Inspection on 22/11/05 for 86 Travis Gardens

This inspection was carried out on 22nd November 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

86 Travis Gardens 14/06/06

86 Travis Gardens 03/02/05

86 Travis Gardens 30/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Snydale Care Home

Whitwood Hall

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

CARE HOME ADULTS 18-65 86 Travis Gardens 86 Travis Gardens Hexthorpe Doncaster South Yorkshire DN4 0DP Lead Inspector Valerie Hoyle Unannounced Inspection 22nd November 2005 11:30 86 Travis Gardens DS0000053274.V266579.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 86 Travis Gardens DS0000053274.V266579.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. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 86 Travis Gardens Address 86 Travis Gardens Hexthorpe Doncaster South Yorkshire DN4 0DP 01302 859510 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) Craegmoor Homes Ltd Ms Kay Bliss Care Home 12 Category(ies) of Learning disability (12), Physical disability (12) registration, with number of places 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th May 2005 Brief Description of the Service: The service provided at the home is in partnership with Doncaster Metropolitan Borough Council (owner of the property) and is managed by Craegmoor Healthcare Services. The home provides a respite service for up to twelve adults with a learning disability including those with a physical disability who require personal care. Service users can have up to 42 nights respite a year and the admission can be booked up to three to four months in advance. The home is a modern purpose built building situated within a small complex consisting of two other quite separate establishments, one a resource centre for people with a learning disability and the other a long stay residential care service for adults with a learning disability. The accommodation comprises of 12 single bedrooms 8 on the ground floor and 4 on the first floor. There is no lift to the first floor and so only the more able service users are allocated a room on the first floor. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection of this inspection year. (2005/06) This unannounced inspection was conducted over 6 hours where a partial tour of the building was undertaken. The inspector examined three guests (service users) care plans and supporting documentation. Six guests (service users) and five staff were spoken to during the visit. The manager assisted with the process while examining records, policies and procedures. What the service does well: What has improved since the last inspection? Since the last inspection the manager has successfully been registered by the Commission for Social Care Inspection, and continues to works towards attaining the Registered Managers Award 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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. Guests (service users) are not admitted into the home without a full needs assessment taking place by the registered manager, to ensure their needs can be met. Procedures ensure that visits take place prior to any arranged stays at the home. Staff are able to meet the needs and aspirations of guests who spend time at the home, by providing a stimulating lively environment where they are supported to take part in leisure and social activities. EVIDENCE: The registered manager confirmed arrangements for ensuring the needs of service users (guests) are met. She has responsibility for undertaking all assessments prior to admission. New guests are always encouraged to visit the home for tea and meet other guests and staff before making decisions about if they want to use the respite services. Discussion with staff confirmed that they encourage guests to maintain their interests and lifestyles while enjoying the activities provided at the home. One guest was looking forward to going to the wrestling with his/her father. A number of guests have been of admitted on emergency stays, although they are known to the respite service. The process for assessment was still followed to ensure their care needs can be met. Some guests were able to describe the circumstances leading to their admission and expressed some anxieties about how long they could expect to stay at the home. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 9 The placing authority and registered providers should be clear about the length of time guests can expect to stay whilst occupying emergency stays, as this may interfere with the availability of planned stays for other guests. The placing authority contracts state that reviews of emergency stays should take place within seven days of admission, although their appeared little evidence that these reviews have taken place. The statement of purpose should also be reviewed to clearly detail what can be expected when a guest is admitted on an emergency stay. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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, 7, 8, 9 The care planning system is not always sufficient to enable staff to deliver the care to service users who have specific identified risks. Guests or their relatives must be given the opportunity to agree and sign their care plan, so that they are fully aware of the care they can expect to receive. Guests are supported and encouraged to make decisions about their lifestyles ensuring continuity from time spent at Travis Gardens and their own homes. EVIDENCE: Three care plans were examined and these contained details of the care they require whilst staying at the home, although some of the information is generic and may not always be appropriate. There is evidence to show that the care plans are being improved with more specific information to show changes in care needs. The registered manager recognises that further improvement could be made to care plans and training for staff has been organised to assist with this process. There was evidence of risk assessments on each of the guests files examined, although these were mostly generic with regard to risks 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 11 involved outside of the home. Further development of risk assessments should be considered when the process is reviewed. As this is a respite service there is emphasis on supporting the same level of independence in decision making that the guest have at home. For many of the guests the respite stay is also an opportunity to make decisions without family support. Staff recognise the need for consistency and ensure that care records detail issues that the service user may have difficulty making decisions about. Guests returned from day services and immediately were involved in making decisions about meals and activities, Guest were given an opportunity to choose from a hot meal or sandwiches. One guest said he/she enjoyed spending time at the home and liked the staff that were very kind. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14, 15 Social and leisure activities are provided at the home for guests, to maintain and develop independent living skills, supported by an informed staff group. Guests are helped to maintain links with family members and follow routines outside of the home, although relatives usually take the opportunity to take a holiday break, while guests are in Travis Gardens. EVIDENCE: The manager provides transport to help guests pursue leisure activities outside of the home during their respite stay. Bowling and trips to the pub for a meal were popular with the current guests at Travis Gardens. One guest was looking forward to going to the cinema to watch the latest Harry Potter film. Staff confirmed arrangements to integrate guests into the community and said it was an important to offer this service, so that they are able to develop social skills. The provision of respite care at the home means that guests return to their families after their stay, and therefore staff are aware of the importance of maintaining routines to ensure continuity of care for when they return to their own home environment. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 13 Guests are encouraged to help with tasks around the home such as laying the tables for meals and helping clear away the pots and help with the dishes. There were many good examples of staff interacting with guests and all guests were referred to by their first name. Guests were seen helping to clear tables and washing the pots, one guest said she/he liked to help staff, as she/he liked to keep busy. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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 the following standard(s): 18, 20 Staff provides sensitive personal support to ensure privacy dignity and independence is maintained for all guests. Medication policies and procedures are well managed and staff have the necessary skills to administer the medication to service users, ensuring the safety and protection of guests. EVIDENCE: Guest retains their own GP whilst staying at the home, although an emergency arrangement can be made if needed. Records examined and discussion with the senior on duty confirmed guest’s healthcare needs are met. Guest are escorted to medical appointments by staff and comprehensive records are completed ensuring information is shared with those who care for the individual. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 15 Guests and their carers are responsible for ensuring that sufficient medication is sent to the home while receiving respite. Any guest wishing to self medicate can do so, this is risk assessed and there is provision of a lockable facility in each bedroom. An audit of medication stocks and records was examined and were found to be correct. All staff has received accredited medication training provided by a local college, to ensure they have the necessary skills and knowledge to undertake this task 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 16 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 Guests are provided information to enable them to raise concerns about the home and their care. Adult Abuse Policies and procedures and training of staff on abuse, ensures the protection of guests from abuse. EVIDENCE: The home has a complaints procedure that is available to guests and visitors that is kept in the entrance. The procedure is also referred to in the guest’s charter, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. The registered manager has a copy of the Local Authorities Adult Protection procedures. They also have an Abuse Policy, which has been prepared by the owners and is incorporated into the homes policy and procedure manual. The manager reiterates the procedures at staff meetings and supervision and staff training files also confirms types of abuse and how to respond to any incidents. The registered providers ensure that all the necessary checks are carried out on new staff for the protection of vulnerable adults. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 The home provides a well-maintained safe environment suitable for guests to spend their time. The home provides a clean and hygienic environment to maintain the health and safety of guests. EVIDENCE: A partial tour of the building found it clean and free from odours. The home provides a number of rooms to enable guests to pursue life skills, including two main lounges and dining facility. All rooms are well equipped and guests were able to tell the inspector that they enjoyed watching television and often used the lounges to play games. Bedrooms meet the spatial requirements and several guests showed the inspector their rooms that were nicely decorated and personalised to their taste. One guest had brought in a games console and DVD player so that he/she can continue with interests from home. Another guest was discussing bringing in a hifi and records to have in his/her bedroom. The home stands within a small complex and has an enclosed area that is lawned and has seating available. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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 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): 32, 34, 35 Staff have the skills and knowledge to fulfil their roles within the home. A stable staff group ensures continuity of care by staff who knows the guests. Recruitment policies are followed ensuring the safety and protection of guests. EVIDENCE: Staff rotas examined demonstrated there is sufficient staff to meet the needs of service users. The registered providers have responsibility for ensuring references and CRB checks are obtained prior to commencement of employment. The registered manager is currently recruiting three new care assistants to ensure adequate cover can be maintained. There is a senior structure in place with a manager, deputy and senior carers on each shift. The remaining staff are designated as support workers. Staff is encouraged to register and undertake formal NVQ training and the senior carers are working towards NVQ level 3. Staff are commended for attaining the required 50 NVQ qualified staff. A training matrix is used to demonstrate staff receives statutory training to enable them to meet the complex needs of guests. Discussion with the manager indicated that staff have not recently received any formal training to deal with challenging behaviour, therefore staff must attend a behaviour management course to ensure they have the necessary skills to deal appropriately with guests. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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, 42 The home is well managed to ensure the safety and protection of the guests. Staff and guests follow health and safety procedures and records provide evidence of servicing of essential equipment. EVIDENCE: The registered manager has a wealth of experience and knowledge and is able to demonstrate her ability to manage the home. She was registered with CSCI in August 2005 and is currently undertaking the registered managers award and is hoping to complete the award within the next twelve months. Guests spoke fondly of the manager and said she was very kind. Maintenance and service records examined were up to date and current to the services provided. Accident records were fully completed for both service users and staff and the manager carries out her own investigation. The manager has the required Health and Safety policies and procedures and displays the relevant notices. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 20 Fire safety procedures are in place and service records were examined and were current. Monthly fire checks/drills and refresher training with regard to fire evacuation is now required to ensure guests safety and protection. The manager said this was scheduled for later this month. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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 X 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 86 Travis Gardens Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 2 X X X X 3 X DS0000053274.V266579.R01.S.doc Version 5.0 Page 22 YES 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 YA35 Regulation 18 Requirement The registered manager must ensure that staff have the necessary skills and knowledge in dealing with challenging behaviour Timescale for action 01/04/06 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 YA37 Good Practice Recommendations The manager should achieve NVQ4 in management and care in 2005. 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Doncaster Area Office 1st Floor, Barclay Court Heavens Walk Doncaster Carr Doncaster DN4 5HZ 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 86 Travis Gardens DS0000053274.V266579.R01.S.doc Version 5.0 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. 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