Inspection on 05/11/08 for Cardinals Gate 55

This inspection was carried out on 5th November 2008.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cardinals Gate 55 12/11/07

Cardinals Gate 55 09/03/07

Cardinals Gate 55 05/10/05

Cardinals Gate 55 20/04/05

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Extracts from inspection reports are licensed from CQC, this page was updated on 31/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Cardinals Gate 55 55 Cardinals Gate Werrington Peterborough PE4 5AT     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Don Traylen     Date: 0 6 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Cardinals Gate 55 55 Cardinals Gate Werrington Peterborough PE4 5AT 01733576660 01733576650 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Community Care Solutions Limited Type of registration: Number of places registered: care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Learning Disability (6) Mental Disorder (2) - Only associated with learning disability Date of last inspection Brief description of the care home 55 Cardinals Gate is a bungalow in a residential area of Werrington, a village on the outskirts of Peterborough. It is no different in appearance from the neighbouring properties. There is a small parking area and garden to the front of the bungalow and a spacious enclosed garden to the rear. There are six single bedrooms, four with en suite facilities. There is a lounge, dining room and an additional conservatory with patio doors to the garden. The home can accommodate up to 6 adults with a learning disability and for two of those people having associated mental health problems. The home has its own transport and there is also local public transport, which is accessible Care Homes for Adults (18-65 years) Page 4 of 26 6 2 Over 65 0 0 Brief description of the care home from close by. Local amenities are within walking distance and staff support people living at the home to use all the amenities of Peterborough. The weekly fees are from £1300. Copies of CSCI inspection reports are available to the residents and their relatives and are kept in the office. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection lasted 7 hours and was conducted over two days. This was done to ensure that people living at the home were seen. Two people expressed their feelings about the service. The home completed an Annual Quality Assurance document prior to the inspection. Care plans were read and people were observed for the care and support they were offered. The administration of medication records were assessed, as were care plans, fire drills, incident records and staff recruitment record. Policies for abuse and recruitment were read. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured the home has adequate information about their needs before they decide to move into the home. Evidence: Six people were living at the home. Each person had a rigorous and comprehensive assessment of their needs carried out by a Learning Disability Partnership, before they moved into the home. Each person visited the home before they moved there and before it was agreed they would move there. All of the people living at the home are funded through Local Authorities and therefore the home was provided with complete assessments of needs. The Statement of Purpose and the User Guide are in pictorial format and facilitate easier understanding. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured their care is provided in a person centred way. Evidence: The care needs of the six people living at the home are varied. Four people need oneto- one support from care staff and there are periods when more staff are needed to support each of these persons. When people are in the community this individual support is essential and is part of the risk assessments carried out for each person. There are times when challenging behaviour determines that more than one care support worker is required to assist people. At least two or three people need two staff to support them at critical times. Staff expressed their knowledge of peoples needs and when more than one care worker is required to give support. Three peoples care plans were read. The plans were extensive and contained adequate details of how each persons needs should be met. Peoples daily routines included social activities and domestic tasks that are geared to encourage them to be Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: independent and responsible. Daily records are kept as a part of each persons care plan. A record is kept of particular challenging behaviour incidents in an Antecedent Behaviour Consequences (ABC) sheets. The handwriting on these records was unclear and difficult to read. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured of encouragement to achieve personal development and to keep regular family contacts, whilst their rights are respected. Evidence: A routine of daily activities for each person is recordec within their care plan. This includes social, educational and physical activity. People attend workshops, day centres and employment and college, during the day. People said they wanted to participate in these events and one person expressed how she did not want to continue to attend college and had recently decided not to attend. Most people are accompanied or transported by the home to their placements. Risk assessments have been written in relation to their attendance at these venues. Families are involved and some people have frequent and regular contact and visit their families. Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: Choices about meals are made for the evening meal that everybody eats together and was observed during this inspection. All people are encouraged to do their personal shopping and to share the household shopping task and have every assistance to do this. Staff were observed to treat people with respect and they did this in a considerate and attentive approach. During the evening there was a convivial and relaxed atmosphere when staff and five people living at the home were laughing and talking as a group. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured of receiving personal, emotional and physical health care to suit there preferences. Evidence: Care staff expressed their views and demonstrated knowledge of people needs and psychological approaches that are used by staff when supporting people. These specific approaches are written in the care plans for each person in a way that is specific to them. Care records showed people have access to Health Service professionals. Medication records were assessed. They showed accurately recorded administration charts and amounts had been kept. When medicines were counted, they showed accurate amounts of medicines in the home. Medicines were stored safely and keys for the medicine cupboard in the managers office was kept by the manager only. Care Homes for Adults (18-65 years) Page 14 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are generally protected from abuse by the homes policy, although the home could improve their reporting procedure. Evidence: Staff who were observed during the inspection showed they listened to peoples views. The home has an acceptable abuse policy. Staff receive training in abuse and this subject is included in their induction training. A recent adult protection matter had been dealt with by the home and had been reported to the local adult protection team. It was discussed with the manager that the challenging behaviour incidents recorded in the ABC sheets referred to in individual needs and choices in this report, should always be considered for reporting as abuse to adult