Inspection on 25/03/09 for 103 Glebe Road

This inspection was carried out on 25th March 2009.

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

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

Other inspections for this house

103 Glebe Road 21/03/07

103 Glebe Road 16/12/05

103 Glebe Road 05/07/05

103 Glebe Road 08/02/05

103 Glebe Road 29/09/04

103 Glebe Road 11/12/03

Similar services:

Radfords

Honeybourne House

32 Beaumont Way

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 103 Glebe Road 103 Glebe Road Minchinhampton Stroud Gloucestershire GL6 9JY     The quality rating for this care home is:   one star adequate 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: Paul Chapman     Date: 2 5 0 3 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 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 103 Glebe Road 103 Glebe Road Minchinhampton Stroud Gloucestershire GL6 9JY 01453835023 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): jeff@ggh.org.uk Gloucestershire Group Homes Name of registered manager (if applicable) Mr Jeffrey Michael Bird Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 2 The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Brief description of the care home 103 Glebe Road is a semi detached house on an estate near Minchinhampton and offers a specialised individual service for people with Asperger?s Syndrome, a form of Autism. Service users have transport that is provided by the home enabling them to access facilities in several other local towns and enjoy regular trips out with staff. The home is staffed 24 hours a day by carers and Manager who have experience in dealing with service users with Aspergers Syndrome. The home has three bedrooms; two are occupied by service users, the other is used as an as an office and sleeping in room for staff. Bedroom accommodation is on the first floor and both service users have access Care Homes for Adults (18-65 years) Page 4 of 28 care home 2 Over 65 0 2 Brief description of the care home to a bathroom with shower and a separate toilet adjacent to the bathroom on this level. On the ground floor there is a suitably equipped kitchen. Leading from the kitchen is the dining room, with a comfortably furnished lounge leading from the hallway. . Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate 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: Before we completed the site visit the registered manager supplied us with an AQAA (Annual Quality Assurance Assessment) for the service. This document enables the provider to give their opinion as to what they do well, what has improved since the previous inspection and what the planned improvements for the next 12 months are. In addition to this it provides us with information about people supported by the service, policy reviews, complaints, safeguarding and information about staffing. The AQAA helps us to form hypothesis against the different National Minimum Standards. We contacted the service before we completed the inspection site visit to check that people would be at the service when we arrived. On the day of the site visit we were supported by the organisations manager, as the registered manager was unavailable. One person was home when we arrived, the other Care Homes for Adults (18-65 years) Page 6 of 28 person was out completing an activity. At lunch time one person arrived home and supported us to look around the home. They also spent time talking to us about what it was like to live at Glebe Road. In addition to speaking with a person living in the home was also spoke to the senior support worker on duty. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 8 of 28 Care Homes for Adults (18-65 years) Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisations policy provides staff with guidance to minimise the risk of people being admitted to the service whose needs cannot be met. Evidence: There have been no new admissions to the service since the previous inspection site visit was completed. The organisation has an admissions policy and records showed that this had been reviewed in July 2008. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The information provided in the guidelines for staff minimises the risk of people receiving an inconsistent service from the staff that support them. Peoples goals have been identified and the senior support worker showed a good understanding of the steps to take in supporting people to achieve those goals. With the recent introduction of the new goal plans there was limited evidence of progress towards the goals. Risks to people living in the home are limited by the risk assessments completed by staff. Evidence: A new system of care planning has been introduced since the previous inspection site visit was completed. There is no longer a large number of goal plans for each person. Instead there are detailed guidelines for staff to follow when supporting people with day to day tasks. This approach continues to promote independence and helps to ensure a consistent approach by staff. This guidelines will be reviewed regularly by staff to ensure that they remain accurate. