Inspection on 09/05/05 for 5 St Margaret`s Gardens

This inspection was carried out on 9th May 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

5 St Margaret`s Gardens 21/05/09

5 St Margaret`s Gardens 24/05/07

5 St Margaret`s Gardens 25/05/06

5 St Margaret`s Gardens 18/10/05

5 St Margaret`s Gardens 20/12/04

5 St Margaret`s Gardens 20/07/04

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 09/07/2008.

CARE HOME ADULTS 18-65 St Margarets Gardens (5) Melksham Wiltshire SN12 7BT Lead Inspector Malcolm Kippax Unannounced 9th May 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. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service St Margarets Gardens (5) Address Melksham Wiltshire SN12 7BT 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) 01225 709691 Ordinary Life Project Association Mrs Jacqueline Mitchell Care Home 4 Category(ies) of LD Learning Disability (4) registration, with number of places St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th December 2004 Brief Description of the Service: 5, St Margaret’s Gardens is a care home for four adults with a learning disability. The home is located in a residential area on the outskirts of Melksham. It is one of a number of homes that are run by the Ordinary Life Project Association (O.L.P.A.). 5, St Margaret’s Gardens is a two storey detached property. Each service user has their own bedroom. One of the bedrooms is on the ground floor and has an en-suite bathroom. The accommodation includes a lounge, dining room, kitchen, an upstairs bathroom and a separate W.C. There is a large garden at the side of the property. There is a permanent staff team that is managed by Ms J. Mitchell. At least one member of staff is on duty throughout the day. Service users attend day activities in the community. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 2 pm and took place over three and a half hours. Service users returned home during the afternoon from different activities and quickly settled into their own routines. One service user had been out dog walking with a support worker. This was one of her personal goals. The four service users and two members of staff were spoken to. The communal areas of the home were seen. A selection of records was examined, including two of the service users’ care records. What the service does well: What has improved since the last inspection? What they could do better: One service user said that she is moving out because the home environment is not safe for her. Problems with safety could have been foreseen when the service user first moved in. The home must ensure that a service user is only admitted if the accommodation is suitable and meets their assessed needs. Service users would benefit from better conditions in the domestic areas. These need to be more hygienic and the kitchen should be refurbished, rather than just ‘patched up’. Specialist training should be available to new staff. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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 St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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) 1 and 4, Prospective service users have the opportunity to visit the home and to meet with service users and staff. The current service users can give feedback about the visits and their views are listened to. A new service user would have a settling in period and be given time to decide whether they wished to stay at the home on a permanent basis. New service users would receive a guide to the home, which includes factual information and a range of personal comments about what life is like in the home. EVIDENCE: Service users said that they had been consulted after a prospective service user had visited the home. They like to be involved in this way and had discussed the visit during one of the ‘tenants’ meeting that are held each month. Good minutes are kept of the tenants meetings. Service users have raised some relevant points and are open in their comments. There is an admissions policy that includes a trial period and review meetings to discuss how well things are going. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 9 Each service user has a personalised copy of the ‘service user’s’ guide. A survey of the service users’ views about the home has been included. This provides a selection of comments about how the service users’ feel about the home and the support that they receive. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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 standard(s) 6, 8 and 9 Individual care plans are providing a good summary of the service users’ needs and the support that is required from staff. A system of ‘Shared Action Planning’ is helping service users to make choices about their individual goals and to decide on things that they would like to do in the future. Service users are encouraged to pass on their views during individual review meetings and at the monthly tenants meetings. Service users enjoy participating in the home’s domestic activities and daily routines. The atmosphere and the approach of staff encourage service users to treat the home as their own and to act independently. Risk assessments are helping to ensure that the service users can do this safely. One service user had mixed feelings about a move that was being planned from 5 St. Margaret’s Gardens to new accommodation. Her independence and dignity are being compromised while living at the home. EVIDENCE: Service users spoke about their different routines and what they enjoy doing. These were reflected in their personal records, which showed the goals that St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 11 service users are working towards and the support needed to achieve these. Examples of the service users’ care and support records were looked at. The main care plans had been updated in March 2005. During the inspection, one service user hoovered the lounge and a staff member was overheard praising her for the job done. The involvement of an advocate has helped one service user to make decisions about her future and where she would like to live when leaving 5 St. Margaret’s Gardens. The move was necessary on safety grounds as the service user had an upstairs bedroom but was at risk when using the stairs. This service user moved into 5 St. Margaret’s Gardens in spite of preadmission records, which confirmed that stairs were a potential hazard. This situation was being managed through a risk assessment. Risk assessments have been undertaken in relation to the service users’ individual activities. During the inspection, one service user returned to the home after cycling to a friend’s house in a nearby village. She felt confident to do this and a staff member said it had been assessed as a safe activity. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 12 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) 12, 13 and 17 Service users have individual lifestyles and generally enjoy how they spend their time. Good arrangements have been made to support service users with particular areas that are important to them, such as going to Church and looking after a pet. Service users like the balance that they have between planned activities and unstructured time. Service users go out in the local community and have well established social networks. Service users are consulted about what they want to do and about the meals. There is encouragement from staff about healthy eating. EVIDENCE: At the time of the inspection the service users were engaged in different activities that they had chosen to do. The dog walking and the cycling were two of the service user’s main afternoon activities. One of the service users also went out food shopping with a support worker later in the afternoon. Another service user had a part-time job in a nearby pub, which he is able to get to independently. This was also a social event. