Inspection on 25/08/05 for 33 Abbotswood

This inspection was carried out on 25th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

33 Abbotswood 30/08/07

33 Abbotswood 16/02/07

33 Abbotswood 12/12/05

33 Abbotswood 21/12/04

33 Abbotswood 01/07/04

33 Abbotswood 12/02/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

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Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 33 Abbotswood Guildford Surrey GU1 1UZ Lead Inspector Mr D Griffiths Announced Inspection 25 August 2005 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 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 Stationary 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. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 33 Abbotswood Address Guildford Surrey GU1 1UZ Telephone number Fax number Email 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 Four Seasons Trust Ltd Mr Paul Joseph Fitzroy Bennett CRH (PC) 4 Category(ies) of Learning Disability (LD) 4. registration, with number of places 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no conditions of Registration. Date of last inspection 21 December 2004 Brief Description of the Service: 33 Abbotswood ,The Four Seasons Trust, is a large detached house developed to provide a good standard of accomodation for 4 adults with learning disabilties. It is set in a pleasent residential area of similar homes and situated close to Guilford town centre. All the service users bedrooms are on the 1st floor are single occupancy and have en-suite facilities. Staff accomodation is limited to a small room used for sleeping in and for storage of documents. The ground floor has a dining room, sitting room,utility room, kitchen and toilet. There are plans to redevelop the basement area to provide a new office and games room. There is a garden to the rear and side of the property and some off road parking. There is a multiperson-vehicle to ensure residents have easy access to local community. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of two to be undertaken in the Commission for Social Care Inspection Year April 2005 to March 2006. It was an announced visit and took place over a period of 7 hours. Lead Inspector Damian Griffiths was assisted throughout the inspection by Registered Manager Mr Paul Bennet representing the establishment. The Inspector met all the service users before they went to work at a local horticultural centre nearby. The service users were very welcoming and interested in the inspection. They had all completed a pre-inspection comment card requesting to speak to the inspector. The inspector also met two staff members including Mr Layne Penrose, the Responsible Person for the Four Seasons Trust. The Inspector would like to extend thanks to the residents, staff and management of Abbotswood for their assistance and hospitality. It is recommended that the reader should also look at the previous report that can be accessed by using the CSCI website details on the last page of this report. What the service does well: What has improved since the last inspection? Work to reinforce the structure of the premises had been completed. A recommendation made at the previous inspection relating to safer medication distribution had been followed. The residents were enthusiastic and happy about their home and were looking forward to going abroad later in the year. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 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. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 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 standard(s) These standards were not inspected. EVIDENCE: These standards were not inspected. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8, and 9. Care Plans were clear and comprehensive and service users were supported to make daily decisions about their activities. Risk assessments were in place to support services users to participate with independent lifestyles as much as possible. EVIDENCE: All care plans were based on the assessment needs of services users and contained clearly defined sections highlighting areas of need, i.e. personal hygiene, medical records, risk assessment, hobbies, activities and costs of care. Risk assessments had been completed in order for service users to gain the most from engaging in everyday activities and to go abroad later this year. Service users goals related to successful transition to Abbotswood and access to College. All care plans were due for review in October of this year. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 10 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 standard(s) 11,12,13,14 , 15 and 16. Service users have ample opportunity for personal development. They are able to use the local amenities within the community and maintain good links with family and friends. EVIDENCE: Services users all attended a local horticultural centre and they confirmed to the Inspector their enjoyment of this work. The local college is also attended by service users interested in gaining independent living skill and staff encourage hobbies and other interests of the services users, i.e., football, buses and trains and disco dancing were a few discussed. Service users are encouraged to participate with usual tasks associated with independent living these included: cooking, shopping and budgeting skills. Service users have a variety of arrangements for the care of their finances including parental appointees and access to bankcards. The home keeps good records of receipts and bank statements were observed in some service users files. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 11 One service has been reliant on the manager to cash cheques for welfare benefits. A requirement was made for alternative arrangements to be explored by the service users local authority and to arrange, if appropriate, a bank account to be opened. The home has it’s own transport benefiting the service users who regularly attend the leisure centre and community events. They were supported to vote in the last election. Families and friends are in regular contact with the service users and are able to visit freely. Some service users regularly go away for the weekends with their parents. Services users are due to go away on their first overseas trip to Tenerife later in the year and regular trips to the coast were also possible as the home has the uses of a caravan. Monies donated by well-wishers and charitable events help support the services users holidays. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 12 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 standard(s) 20 Policies and procedures were observed to be relevant to the needs of the service users and risk assessments had been completed and regularly reviewed. EVIDENCE: Service users at Abbeywood require limited medication. This was observed to be securely stored. Staff allowed to administer the medication had all received the appropriate training and medicine administration sheets had been correctly completed: all secondary dispensing for purpose of home visits or holidays was clearly recorded and details of family receiving this medication was present. Risks connected with the holiday were also in evidence. A GP letter of authorising medication overseas and included details of safe use of medication in emergencies. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 13 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 standard(s) 22 and 23 These standards were not inspected. EVIDENCE: These standards were not inspected. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 14 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 standard(s) 24 and 30. Improvements to structural defects of the premises due to subsidence have been completed and there were plans to redecorate the areas that have been affected. Despite this Abbotswood offers service users a clean, airy and homely environment to enjoy. EVIDENCE: Structural reinforcement to the premises due to subsidence were satisfactory completed and will continue to be monitored for any further ground movement. A letter confirming the completion of structural reinforcement to the premises is required. The repairs to the home are funded by the homes insurance company and are dependent on the release of funds. Repairs are required to ceilings walls and bricks contained in the patio areas outside the home. The inspector was informed that the repair and redecoration would commence as soon as funds are released and service users are able to make use of the holiday caravan when repairs are undertaken. The manager has plans to open up the basement area for conversion to a games room and a new office. The premises were clean, light and airy. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33, and 35 The arrangements for the induction of staff were appropriate and the staff demonstrated a clear understanding of their roles and responsibilities. EVIDENCE: Staff roles and responsibilities were well defined and confirmed by the homes individual job descriptions. Services users were observed communicating freely with the staff that were sensitive to their needs. Staff members are committed to achieving NVQ training awards and 33 have achieved NVQ level 2 or above. Staff receive induction training that includes: Food Hygiene, Health and Safety, First Aid and received specialised training to meet the requirements of the service users, e.g., emergency use of medication. Training is usually commissioned from outside sources however the manager also ensures that training he receives is passed onto staff, i.e. Adult Protection training. Staff rota’s were inspected and showed that each shift included staff trained in First Aid and Safe Handling of Medication. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42 Quality assurance monitoring systems were not in evidence. The manager was fully aware of the Health and Safety requirements of the home. EVIDENCE: The responsible individual undertakes formal visits as required under Regulation 26 of the Care Homes Regulations 2001 and it was recommended by the inspector that the home conduct quality assurance monitoring. The service users benefited from staff training previously mentioned and details of COSSH, Fire drill and RIDDOR procedures were in place. The accident book was inspected and there had been no serious accidents recorded since the last inspection. All certificates for inspection of electrical appliances were in place except for a gas safety certificate, this needs to be checked annually and a requirement was made for the Registered manager to arrange. The home had been regularly monitored for risk during and after the building repairs. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 17 The holiday caravan was available for service users during the restructuring work and will be available again if further work is required and holiday travel insurance had been arranged for the trip to Tenerife. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 18 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 x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 2 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 33 Abbotswood Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x 2 x H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 19 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. 1. Standard 12 Regulation 20(1) Requirement Timescale for action 03/10/05 2. 24 23(2)(b) 3. 42 13(4)(a) The registered person must not pay money belonging to a service users into a bank account unless it is in the name of the service user and request the local authority responsible to make alternative arragements for payment of monies belonging to the said service user. The registered person must 30/09/05 ensure that the premises are of sound construction and are kept in a good state of repair internally and externally by providing a written confirmation of work completed to reinforce the structure of the home. The registered person must 20/09/05 ensure that all unnecessary risks to health and safety are identified and eliminated by the provision of an current gas safety certificate. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 20 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 20 39 Good Practice Recommendations It is recommended that staff provide specimens of initials and signatures to be included within the medicine administration recording sheets. It was recommended by the inspector that the home conduct quality assurance monitoring. 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 21 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 33 Abbotswood H09 H59 s40846 33 Abbotswood v240154 250805 Stage 4 ann.doc Version 1.40 Page 22 - 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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