Care Home: Kettlewell House

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Annual service review Name of Service: Kettlewell House The quality rating for this care home is: The rating was made on: two star good service 1 2 1 1 2 0 0 8 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 review of the service. We call this review a ‘key’ inspection We do an annual service review when there has been no key inspection of the service in the last 12 months. It does not involve a visit to the service but is a summary of new information given to us, or collected by us, since the last key inspection or annual service review.   Has this annual service review changed our opinion of the service?   No You should read the last key inspection report for this service to get a full picture of how well outcomes for the people using the service are being met. The date by which we will do a key inspection: Name of inspector: Deborah Sullivan Date of this annual service review: 2 3 1 0 2 0 0 9 Annual Service Review Page 1 of 8 Information about the service Address of service: Kettlewell Hill Chobham Road Woking Surrey GU21 4HX 01483756362 01483841809 Telephone number: Fax number: Email address: Provider web address:   Name of registered provider(s): Name of registered manager (if applicable) Kettlewell House Ltd Conditions of registration: Category(ies) : dementia old age, not falling within any other category Conditions of registration: The maximum number of service users to be accommodated is 29. The registered person may provide the following category/ies of service only: Care home with Nursing - N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - OP Dementia - DE Have there been any changes in the ownership, management or the Yes service’s registration details in the last 12 months? If yes, what have they been: The registration of the home was changed in February 2009 and it became registered as a care home with nursing. 1 2 1 1 2 0 0 8 Number of places (if applicable): Under 65 Over 65 29 0 0 29 Date of last key inspection: Date of last annual service review (if applicable): Annual Service Review Page 2 of 8 Brief description of the service Kettlewell House is a large detached property, situated in a semi -rural location a short distance by car from Woking Town Centre. The home is owned by Graham Care Group who also have a number of other care homes in Surrey, Kent and Sussex.The home provides accomodation, care and support to twenty nine older people and those with dementia over 65 years of age.It became registered to provide nursing care in February 2009. The home has been refurbished by the new owners,accomodation is situated over two floors and a passenger lift is available. Bedrooms are mainly single occupancy and have en suite facilities,there are two double bedrooms.There is a spacious lounge and dining room which has retained some of its original character such as wood panelling. The home provides fully assisted toilets, bathrooms and wet rooms to assist people in maintaining their independence.There are extensive gardens to the rear of the property and car parking is available at the front of the building. Annual Service Review Page 3 of 8 Service update since the last key inspection or annual service review: What did we do for this annual service review? We looked at all the information that we have received, or asked for, since the last key inspection or annual service review. This included: The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. Surveys returned to us by people using the service and from other people with an interest in the service. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. The previous key inspection and the results of any other visits that we have made to the service in the last 12 months. Relevant information from other organisations. What other people have told us about the service. What has this told us about the service? The home was rated as good following its first key inspection on 12th November 2008.No requirements were made as a result of the visit,one outcome area was judged as excellent with the others all being good. The AQAA (Annual Quality Assurance Assessment) completed by the registered manager provides us with good quality and comprehensive information about the home and how it has changed,developed and improved since the inspection and identifies areas for further development. In February 2009 the home became registered as a care home with nursing. The AQAA tells that the home promotes equality and diversity and the pre admission assessment process covers all areas of a persons life.Religious and cultural needs are recorded as well as health,personal care and social needs. The assessment process includes visits to the home wherever possible and prospective service users and their representatives have access to detailed information about the service in text format and on the homes website.The statement of purpose and service users guide are reviewed regularly and during the past year the brochure has been improved. Survey forms were received by the Commission from eleven residents some of whom had been supported to complete them by relatives,the forms told us that the residents and relatives felt they had had enough information about the service before a place was accepted.One relative said their mother had spent some time at the home liked it and Annual Service Review Page 4 of 8 decided to move in permanently. The philosophy of the home is that it is Christian based and emotional and spiritual needs are considered as very important. The AQAA says that health and personal care needs are well met and residents are supported to be as independent as they can.Each person has a care plan that is reviewed monthly.Personal care preferences are respected and there is a keyworker system.Residents are supported to make decisions for themselves and risk assessments are undertaken.The home has a web based system that can be used by residents and other authorised users to keep up to date with information about their care. Surveys sent in by residents and relatives reflected