewhere causing pressure in other areas. Although it was stated that the home was fully recruited to in terms of care staff the home does seem reliant on agency staff. The AQAA said that in the previous three months 5 nursing and 112 care shifts had been covered by agency staff. At the site visit we saw that on average 10 shifts a week are covered by agency staff. The manager said that they try to use the same staff for consistency. However it is not good practice for a home to be so reliant on agency staff, and enough permanent/bank staff should be employed to cover the home properly. It was evident at the site visit that the home are trying to recruit bank staff. At the site visit staffing levels seemed sufficient to meet peoples needs. People spoken with felt that staff were always available to them. The manager felt that current care staffing levels were sufficient. The previous inspection identified that the recruitment of staff was carried out to a good standard so that residents were safeguarded. At this site visit we looked at the files of two recently recruited staff to make sure that good practice is being maintained. We saw that all appropriate checks such and Criminal Records Bureau (CRB), references and proof of identification had been undertaken before staff started working in the home. We saw that a good interview process was in place. On four staff surveys received all said that their recruitment had included carrying out proper checks. The manager also demonstrated good practice in confirming that agency staff were who they said and had been safely recruited. The service users guide says residents are involved in the recruitment process. Prior to the formal interview candidates are introduced to service users and time is allowed for an informal chat. A new member of staff spoken with said that they received a very good induction and were still working through a large induction book. Files showed that a good induction programme was in place. On surveys staff felt that their induction had covered things very well or mostly. We saw that each member of staff has a training profile in place which identified further training needs. The home has their own training room for staff and we saw that This contained lots of useful training materials, information and Care Homes for Adults (18-65 years) Page 24 of 30 Evidence: equipment for staff to access. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and well managed home where they are encouraged to have their say. Evidence: The registered manager at Kenway Court is a registered nurse who has many years of experience in care and management. They have an open and hands on approach to managing the home. A resident said, I love it here, the manager is very good. You can go and talk to her at any time about any problem. On surveys staff said that they felt well supported by the manager. The home has an open and inclusive feel. Residents are encouraged to be self determining and to express their views. There are frequent opportunities for them to do so through the manager having an open door policy, key worker time, residents/activities meetings, reviews and occasional resident/family meetings. Staff have access to an organisational staffing forum and we saw from minutes that regular staff meetings are held. Care Homes for Adults (18-65 years) Page 26 of 30 Evidence: The manager had completed the AQAA. Although it was quite briefly completed it gave a clear indication that the manager understands what the home does well, and is aware of where improvements need to be made. The manager reported that a quality assurance exercise had been undertaken by the organisation last October. Surveys had been completed, but the home had not had a copy of any report. As is required by Regulation, a monthly visit is carried out to the home by a senior person in the organisation. This is to ensure that the home is complying with standards. These visits include talking to people living in the home. Although the last such report available in the home was dated March 09, the manager said that subsequent visits had been undertaken. A copy of the May visit report was given to us following the site visit. Other checks and audits such as medication audits and audits of finances contribute to the overall monitoring of the home. No health and safety issues were highlighted during the site visit. The AQAA identified that systems and services are checked and maintained on a regular basis. Fire records viewed were well maintained. From training information available staff training in core areas appeared to be satisfactory. 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 1 1 Detailed and user friendly written information should be available to people to help them know about the home, what is provided and what it will cost. 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. 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