Inspection on 10/02/09 for 22-25 Trevean Gardens

This inspection was carried out on 10th February 2009.

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

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

Other inspections for this house

22-25 Trevean Gardens 21/03/07

22-25 Trevean Gardens 24/11/05

22-25 Trevean Gardens 04/05/05

22-25 Trevean Gardens 01/11/04

22-25 Trevean Gardens 04/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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: 22-25 Trevean Gardens 22 Trevean Gardens Alverton Terrace Penzance Cornwall TR18 4JD     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: Michael Dennis     Date: 1 0 0 2 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.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 22-25 Trevean Gardens 22 Trevean Gardens Alverton Terrace Penzance Cornwall TR18 4JD 01736361369 01736361369 h5012@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Mrs Hilary Sarah Jane Reynolds Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home Trevean Gardens provides care for up to eleven service users with a learning disability. The registered provider of the scheme is Mencap. The Registered Manager is Mrs. Hilary Reynolds. Mrs Reynolds is currently away on a twelve month sabbatical and has been replaced by Mr. Keith Marjoram. Mr. Marjoram is in the process of submitting his application to be registered.The home consists of two interconnecting houses, and two self-contained flats, in a terrace of properties. The houses each provide accommodation for four service users each and the flats currently accommodate a single person and a married couple. The home is within walking distance of Penzance town centre, and its services and facilities. The houses and flats have their own sitting rooms, kitchens, bathrooms and single bedrooms. The staff support and encourage the service users to be active and independent, and to be involved in the local community. Service users pursue varied day activity programmes. A copy of the inspection report Care Homes for Adults (18-65 years) Page 4 of 28 care home 11 Over 65 0 11 Brief description of the care home is available in the home, and it is suggested a full copy of the report is requested from management or CSCI if required. The range of fees at the time of the inspection start from approximately 355 per week and increase on an individual care needs assessment. There are additional charges e.g. for hairdressing, newspapers etc. Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key inspection took place during the course of one day and over a period of seven hours. All of the key standards were inspected. The methodology used for this inspection was To case track three service users. This included, where possible, meeting and discussing with the service users their experiences, and inspecting their records. Discussing with staff their experiences working in the home. Observing care practices. Discussing care practices with management. Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home, example, regarding any incidents which occurred, was used to help form the judgements made in the report. The home also sent us the Annual Quality Care Homes for Adults (18-65 years) Page 6 of 28 Assurance Assessment when we asked for it. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are issued with a tenancy agreement and a copy of Mencaps terms and conditions of residency at the time of admission. Service users subsequently receive suitable information regarding their rights and responsibilities. The pre admission assessment procedure is good, and enables the registered persons to ascertain they can meet the needs of service users, before admission is arranged. Evidence: Copies of tenancy agreements and individualised copy of terms and conditions of residency are contained on all service user files, in line with Mencap policies and procedures. Copies of social services contracts of care were available for inspection on some service user files. There has been one admission since the last inspection. The service user concerned was able to visit the home, full information was received from the previous placements, and from service user representatives. Suitable documentation regarding the assessment process was available for inspection. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: 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. All service users have a care plan and these are reviewed. Care plans ensure staff have suitable information to provide care. Service users are encouraged to make decisions about their lives with suitable assistance as required. The registered persons approach to handling service users moneys is good so service users can be assured their finances are maintained appropriately where staff are involved in this area of their lives. The registered persons have a suitable approach to risk, so service users can be assured they will be supported to take risks as part of an independent lifestyle. Evidence: There is a copy of a care plan in each service user file. Staff said care plans were accessible to them. The service has a system of person centred planning. As part of the review process, service users are able to present their plans using various types of media, at their review meetings. Documentation regarding the care planning process is to a good standard. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Service users and staff said service users are encouraged to make decisions regarding their lives. Service users spoke eloquently about their experiences of living at Trevean Gardens, and seemed to take a real sense of ownership of their home and how it was run. Suitable risk assessments are in place to assess any risks or actions to promote independence. Two service users have got married since the service opened and now live together in one of the flats. Some service users are able to go out on their own and use public transport. Staff look after some service user moneys, for which suitable records, including a risk assessment are maintained. The registered provider has a satisfactory policy regarding diversity and equality. There are currently no service users from ethnic minorities, although the registered provider stated the home would be more than happy to accommodate service users from other cultures. The local population is predominantly Cornish, and from White-UK background. Women service users have equal opportunity compared with their male counterparts. Issues regarding sexuality seem to be suitably addressed. 