protection teams. It was discussed that the home should be vigilant about reporting these incidents as abuse when harm had been caused. There are many instances in the home where challenging behaviours occur and some were observed during the inspection. This is an element of peoples needs and there has been a history of challenging behaviours. These incidents present a significant risk to peoples safety. A further aspect of these incidents was that care staff were at risk of physical and verbal assault. After this was discussed with the acting manager it was thought the home could keep a cronological record of the frequency of these events and might Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: want to consider what further protection and action they should implement to protect all people living at the home, including care staff. No complaints have been recorded by the home. Care Homes for Adults (18-65 years) Page 16 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are not assured all parts of their are accessible to them at all times. Evidence: The home has a method to refer necessary maintenance work to their maintenance person for him to carry out. The home is comfortably furnished bungalow and is clean and of a style that is ordinary and homely. All the rooms are within close proximity to each other. The office used by the manager was small and contained many files and documents and medication, with little room for more than one person to enter, although all staff use it as a cloakroom. When there are six people and four or five care staff at home it does create a crowded environment. The home has one bathroom with a toilet and shower that is used by all the staff and by any person living at the home. Four rooms have full en-suite facilities which means that mostly two people and the four or five staff working and any visitors, share the same bathroom. This bathroom had a dirty toilet. The night time sleep-in care worker sleeps in the conservatory on a fold-up bed stored in this annex. The conservatory leads from the dining room and is separated by two glazed double doors. There are no private or separate washing or toilet facilities for Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: use by staff and none that can be accessed by the sleep-in staff without using the communal lounge and communal toilet/bathroom. Staff told us they are disturbed every night by people who want to enter the conservatory from the lounge and who bang the locked doors when trying to open them. This arrangements has implications for privacy, dignity and access to communal areas by people living in the home and the maintenance of good professional relationships. Care Homes for Adults (18-65 years) Page 18 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured that staff are safely recruited, although further assurance is needed that staff are competent in all aspects of the needs of people living in this home. Evidence: The home employs ten staff, including the acting manager. The usual staff arrangement is to have four care staff working during the day between 7 am and 9.30 pm. The acting manager works Mondays to Fridays and often as part of the care team. The acting manager stated the service is recruiting additional care staff so the home has a larger number of support workers. During the night there are two staff employed, one of whom sleeps on the premises and is immediately available if required. The acting manager and staff stated the sleeping care worker is often called upon to provide support to during the night. The needs of at least two people indicate that there are times when two care support worker are necessary to attend and intervene when challenging behaviour is expressed. there may be times when staffing levels are compromised by challenging behaviour or when people are accompanied in the community. The training matrix showed that all staff received a ten-day induction. Training in Non Care Homes for Adults (18-65 years) Page 19 of 26 Evidence: Abusive Physical & Psychological Intervention (NAPPI) showed that six people had not received this essential training and that managing challenging behaviours training had been received by only one person, although five staff had received Understanding Challenging Behaviour training. PACT training has recently replaced NAPPI training for challenging behaviour, although only the acting manager has been trained in this. Three staff plus the acting manager have an NVQ level 3 award in care, whilst another worker had an NVQ level 2 award. The recruitment records for two staff were assessed and showed they each received a ten day induction prior to starting work. They each had satisfactory Criminal Record Bureau disclosures and all employment checks prior to commencing employment. Care Homes for Adults (18-65 years) Page 20 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured the managenmenst of the home is improving. Evidence: The home appointed an acting manager approximately four months previous to this inspection who is not yet registered with the CSCI. This person is an experienced manager. The management of the risks to the health and safety of staff from the challenging behaviour of people living at the home should be reviewed and has already been referred to in the Concerns & Complaints section. Records maintained for the incidents of abuse recorded in the ABC sheets were not all written in a clear and legible handwriting. A record of the jobs requested for the maintenance of the home were seen. Fire drills, fire equipment and fire alarm testing records were read and the annual fire certificate Care Homes for Adults (18-65 years) Page 21 of 26 Evidence: was seen. Emergency light are tested weekly. Water temperatures had been tested and were safe. there are weekly management spot checks for different topics, such as the weekly activities that people should be assisted to do. The Care Homes Regulations 2001, Regulation 37 reports completed by the home are first sent to the organisations Head Office before being passed to the CSCI. Care Homes for Adults (18-65 years) Page 22 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 28 23 The home must provide suitable sleeping accommodation for staff where this is needed. So that people are assured their home is suitable for its stated purpose and they have access to their communal rooms at all times. 01/01/2010 2 41 37 Regulation 37 reports completed by the home must be sent to the Commission without delay. So that people are assured that any urgent and significant event is made known. 01/12/2008 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 The home should consider what further protection and action they should implement to protect all people living at Page 24 of 26 Care Homes for Adults (18-65 years) the home as well as staff and should consult people about this by asking for their views. 2 3 23 27 The home should ensure they always report all incidents or suspicions of abuse. The home should review the premises for the provision of sufficient numbers of lavatories, baths and showers and wash basins. More staff should acheive and NVQ award or a LDQ award. All staff should receive training for dealing with challenging types of behaviours. The home should record the times and frequency when sleeping staff are asked to assist during the night time and should review their sleep-in arrangement. Record keeping should always be legibly written to ensure correct factual information is easy to report and inform the Commission. 4 5 6 32 32 33 7 41 Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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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