Inspection on 21/03/07 for 22-25 Trevean Gardens

This inspection was carried out on 21st March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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 10/02/09

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 08/07/2008.

CARE HOME ADULTS 18-65 Trevean Gardens 22 Trevean Gardens Alverton Terrace Penzance Cornwall TR18 4JD Lead Inspector Ian Wright Key Unannounced Inspection 21st and 23rd March 2007 16:00 Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trevean Gardens Address 22 Trevean Gardens Alverton Terrace Penzance Cornwall TR18 4JD 01736 361369 01736 361369 h5012@mencap.org.uk www.mencap.org.uk Royal Mencap Society Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Hilary Sarah Jane Reynolds Care Home 11 Category(ies) of Learning disability (11) registration, with number of places Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Trevean Gardens provides care for up to eleven service users with a learning disability. The registered provider of the scheme is Mencap and is managed by Mrs Hilary Reynolds. 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 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 is £336 to £830 per week. There are additional charges e.g. for hairdressing, newspapers etc. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in 10.25 hours over two days. 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. • Discussion with other service users. • 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 (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: What has improved since the last inspection? What they could do better: This service is managed to a very high standard, and service users all stated high levels of satisfaction. There are therefore no statutory requirements. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are issued with a tenancy agreement and a copy of Mencap’s 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. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8, 9 Quality in this outcome area is good. This judgement has been made using available 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 Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 10 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. Service users and staff said service users are encouraged to make decisions regarding their lives. On both days of the inspection, there seemed a real sense that staff do their best to create a culture where service users are empowered to make decisions about how they spend their time, and what decisions they wish to make. 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 etc. 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. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available 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. Service users and staff said other activities are also arranged in the evenings and at weekends. For example, on one of the days of the inspection, one of the service users was attending a dance class which she said she enjoyed. Service users can have an annual holiday, which they have to pay for. The home has a car for service user use. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 12 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. One service user had pureed food. The person is involved in drawing up their own menu. The inspector saw examples of pre prepared pureed meals and these looked healthy and appetising. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available 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 the inspector 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 GP’s, dentists, opticians, chiropodists and other professionals. Service users said they regularly saw Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 14 medical professionals when required. The manager and other staff reported no problems with links with medical professionals. One service user in particular has complex needs, and, according to the manager, this person has received good support from the NHS and Cornwall Adult Social Care 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. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with appropriately although the registered provider’s complaints procedure does not meet the national minimum standard. 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 / service user guide. The inspector read the organisation’s complaints policy in the ‘Operations Manual.’ This requires updating, for example the organisational policy refers to the National Care Standards Commission, which has now been superseded by the Commission for Social Care Inspection. The policy also regards complainants’ right to contact the Commission as the last stage of the procedure, rather than stating complainants can contact the Commission at any time as outlined in NMS 22.3. The registered provider has been notified regarding this in several CSCI reports for Mencap care homes in Cornwall. 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 / management if they had a concern or a complaint, and they felt the matter would be dealt with appropriately. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 16 Mencap has an appropriate adult protection policy. New staff attend the Mencap training regarding abuse (Protect Me) as part of the organisation’s foundation training. Many staff have also attended prevention of abuse training run by Cornwall Adult Social Care. All staff have a Criminal Records Bureau (CRB) check and where appropriate a Protection of Vulnerable Adults (POVA) check. Staff and service users all said they had not witnessed any bad or abusive practices. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available 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 wide-ranging 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 abit 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 Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 18 them to assess if they would like to live more independently on a more permanent basis. The home was clean and hygienic on the day of the inspection. Suitable cleaning routines are in place. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is good. This judgement has been made using available 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 satisfactory. On the days of the inspection there was one member 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 / evening (from 1500 or 1600hrs). This level of staffing seems currently satisfactory to meet the needs of the service users. However staffing levels first thing in the morning may need to be reviewed in future, particularly if the needs of one service user increase. The inspector inspected staff files. The registered persons obtain suitable information regarding the recruitment of staff. This includes two references and evidence confirming the person’s identity. Staff also have a Criminal Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 20 Records Bureau (CRB) check and Protection of Vulnerable Adults (POVA) check (as applicable) when they commence employment. A staff induction system is in place for new staff. This involves staff working ‘shadow’ shifts with managers / more experienced staff. Mencap has a comprehensive induction and foundation course programme, which all new staff have to complete. It would however be beneficial for an ‘in house’ induction checklist to be developed for new staff. This should cover procedures specific to Trevean Gardens, basic principles of good care, and practical information such as where the stop cock, fuse box is etc. Mencap has a suitable training programme. This includes fire training, first aid, food hygiene, manual handling, and infection control. The majority of staff have attended these courses, although some staff need to attend an infection control course. New staff also need to attend some training required by regulation. However the manager has a suitable plan to ensure all staff receive the required training shortly. 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 66 of staff have either a NVQ 2 or 3. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available 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 appears to be suitably experienced, knowledgeable and skilled to manage the home. Staff and service users spoke highly of her leadership, and it appears she has completed a very good job at developing a person centred service. MENCAP has a suitable approach to quality assurance. A survey was completed in 2006 regarding stakeholder views and these were positive. Monthly Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 22 monitoring takes place to ensure the home complies with Mencap’s standards. A continuous improvement plan is in place, and a service development plan has been developed. 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. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 4 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 4 X 3 X X 3 X Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA35 Good Practice Recommendations Develop an ‘in house’ induction checklist for new staff covering local policies, procedures and routines relating to Trevean Gardens. Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Devon Area Office Unit D1, Linhay Business Park Ashburton Devon TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 26 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Trevean Gardens DS0000008904.V333806.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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