Inspection on 25/10/05 for 3 Water Meadows

This inspection was carried out on 25th October 2005.

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

3 Water Meadows 08/06/07

3 Water Meadows 15/02/06

3 Water Meadows 24/11/04

3 Water Meadows 21/07/04

3 Water Meadows 23/02/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 3 Water Meadows 3 Water Meadows Cullompton Devon EX15 1QS Lead Inspector Louise Delacroix Unannounced Inspection 25th October 2005 17:50h 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 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 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 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. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 3 Water Meadows Address 3 Water Meadows Cullompton Devon EX15 1QS 01884 34287 01884 34806 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 Disabilities Trust Mrs Christine Mary Chitty Care Home 2 Category(ies) of Learning disability (2), Physical disability (2) registration, with number of places 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th November 2004 Brief Description of the Service: 3 Water Meadows is a three bedroomed house situated in a residential area of Cullompton. The house has a lounge, a kitchen / dining room and a toilet on the ground floor and on the first floor there is a bathroom/ toilet, the service users’ bedrooms and an office/sleep-in room. There is garden at the front of the property and a small-enclosed garden to the rear. The home provides rehabilitation care for two service users who have an acquired brain injury. The staff support the service users to re-establish their independent living skills and the home is seen very much to a step onwards for service users from The Woodmill, which is the main unit situated not far from the home. Prospective service users may also come from their own homes after a detailed pre-admission assessment. Whilst the home has its own staff team it is also able to make use of the multi-disciplinary staff team based at The Woodmill. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place in the evening over two hours, and during the visit both residents (who were spoken to individually in their rooms) and two members of staff contributed with their views on the service and provided information about the home. The inspection included looking at fire records, medication storage and administration sheets, care plans, financial records and daily notes, plus a tour of the building. What the service does well: What has improved since the last inspection? 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. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 6 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 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 7 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): 2,4,5 Prospective residents are actively involved in the decision to move to the home and are involved in setting the goals in their care plans, which help staff to meet their needs and aspirations. EVIDENCE: The home calls itself a “near reach house” with the goal of working towards the service user eventually moving on to more independent living. The team at the brain injury unit carries out full assessments and then with the resident creates a treatment and rehabilitation programme. The team consists of care workers, occupational therapists, physiotherapists, psychologists and GP’s as necessary. Assessments from social care professionals, i.e. care managers also play an important role within the assessment. Residents and staff confirmed how a new resident was introduced to the home and to the current resident over a period of time. This was also confirmed by care records and involved support from The Woodmill team as well. Both residents already knew one another. A resident had signed their contract, which contained all the required information i.e. notice period. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 8 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): 6,7,9 The standard of care planning is good, showing the involvement of residents and a multi-disciplinary approach to their goals. EVIDENCE: Care plans are generated from detailed assessments and have a holistic approach to residents’ lives. They include clear guidelines regarding communication and risk assessments regarding restrictions on activities. Residents spoke about their goals, which were reflected in their care records and through discussion illustrated their involvement in decisions. These also evidenced the multi-disciplinary approach to support residents’ goals i.e. attending an art class or a communication class. The minutes from reviews evidence that residents are able to attend and contribute to these meetings, which a resident also confirmed. These are held at appropriate intervals. The home’s missing person’s policy has clear steps for staff to take, which also includes informing CSCI. A range of professionals contributes to the risk assessments with multi-disciplinary advice whilst also identifying training that is needed for the resident’s personal safety. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 9 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): 12,13,14,15,16,17 Links with the community are good, and residents are supported to access areas of interest for their personal development. EVIDENCE: The residents explained that they weren’t currently involved in a work placement but spoke positively about their ability to access courses related to their own interests or self-development. One person felt that they had a full weekly schedule but the other felt that they would prefer to have more stimulation. Both spoke about being able to use the local resources i.e. gym and shops. One resident spoke enthusiastically about a recent holiday, which staff supported them to organise, although this was not part of the basic contract price. Records and discussion with staff confirmed that residents choose whom they mix with socially, and that they are supported to maintain contact with friends and family with recognition of their communication needs. From talking with residents, it was clear that they felt able to indicate when they wanted company or privacy. One person said they had a key to the home while the other person had been risk assessed as this being an unsuitable option. Staff were seen respecting residents’ privacy throughout the 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 10 inspection, and records demonstrated a careful balance of care and independence in the monitoring of a resident’s health and safety. Residents spoke about how they made decisions about what they ate and how they reached a decision about what they ate. Care records recognised the individual likes and dislikes of residents. During the inspection, a meal took place and the atmosphere was relaxed and unhurried. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 11 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): 18,19,20 The medication at this home is well managed, and staff are provided with clear information to support residents in an individual and respectful manner. EVIDENCE: Care records contain individual and clearly written guidelines about supporting residents with personal care, which recognise resident choice, and provide advice for staff about a sensitive approach. Daily notes about this aspect of care are written appropriately. Small adaptations have been made to the environment to maximise residents’ independence following assessments by the multi-disciplinary team, which includes occupational therapists. One resident spoke positively about a regular physiotherapy group, which was helping with their mobility and confidence. Medication is appropriately stored, recorded and checked in, with written additions double signed, which is good practice. A member of staff spoke about a resident’s medication demonstrating their awareness of the resident’s health issues and the staff member’s responsibility to respond to this. Guidelines were clearly written and informative. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 12 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): 23 The home’s financial system and guidelines promote the safety and protection of residents. EVIDENCE: Staff explained that one resident manages their own money, while another has support due to the outcome of a risk assessment. Receipts are kept, with credits and withdrawals signed for within clearly kept records. A resident spoke about the management of their money and their understanding around this issue. There are clear guidelines within residents’ care records about how staff should respond to possible verbal or physical aggression. The Brain Injury Trust provides a thorough in-house training programme for staff, which has three levels. All three levels include vulnerable adult training, including the induction programme, as well as specialist training on brain injury. A new member of staff confirmed that their induction was in hand and expressed their positive impression at the level of training and support available to staff. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 13 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): 24,25,26,27,30 The maintenance and décor of the home is well maintained, and provides a clean and homely atmosphere for residents living there. EVIDENCE: The home blends in with the neighbouring houses and is walking distance from Cullompton High Street. Each resident has a single room, and they have use of all other parts of the home, apart from the office/sleep in room. There is a communal domestic sized bathroom. There is a separate lounge with a kitchen/diner. The home is decorated in an attractive style, and is well maintained and odour free. Furnishings are of a good quality. There are maintenance records in place. Both residents were positive about the size of their rooms and the furniture within them, which includes lockable storage space. One room particularly reflected the interests of the resident. One bedroom radiator does not have a guard and a member of staff explained that a risk assessment had shown this was necessary for the new occupant, and that a bespoke cover was being made. At the present time, a piece of furniture partially obscures the radiator. They also explained that a flashing light fire alarm was being considered to promote the safety and independence of one resident. The home was clean, tidy and odour free. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 14 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): 35,36 Staff work in a supportive atmosphere, where training is promoted. EVIDENCE: The staff rota reflected the staff on duty and showed a staff team of two women and a man. Residents spoke positively about the staff team. A new member of staff, with experience in care work, spoke about their forthcoming induction programme, which they described as full and comprehensive. They also explained that they had visited the home and met with residents before beginning work, and how the atmosphere was supportive and members of staff informative. Residents confirmed this. Staff spoke positively about regular supervision on a six weekly basis, and at least once a week visits from the manager. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 15 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): 42 Health and safety measures are well maintained. EVIDENCE: The home’s accident book is completed appropriately, and water temperatures are monitored. Portable appliance testing is up to date, as are the fire checks. Staff confirmed that a member of staff from The Woodmill (another Brain Injury Trust home) visits on a weekly basis to over see safety and maintenance checks. Staff also confirmed that regulation 26 visits happen on a monthly basis to audit the service and safety checks. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 16 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 3 Water Meadows Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x DS0000021846.V250719.R01.S.doc Version 5.0 Page 17 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 YA14 Good Practice Recommendations Service users in long-term placements should have as part of the basic contract price the option of a minimum sevenday annual holiday outside the home, which they help choose and plan’. 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY 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 3 Water Meadows DS0000021846.V250719.R01.S.doc Version 5.0 Page 19 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!