that there is a good standard of care,one relative wrote that there was Good personal care,liaison with relatives,good communication with the GP. The home supports residents to keep in contact with health and social care practitioners. Six health and social care professionals returned surveys,none had any concerns about the care provided,comments from a health professionals include polite professional staff,always helpful and informative and a social care professional wrote that the service responded most helpfully and efficiently to a request for assessment of a service user needing respite care leading to long term care provision. The home became registered to provide nursing care in early 2009.Residents near the end of their lives are treated with dignity and their cultural and spiritual needs are respected.Unless medical reasons prevent it residents who choose to are able to end their lives at the home. Residents are offered the opportunity to self medicate if they are able to.Medication policies and procedures are in place. The home has an activities co-coordinator and the AQAA says it views activities as extremely important.A range of activities such as music,craft and physical activity sessions are available.The home plans to provide a specially adapted laptop so that residents can keep in touch with relatives. Religious services from a variety of denominations take place at the home. The AQAA tells us that meals are nutritious and attractive,dietary preferences are catered for and nutritional monitoring takes place.Since the last inspection two lunch sittings have been introduced to ensure that residents needing one to one support with their meal receive it. Survey forms from residents and relatives gave mixed views on the meals provided,the majority of respondents said residents liked the meals,one relative said there was good provision of meals and menu whilst one commented they had not seen fresh fruit available and another that they thought the home needed to provide more fresh fruit and vegetables. The home has a complaints procedure,the AQAA says that since the last inspection it has not received any complaints.The manager welcomes discussion with residents and relatives if they have any concerns. The AQAA tells us that residents are safeguarded by the policies and procedures in place at the home.There is an internal safeguarding policy and the home follows the Surrey multi agency safeguarding procedures as well.The recruitment process is robust and new staff are vetted.There have been no safeguarding alerts during the past year.Staff have been provided with training on the Mental Capacity act and deprivation of liberty safeguards and the home has referred one resident for a deprivation of Annual Service Review Page 5 of 8 liberty assessment. The AQAA also says that health and social care professionals have commented on the improvement to the home over the last year, this is reflected in the survey forms we received from health and social care professionals.Their comments included,I have been very impressed with the service provided and the professional co-operation I have received from management staff at Kettlewell House, 150 improvement in every aspect! and The general mood and feel of the home has improved beyond telling. The home has been extensively refurbished this year and has become registered as a care home with nursing.The AQAA tells us that refurbishment has enhanced the environment for residents and they have plenty of space.Bedrooms are personalised and equipment is provided for people that need it,equipment is properly maintained.The AQAA says the gardens could be improved to make them more suitable for people with dementia and it intends to action this,one relative commented on this in a survey and said uneven paths make walking and pushing a wheelchair difficult. Several complimentary comments were received from relatives about the environment and improvements one wrote ,Always clean,no unpleasant smells,always fresh flowers in the entrance hall and another said The house has improved tremendously over the last year since refurbishment. The AQAA says that staff receive relevant training including service specific training such as dementia and on the mental capacity act.The majority of staff have undertaken equality and diversity training.Training files have been reviewed to ensure that all training is up to date.Staff receive regular supervision and staff meetings are held.No agency staff are used,the home uses bank staff if necessary. Staff survey forms reflect that staff feel well supported,have enough training and like working at the home.Staff who returned surveys and added written comments were unanimously complimentary about the home and the manager.Examples of comments are,The support and teamwork are second to none---team work is excellent,morale is high,brilliant friendly atmosphere, For me as an individual and employee everything is of high standard and The care has dramatically improved especially over the past year.The manager has made the home a happy place to work. Relatives also commented favourably on the quality of staffing,one said Staff are welcoming and supportive and another The staff are always very helpful and cooperative and someone is always available to answer questions. The registered manager of the home is experienced and well qualified for the role.Internal quality assurance takes place,the AQAA says that there are Regulation 26 visits and the owner visits each week.Residents and relatives meetings are held so that they have opportunities to air their views and residents and relatives they are surveyed twice a year. Annual Service Review Page 6 of 8 One concern about the service received by the Commission was referred to the registered manager who supplied with a full response. There have been no safeguarding issues raised about the home. What are we going to do as a result of this annual service review? We are not going to change our inspection plan and will do a key inspection by 12th November 2010. 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