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Both of the people living in the home now have more specific goal plans that identify what they would like to achieve. All of the goal plans we saw were signed by the person confirming that they had been involved in developing them. This was further evidenced when we spoke to one of the people living in the home. They explained one of their goals to us and why they wanted to achieve it. The person commented New car plans have been introduced, they are much better than IPPs, I like the fact they are called goals as it sounds like I am achieving something. Speaking to staff there is an expectation that they will review the progress towards meeting the goals monthly. Staff showed a good knowledge of the importance of setting targets to achieve on the way to achieving the overall goal. Speaking to one of the people living in the home about making choices they explained that they are able to eat what they want. An example of this was the menu which showed that the persons favourite meal was on it. Other examples they gave us included places they go to either alone, or with staff support. The person we spoke said, Glebe Road is a great place to live, Im very lucky. I have lived in places in the past that have been institutionalised. Both of the files we examined contained a wide range of risk assessments for each person. Information for both people is stored confidentially and securely in the homes office. Speaking to one of the people living in the home they stated, I am able to see/read my care file when ever I like. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home live varied and fulfilling lifestyles and staff support them to do this where required. Evidence: Both of the people living in the home live varied and fulfilling lifestyles. One of the people that spoke to us made the following comments: Im going to Glasgow on holiday this year, last year I went to Spain. I go into the pub in Minchinhampton regularly to have a cup of tea by myself. I also go to the tea shop. I am able to go out to Cheltenham, Gloucester, Cirencester by myself and meet my Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: friend for tea. Friends are able to visit me here. Examples of activities that take place regularly are documented in each persons file. This showed us that both people complete a range of activities including using the day service provided by the organisation, college, using facilities in the local community, local transport and domestic tasks around the home. Family and Friends are welcome to visit. Menus are chosen each Sunday by people living in the home. One person commented, We are able to have what we want. We saw a copy of the current menu which showed that there was a good range of meals available. People are able to help prepare meals if they wish. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and health needs are appropriately addressed by staff and other medical professionals as required. The homes medication practises minimise potential risks to people living in the home. Evidence: Both of the people in the home only require minimal support with their personal care. This is in the form of prompts. Where appropriate guidelines are available for staff. Both of the files we saw provided evidence that all appointments with other health professionals are well documented, and actions are taken to address peoples needs appropriately where required. Staff complete a monitor peoples health from month to month and record an issues they identify, were they identify an issue appropriate medical support is sought. The homes medication system has been reviewed and updated since the previous inspection site visit was completed. The home now uses a monitored dosage system. The records we examined showed there were no gaps in recording and procedures Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: minimise potential risks to people. All staff have completed medication training. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure that people know how to use if they are unhappy with the service they are receiving. Records of peoples income and expenditure are thorough and minimises potential risks. Staff have not received recent update training in safeguarding vulnerable adults and this potentially puts both staff and people in the home at unnecessary risks. Evidence: The home has a complaints procedure. The AQAA completed by the registered manager states that there have been no complaints made to them since the previous inspection was completed. The CQC has not received any complaints about the service. Speaking to one of the people living in the home they stated, I know how to make a complaint, I have a copy of the procedure in my bedroom when I have made complaints in the past they have been sorted out. We examined records for peoples income and expenditure. This showed that people living in the home are asked to sign confirming they have received their money, and staff sign to confirm people have received their money. Staff training records showed that there is a need for staff to refresh their safeguarding adults training. Speaking to the general manager for the organisation Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: they recognise this and gave their commitment to ensure this training is provided. It becomes a requirement of this inspection report that this is completed. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is decorated to a good standard throughout, it is homely and was clean at the time of our visit. The home meets the needs of the people currently living there. Evidence: The home is nicely decorated throughout and personalised with peoples possessions. On the day of the site visit all of the communal areas were being measured for new carpets. One of the people living in the home showed us around the home including their bedroom. The other bedroom was not seen on this occasion as the person was not home and we did not have their permission to see their room. Since the previous inspection site visit was completed the service has employed a gardner. The AQAA completed by the registered manager states that a person living in the home has asked for new curtains in the dining room. It is planned that these will be purchased in the near future. Care Homes for Adults (18-65 years) Page 20 of 28 Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff training records showed that staff there have been limited opportunities for staff training and development since the previous inspection was completed. Staff receive regular