Inspection on 07/02/06 for 26 Cheddar Grove

This inspection was carried out on 7th February 2006.

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

26 Cheddar Grove 29/10/07

26 Cheddar Grove 14/02/07

26 Cheddar Grove 21/11/05

26 Cheddar Grove 18/02/05

26 Cheddar Grove 29/09/04

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 Cheddar Grove 26 Cheddar Grove Bedminster Bristol BS13 7EN Lead Inspector Karen Walker Unannounced Inspection 7th February 2006 09:30 Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cheddar Grove Address 26 Cheddar Grove Bedminster Bristol BS13 7EN 0117 9077214 0117 9699000 colin.westwoodrandontrust.org 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) The Brandon Trust Mr Colin Richard Westwood Care Home 7 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (7) of places Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Staffing Notice dated 28/03/1994 applies Manager must be a RN on parts 5 or 14 of the NMC register May accommodate up to 7 persons aged 40 years or over, with Learning disabilities. 21st November 2005 Date of last inspection Brief Description of the Service: Cheddar Grove is a large (ex Vicarage) house set in a quiet area of Bedminster Down on the outskirts of Bristol. It has good links with local amenities, shops, pubs and a post office, which are all within walking distance. The church is next door. The house has seven bedrooms, four of which are on the ground floor. There is a large back garden overlooking a school field. The home has qualified nurses on duty at all times and caters for adults with learning difficulties and mildly challenging behaviour. The aim of the home is to provide total support for residents in all aspects of their lives. Residents are encouraged to develop self-confidence and life skills. Residents are taken on various holidays, outings and have links with local colleges and day centres. The home caters for ambulant and non-ambulant residents and have mobility aids so all parts of the home are accessible. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector spoke briefly with two residents and met with staff and the homes manager. Positive interactions were noted between staff and residents and staff were observed speaking respectfully to residents. Two residents were ‘case tracked’ and documentation examined in respect of them. Other documentation relating to the health, safety and welfare of residents was also examined. There were no requirements made as a result of this inspection and two recommendations made. What the service does well: What has improved since the last inspection? All of the requirements made at the last inspection have been met and further work gone into the development of care plans and recording systems. There are now ‘As and When’ (PRN) medication protocols in place to ensure staff are aware of when and how to administer PRN medication. There is now a clear procedure in place for the administration of emergency epilepsy medication, which includes when to give, how much, how long to wait between doses and when to call the emergency services. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 6 What they could do better: 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. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 Prospective residents’ needs are assessed and a plan put in place to ensure they are met. Residents are encouraged to ‘test drive’ the service to ensure all parties are happy with the placement. Residents’ contracts are not ‘user friendly’ EVIDENCE: There is currently one vacancy at the home and one new resident has been identified. The manager has visited the resident at his current home and has shown him pictures of Cheddar Grove and explained the set up. The placing authority social worker has visited Cheddar Grove with the resident for afternoon tea. There is a clear and informative assessment in place with essential lifestyle plan devised at his current home. It is made clear that the admission process is a slow one and the resident will not move in until the home are satisfied that they can meet the assessed needs and that the current resident group and the new resident are compatible. There is also a trial period of 3 months. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 9 Residents’ contracts are not ‘user friendly’ but the manager said this is an organisational issue. It is recommended that contracts be made user friendly and individualised to meet the communication needs of each person. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,9 Residents know that their assessed needs will be reflected in a care plan and that associated risk assessments will support an independent lifestyle. EVIDENCE: Care plans examined were detailed and had the appropriate reviews carried out. Amendments had been made to care plans to ensure the requirements set at the last inspection were met. It would be beneficial if the Essential Lifestyle Plan (ELP) seen was dated and signed to ensure an appropriate review date was planned. There is now a care plan relating to epilepsy care and support with an associated risk assessment. There is also an updated ‘as and when’ (PRN) policy in place relating to the administration of emergency medication and status epilepticus. Generally the risk assessments were detailed and current, including manual handling, transferring from chair to bed etc, choking, access to the bedroom, use of hydrotherapy and general activities. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,16,17 Residents’ rights are respected and responsibilities recognised in their daily lives. There are opportunities for personal development. Residents are offered a healthy diet and are able to make their preferences and choices known. EVIDENCE: The menu was varied and appealing and it was evidenced that residents have input into the planning and preparation of food. The manager and one staff member confirmed that residents are encouraged and supported to use the kitchen, making snacks and helping with the preparation of a main meal. Residents’ rights are respected and responsibilities recognised in their daily lives. One staff member said, “this home is very laid back and run by the residents rather than the staff”. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 12 House meetings evidence that residents are asked their opinions about various aspects of life in the home. The minutes of the last meeting show that a discussion was held regarding the new resident and input was given regarding menu choices. The manager confirmed that residents were asked if they would like a key to their bedroom. One resident currently has his own key. No residents have a front door key, as they do not go out unsupported. Pictures were seen of the residents on holiday and it was confirmed that two residents supported by two staff would be going to Spain this year in a family members villa. Two other residents have booked a barge holiday and another resident prefers one to one short breaks and finds this preferable to a longer holiday. One resident was supported by staff to post her passport application in readiness for her holiday. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21 Residents’ physical and emotional needs are met. Medication practices are sound and records in place to reduce any risk. The aging, illness and death of any resident is handled with respect and as the person would want. EVIDENCE: The Medication Administration Sheets (MARS) were seen and it was noted that the necessary PRN protocols were in place. Any medication changes were recorded and there were medication profiles in place including the uses and side effects of each medication. Three PRN medication balances were checked at random and found to be correct. Stock checks take place on a weekly basis and all medication is signed in and dated. There is a separate PRN cabinet. All medications are stored correctly. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 14 It was noted that the healthcare needs of the residents are assessed and met and the appropriate healthcare specialist accessed where necessary. There was evidence of visiting professionals including the dentist, optician, physiotherapist, occupational therapist, and district nurse etc. There is now quick view healthcare charts in place to complement the more detailed records kept. The manager and staff deal with aging, illness and death with sensitivity and respect. One resident recently died unexpectedly although there was a history of illness. She was fully supported at her home with staff well known to her. It was evidenced that the residents’ thoughts and feelings were discussed and support offered at the house meeting. The manager confirmed that these discussions were used as a platform to ask residents about their wishes and feelings around their own deaths and any plans they would like followed. The funeral service was held at the church next door to the home and was carried out by a Reverend known to the residents. All residents and staff attended. The staff have since identified training they wish to attend, ‘death and dying’ and ‘supporting people through loss and bereavement’, this has been agreed by the manager and requested from the Brandon Trust who has a wealth of training courses on offer. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents are protected from potential abuse and their views and concerns are listened to and acted upon. EVIDENCE: The inspector saw that there were adequate policies in place regarding the protection of vulnerable adults. Staff were aware of the whistle blowing policy and policies were discussed at team meetings. The inspector saw that the ‘No Secrets’ in Bristol DOH document was available to all staff alongside the General Social Care Council (GSCC) codes of conduct. Staff confirmed their knowledge of the policies. The inspector saw the minutes from the residents meetings and noted that residents were asked to share any concerns they may have. The complaints procedure was available in each resident’s bedroom. The complaints book detailed no complaints. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X EVIDENCE: These standards were fully assessed and met at the last inspection. The home remains clean and tidy and the manager reports no environmental issues. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Residents’ benefit from an effective staff team with sufficient numbers and complementary skills to support residents assessed needs at all times. Staff are aware of their roles and responsibilities at the home and are well supervised. Residents are supported by a robust recruitment procedure with the appropriate polices in place. EVIDENCE: The supervision timetable was displayed and evidenced 6-8 weekly supervision sessions for all staff. The manager and a staff member confirmed this. Signatures were gained from staff when they had received their supervision session. Staff confirm that topics covered include training needs and keyworker issues. It was further confirmed that all staff have job descriptions and are aware of their roles and responsibilities within the home. Some staff have additional areas of responsibility and one staff member confirmed hers was the management of the Control of Substances Hazardous to Health (COSHH). Product data sheets are kept and the manager said ‘staff tend to buy the same products’. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 18 The home has an effective staff team with sufficient numbers and complementary skills to support residents assessed needs at all times. Training records show staff have attended courses in makaton (communication in signing), understanding epilepsy, understanding multiple disabilities, person centred planning, recruitment and selection. All of the mandatory training has also been accessed. The staffing records are not kept on the premises but held at the Brandon Trust HQ. The manager holds some copies of personal ID and ensures that CRB certificates and references have been obtained in respect of each staff member. The CSCI will at a later date arrange to visit the personnel department and view staffing records. It was noted that there are appropriate policies and procedures in place regarding recruitment and equal opportunities etc. It was confirmed that where possible residents were invited to take part in the interview process. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37-43 Residents benefit from sound leadership and management approach to the home. The home’s record keeping practices safeguard Residents’ rights and interests. The manager and staff team ensure the health and safety needs of the residents are protected and that they benefit from competent and accountable management of the service. EVIDENCE: The management approach to the home creates an open positive and inclusive atmosphere. One staff member said, ‘we are a laid back home which is run by the residents rather than the staff’. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 20 One staff member said, ‘everyone comments on the nice atmosphere we have here; you can always make your concerns known to the manager.’ The manager said he too was, ‘well supported’ by his manager. There are regular resident and staff meetings where everyone has an opportunity to contribute. Fire safety was discussed at the last meeting and questionnaires on the subject given to night staff. The fire logbook evidenced that the appropriate fire equipment checks were taking place and that fire drills and training were also undertaken by all staff. There was written evidence of a recent drill and training carried out at the home. Those staff that didn’t attend will be attending a lecture put on by another Brandon Trust home. Equipment checks take place appropriately including the annual portable appliance testing. The Health and Safety at Work Act poster is clearly displayed in the office and the staff were observed carrying out tasks that had been risk assessed appropriately i.e. shopping and cooking. The certificate of employer’s liability was clearly displayed alongside the registration certificate. There are sound systems in place to ensure financial planning and budgeting within the home, recruitment and selection and appraisal of managers is carried out by the Service Development Manager who also carried out monthly unannounced visits to ascertain sound service provision. There are clear lines of accountability within the home and a chart in the office details which nurse qualified staff member supports which Support Worker. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 21 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 3 4 3 5 X 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 3 3 3 3 3 3 3 3 Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 22 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. 2 Refer to Standard YA5 YA6 Good Practice Recommendations Ensure residents’ contracts are user friendly. Essential Lifestyle Plans (ELP) need dating and signing to ensure an appropriate review date is planned. Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 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 Cheddar Grove DS0000020273.V280028.R01.S.doc Version 5.1 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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