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. Service users can participate in a suitable range of activities, and are able to mix with the wider community. Service users are encouraged to maintain relationships with friends and relatives. Service users rights are respected, and service users are enabled to take a suitable amount of responsibility in their daily lives. Suitable arrangements are in place so service users enjoy a healthy and varied diet. Evidence: Service users said they attend a range of day activities including attending work placements, educational courses and leisure facilities. Foe example, on the day of inspection, people were engaged at work placements to include working at a horticulture nursery, primary school and with the parks service. Another was at college. Service users and staff said other activities are also arranged in the evenings and at weekends. Service users can have an annual holiday, which they have to pay Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: for. There is usually an annual group camping holiday and opportunities for people to take an individual holiday supported by staff. Examples include visits to Dublin, Alton Towers and Centre Parks. Service users said they visit friends and relatives regularly, and they are encouraged to maintain contact via the telephone or post. Visiting arrangements are flexible. Service users said they could get up and go to bed when they wish, although some may need reminding to get up on the days they attend activities. Service users said staff worked with them in a way, which respects their privacy and dignity. Service users said staff knock on bedroom doors, and their mail is not opened without their agreement. Locks are fitted to bedroom doors. When staff go between the two houses they always ring the bell and there is a sense that staff do their best to make each part of the scheme the service users own homes. Service users and staff said service users have involvement in household tasks for example doing laundry, cleaning tasks, shopping and cooking. Service users said they enjoyed the food provided. Where possible service users are supported to make their own meals with appropriate staff support. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal care is delivered to a good standard, and there are suitable links with medical professionals. The management of service users medicines is to a good standard so service users can be assured their medication is suitably looked after. Evidence: Service users said they received suitable care and support from staff. Any personal care needs are documented in care plans. Staff we spoke to seem clear regarding what assistance service users need. The home currently caters for a service user group with diverse needs i.e. people who are relatively independent to others who may need significant staff support with personal care. It appears staff are able to meet the diverse needs of people living at the home to a good standard. Individual needs appear to be met without either neglecting individuals, or disabling others, from maintaining or increasing their independence. Care plans document appropriate links with GPs, dentists, opticians, chiropodists and Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: other professionals. Service users said they regularly saw medical professionals when required. The manager and other staff reported no problems with links with medical professionals. Medication is stored securely, and dispensed appropriately. The management of the system and records kept are to a good standard. Staff have received suitable external training regarding medication. It is recommended that where hand written entries are made to the MAR sheets, that these are witnessed by two signatories. There are no controlled drugs held on the premises at this time. Should this situation change, a Controlled drugs register will be required. It is also recommended that completed accident report forms are removed from the accident book and placed on the individuals file. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are dealt with appropriately and recorded in the complaints log. Mencap has a satisfactory adult protection policy, which provides a suitable framework to protect service users if they are at risk. Evidence: The registered provider has developed a complaints procedure. The manager has included a summary of this in the statement of purpose and service user guide. The manager has put up a poster in the hallway regarding how service users and their representatives can contact CSCI if they have a concern or complaint. Service users said they would have confidence in staff and management if they had a concern or a complaint, and they felt the matter would be dealt with appropriately. Mencap has an appropriate adult protection policy. New staff attend the Mencap training regarding abuse, Protect Me, as part of the organisations foundation training. Many staff have also attended prevention of abuse training run by Cornwall Adult Social Care. One member of staff informed us that she was an adult protection trainer. All staff have a Criminal Records Bureau checks and where appropriate a Protection of Vulnerable Adults check. Staff and service users all said they had not witnessed any bad or abusive practices. Care Homes for Adults (18-65 years) Page 18 of 28 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. Mencap provides clean, well maintained and a homely environment at Trevean Gardens. The scheme provides flexible accommodation to meet the needs of a wideranging service user group. Evidence: The building was inspected. The home offers a pleasant and homely environment for service users. Although purpose built, some of the rooms are a bit on the small side, although the housing association and Mencap have done and are doing their best to adapt the accommodation to meet the needs of the group of the people living there. Bedrooms and communal areas are of a satisfactory size to meet the needs of service users. There are two houses and two flats as part of the scheme. One of the houses caters for a more independent group of service users, and in the second house people are generally more dependent. In one of the flats a married couple live on a permanent basis. In the other flat, at the moment, individuals from the houses can stay for a limited period to have the opportunity to live more independently. Service users said they valued this opportunity, and it enabled them to assess if they would like to live more independently on a more permanent basis. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: The home was clean and hygienic on the day of the inspection. Suitable cleaning routines are in place. Water outlet temperatures are regulated. The radiators in the building are not covered and therefore there is a risk to service users. It is recommended that that risk assessments are put in place to determine levels of risk and safety factors. A new kitchen has been installed in one of the units. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels appear satisfactory so service users can be assured they will get suitable levels of staff support. Recruitment records are good. Suitable recruitment procedures and records help to ensure service users know they are in safe hands. Staff induction and training is to a good standard and meet regulatory requirements. Equal opportunities issues regarding recruitment and work practices seem appropriate. Evidence: Rotas indicate the registered provider provides suitable staffing to meet service users needs. Service users stated they believed staffing levels to be satisfactory. On the day of the inspection there were two members of staff on duty first thing in the morning, at least one member of staff during the day from 9 or 10am, and three staff on duty in the afternoon to evening from 1500 or 1600hrs. This level of staffing seems currently satisfactory to meet the needs of the service users. Two members of staff sleep in at night. We inspected staff files. The registered persons obtain suitable information regarding the recruitment of staff. This includes two references and evidence confirming the persons identity. Staff also have a Criminal Records Bureau check and Protection of Vulnerable Adults check when they commence employment. A staff induction system is in place for new staff. This involves staff working shadow Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: shifts with managers / more experienced staff. Mencap has a comprehensive induction and foundation course programme, which all new staff have to complete. Mencap has a suitable training programme. This includes fire training, first aid, food hygiene, manual handling, and infection control. The manager has a suitable plan to ensure all staff receive the required training at appropriate intervals. Some staff have also had the opportunity to attend training in person centred planning, risk assessment, learning disability awareness and health and safety etc. Mencap has a suitable approach to ensuring staff have the opportunity to obtain a National Vocational Qualification in care. According to the manager all of staff have either a NVQ 2 or 3, or equivalent recognised qualifications. We verified the above by inspecting the training file and talking to individual staff members. The manager is in the process of reorganising the training files. It is suggested that all information pertaining to staff is held on their personal individual file. 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 home is well managed by a suitably skilled, experienced and knowledgeable manager. There is a good quality assurance system in place to enable service users and other stakeholders to be consulted about their views. The management of health and safety issues is good so service users can be assured they live in a safe environment. Evidence: Ms Hilary Reynolds, the registered manager is currently on a 12 month sabbatical. She has been replaced by Mr. Keith Marjoram who appears to be suitably experienced, knowledgeable and skilled to manage the home. He is in the process of applying to be registered for the interim period. MENCAP has a suitable approach to quality assurance. A survey was completed in 2009 regarding stakeholder views and these were positive. Monthly monitoring takes place to ensure the home complies with Mencaps standards. A continuous improvement plan is in place, and a service development plan has been developed. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: The manager also arranges regular staff meetings and regular residents meetings. The registered provider has a suitable health and safety policy. Records kept of checks required by regulation are to a good standard. For example there are suitable records of the testing of fire equipment, the central heating system, portable electrical appliances and the electrical hardwire circuit. Accident records are maintained. Health and safety risk assessments are satisfactory. A suitable fire risk assessment has also been completed. Suitable insurance cover appears to be in place. It is understood that staff may occasionally use their own cars to transport service users. There is some evidence to indicate that car insurance policies are in order. It is necessary to ensure these checks are kept up to date. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 20 When hand written entries are made on the medication admonistration record, these should be witnessed by two signatures. It is recommended that completed accident reports are placed on the individuals file and not kept in the accident book. Risk assessments should be in place regarding the uncovered radiators throughout the building. 2 41 3 42 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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