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 13 One service user has a pet rabbit and another has their own cat. New activities are discussed during review meetings. One service user had recently tried a work placement in a charity shop. The tenants meetings include discussions about day trips and holidays. One service user said that he was particularly looking forward to staying in the caravan that is being bought through O.L.P.A. fundraising. There is a planned menu for the week. This shows a choice of dishes and service users were asked what they would like to have for the tea meal. Dietary advice has been obtained. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 14 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) 18 and 19 Service users receive the level of care that they require and are well supported by staff with their healthcare. One service user continues to receive good support following a major surgical operation that took place during the last year. Staff members monitor the service users’ day to day health and ensure that service users have regular check ups. EVIDENCE: One service user said that staff were helpful and encouraged her after a hospital admission and operation. Written guidance has been produced about the service user’s rehabilitation and the staff team are working in conjunction with the district nurse. The service users’ personal files include a well identified section on healthcare. Visits and appointment with a range of healthcare professionals are recorded on different forms. The records showed that service users have regular check ups with the dentist and chiropodist. Medication is kept under review. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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 standard(s) 22 and 23 Service users know what to do if they are not happy with something. They are encouraged to share any concerns and these are listened to by staff. However, when a complaint is made, the details of the concern and the outcome of the investigation are not being fully recorded and available for inspection. Staff members receive training through O.L.P.A., which increases their awareness of different forms of abuse and what to do if abuse is suspected. Written guidance is available in the home however this should be provided for staff on a more individual basis. EVIDENCE: A complaints procedure is included in the service users’ guide although service users have more informal networks for discussing any concerns. Each service user knew someone they could contact outside the home if they have a problem. Some issues are easily resolved through discussions in the tenants meetings. Staff could not locate a record of complaints, although one complaint made by service user had been reported on a Regulation 26 report. Staff said that the service user had been unhappy that a prospective user was being shown around the home. It was reported that the complaint had been resolved. A member of staff said that she had received training in abuse awareness through O.L.P.A. She had seen a copy of the ‘No Secrets’ guidance booklet but had not been given her own copy. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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 standard(s) 24 and 30 Three service users are well settled in the home. However, the accommodation is not meeting the needs of one service user who has difficulty in using the stairs. Work to improve the domestic areas of the home remains outstanding and some parts are not hygienic. A more planned approach is needed to refurbishment in the home. Changes in the type of floor covering being used should not produce a tripping hazard for service users. Service users make good use of the shared rooms and enjoy using the garden. They have ideas about other facilities they would like to have in the garden and forms of funding for these should be considered. Suitable fire precaution precautions are in place. EVIDENCE: Service users were using their own rooms as well as mixing with others in the lounge and the dining room. The lounge is comfortably furnished and has a television and video; the dining room is available for a range of other activities. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 17 The garage is used as a laundry and storage area. Previous recommendations have not been met. There is an old bit of carpet under the washing machine and the ceiling is covered with cobwebs. Minor repairs to the cupboard doors and the tiling in the kitchen have recently been made. However, as reported at previous inspections, the kitchen is showing wear and tear and is in need of refurbishment. The hall carpet has been cleaned since the last inspection. Consideration is being given replace this with a different type of floor covering, because of spillages. The service users have volunteered ideas in the tenants meetings about other facilities that they would like to have. These include a table tennis table and a swinging seat, however the service users have been told that they would need to buy these things out of their own money. The home’s fire log book was up to date. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 18 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) 33 Members of the permanent staff have a good understanding of the service users’ needs. There is less use of agency and relief following the appointment of a new staff member. New staff get to know the home using an in-house programme of induction but they do not benefit from Learning Disability Award Framework (L.D.A.F.) accredited training. Staff members meet on a regular basis and this results in the service users’ needs and welfare being kept under review Service users enjoy good relationships with the staff. EVIDENCE: The staff rota was up to date. Agency staff have covered several shifts during March 2005 but have been less needed in April and May. At least one member of staff is working throughout the day, with ‘double cover’ for certain shifts. There was a personal file for the new member of staff that included a record of induction produced by O.L.P.A. There was a staff training plan for the year ahead, which included the subject of health & safety. Staff members said that this also covered infection control. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 19 Minutes are kept of the staff meetings that take place approximately monthly. The meetings focus on a discussion of the service users’ progress. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 20 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) These standards were not assessed on this occasion. EVIDENCE: St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x 3 x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Margarets Gardens (5) Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 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. 1. 2. Standard 22 24 Regulation 22 13 Requirement Complaint investigations and their outcome must be fully recorded A risk assessment must be undertaken before the hall carpet is replaced with a different type of floor covering The laundry area needs to be cleaned and a hygienic surface maintained under the washing machine The kitchen drawers and cupboards must be cleaned Timescale for action 09/05/05 09/05/05 3. 30 16 03/06/05 4. 30 16 03/06/05 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. 3. 4. 5. Refer to Standard 23 24 24 30 35 Good Practice Recommendations That each member of staff is given their own copy of the No Secets booklet That alternative means are found to meet the costs of garden and outside leisure equipment That a date for refurbishment of the kitchen is identified That appropriate facilities are provided for hand washing and drying after the washing machine has been used That Learning Disability Award Framework (L.D.A.F.) Version 1.30 Page 23 St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc accredited training is used to provide staff with underpinning knowledge that they need, e.g. when completing N.V.Q. St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 24 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 St Margarets Gardens (5) D51_D01_S28372_StMARGARETSGARDENS_V197495_090505_Stage4.doc Version 1.30 Page 25 - 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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