supervision with their line manager providing them with the opportunity to discuss practises and development needs. All staff have annual appraisals which assess their performance and practise and enables goals to be set for the coming year. Evidence: No new staff have been employed the organisation to work in the home since the previous inspection was completed. A new member of staff has started working in the home since the previous inspection but they were already employed by the organisation, working in another home. As a result of this we did not examine staff recruitment records on this occasion. The staff team comprises of 4 staff, 3 of which have worked at the home for a significant period of time. The home is staffed at all times when people are at home, this includes staff sleeping in. Comments about staff from a person living in the home included, The staff are really nice and are always available when I need them. Speaking with the senior support worker they explained that they have completed a Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: distance learning course through Birmingham University. The course was autistic spectrum specific and is aimed at providing staff with the relevant knowledge to meet the needs of the people they support. In addition to the senior support worker completing this course another member of staff is currently completing an NVQ (National Vocational Qualification) in social care at present. We examined training records for the staff team. This showed that since the previous inspection was completed the senior support worker has attended training in the Mental Capacity Act (2005) and a team leading course. They stated that they had found the team leading course really good and it has influenced their current practises. Records for other people showed that during 2008 two people had completed medication administration training. There were no training records available for another member of staff and the senior support worker stated that he was following this up. As mentioned earlier in this report we identified that there is a need for staff to complete safeguarding vulnerable adults training. Training records examined by us showed that this training was last completed in 2007. Speaking with the general manager for the organisation they explained in future new staff will attend a formal induction course at a local college. At the time of this site visit a member of the organisations management team was developing a training programme for staff across the organisation. This will be implemented in the near future. At the time of this site visit annual appraisals were in the process of being completed. The senior support worker we spoke with confirmed that they had completed their with the registered manager. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The organisation has developed a quality assurance procedure and they are in the process of completing it for the first time. All of the organisations policies have been reviewed and this ensures that they accurately reflect the current practises of staff within the organisation. There are a number of procedures in place that minimise potential risks to people living in the home. Evidence: The registered manager for this service is not based at the home and the day to day running of the service is essentially the responsibility of the senior support worker. They were seen to have a good understanding of peoples needs and this was supported by the paperwork we examined. The organisations management team have developed a quality assurance policy - the home has sent questionnaires to stakeholders and they have completed questionnaires with people in the home. The development plan has not been written yet as the surveys have only been completed recently. The annual quality assurance Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: development plan will be based upon feedback from surveys and the achievable objectives in relation to a range of core provision areas, most notably personal and health care support, concerns, complaints and protection and the management of the service. We examined a sample of Regulation 26 reports (Regulation 26 of the Care Homes Regulations 2001 state that where a provider is not in day-to-day charge of the home they will visit regularly). The sample showed that these visits had been completed regularly. The organisation has a range of policies and procedures that were reviewed in July 2008. There are a range of procedures and policies in place that minimise potential risks to people living in the home. We saw records for the following areas: - a fire risk assessment was completed in January 2009, the homes fire safety equipment is regularly checked by staff and qualified engineers, fridge and freezer temperatures are recorded daily, the home is well maintained and portable appliances (PAT) are tested annually. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 23 13 (6) The registered manager 05/06/2009 must ensure that all staff that have not received safeguarding adults training in the past 2 years complete training. Failure to complete update training in this area potentially puts staff and people receiving the service at unnecessary risks. 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 2 35 35 All staff should have detailed records supporting the training they have completed. The training programme for staff should be implemented as soon as possible to enable staff in developing their skills and refreshing their knowledge of mandatory training. Failure to give staff the opportunity to develop new skills and update their knowledge may put both staff and people receiving the service at unnecessary risks. Care Homes for Adults (18-65 years) Page 27 of 28 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. 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