Inspection on 09/03/07 for Cardinals Gate 55

This inspection was carried out on 9th March 2007.

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

Cardinals Gate 55 05/11/08

Cardinals Gate 55 12/11/07

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 08/07/2008.

CARE HOME ADULTS 18-65 Cardinals Gate 55 55 Cardinals Gate Werrington Peterborough PE4 5AT Lead Inspector Joanne Pawson Unannounced Inspection 9th March 2007 10:00 Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 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 Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 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. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cardinals Gate 55 Address 55 Cardinals Gate Werrington Peterborough PE4 5AT 01733 576660 01733 576650 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) www.communitycaresolutions.com Community Care Solutions Limited Manager post vacant Care Home 6 Category(ies) of Learning disability (6), Mental disorder, registration, with number excluding learning disability or dementia (2) of places Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Learning Disability (6) Mental Disorder (2) - Only associated with learning disability Date of last inspection 5th October 2005 Brief Description of the Service: 55 Cardinals Gate is a bungalow in a cul de sac 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 all with ensuite facilities. There is a spacious L shaped lounge dining room and an additional conservatory with patio doors to the garden. The home accommodates 6 young adults with a learning disability and is registered for two of the service users having associated mental health problems. The home has its own transport and the staff and service users also use local public transport. This is accessible from close by. Local amenities are within walking distance and staff support service users to use all the amenities of Peterborough. The weekly fees are £1250. The acting manager stated that she will make a copy of the report available to all of the residents and their relatives. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Friday the 9th March 2007 at 10.00 for six hours. There is an acting manager On the day of the inspection some of the residents were out, one was baking a cake and another resident was out visiting a prospective new home. Methods used for the inspection included speaking to the staff and residents, reading documentation and a tour of the home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Residents have the information they need in the appropriate format so that they can make an informed choice about where to live. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents only move into the home after a full assessment by care managers and the home manager and they are offered the opportunity to visit the home and meet the other residents. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 Quality in this outcome area is good Care staff have the information they require to meet the service users needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager stated that the format of the care plans are currently changing from all of the information being held in separate folders in a box file to the information being in a indexed file. The file will contain information on person centred plans, risk assessments, daily record sheets, inventory, financial record, admission details, service users guide and contract, incident/accident reports and miscellaneous. The file is very big and would possibly benefit by splitting it up into the current information that needs to be referred to on a regular basis such as the person centred care plans and risk assessments and having another file for Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 9 information that can be archived such as old daily record sheets, financial records and admission details. Two care plans were looked at in detail. The care plans are written using a person centred approach and contain important information such as what the residents like to be called, what they like doing and what they don’t like doing, their dreams for the future, routines and the support they need. The residents had signed the care plan but not all of the reviews. The care plans contained information on accommodation, personal care, medication, medical needs, domestic tasks, technical aids, communication, choice, freedom and protection, health, family, personal/counselling, social life and activities, culture issues, faith issues, financial, transport, ageing and illness and death and dying wishes. At the end of the care plan there is a sheet stating that the resident has been asked if they would like any other information included in their care plans. For one resident the care plans for how to react to his challenging behaviour was very detailed and gave staff the information they needed. It included information about when staff should restrain and also when they should stop using the restraint techniques. Extra information could be included to state that when he threatens to assault a member of staff or another resident they should be aware that this may not be straight away and that if staff need to administer his PRN medication how long should they allow his challenging behaviour to continue for before administering the medication. The area manager also stated that it was the homes policy that staff must gain authorisation from the on call manager before administering PRN medication however this information was not included in the care plan. The personal care part of the care plan is very detailed and explains the different levels of assistance that may be needed. There are regular reviews of goals, progress and any action or change necessary is recorded. The care plans did not contain a weekly structure for the residents. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 Quality in this outcome area is good. Residents are supported to lead a fulfilling life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Planned activities are written in the house diary. The residents may benefit from a more structured approach to the week. The acting manager stated that at least one resident would benefit from a more structured approach but that funding issues were preventing this from happening on a daily basis. The residents attend colleges and take part in various activities such as football, weekly discos, basketball, cinema, drama group, shopping and going to the library. Residents are supported to maintain appropriate personal relationships outside of the home by the staff and given the necessary specialist guidance. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 11 A relative of one of the residents stated that he is always made to feel welcome in the home but would like more information about his relative’s medical issues. One resident stated that she could choose when to get up and go to bed but that during the evening when the night staff commenced their shift she had to go to her room so that the staff could do handover in the lounge. The acting manager stated that this no longer happens, as it should be treated as the resident’s home. Where appropriate residents are encouraged to take part in daily tasks such as cooking, cleaning and ironing. One of the residents was doing her ironing at the time if the inspection. Another resident was baking a cake with the support of the staff to take home to his parents. Community Care solutions requires the home to have a monthly food menu. One of the residents stated that she thought this was institutional and would like to be able to discuss what everyone would like at a residents meeting to held every two weeks (residents meetings are currently held once a month). If residents do not like what is on the menu they can choose something else. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Residents receive personal and flexible support from the care staff according to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans detail how residents would like to be helped with personal care and this agreed by the resident or their representative if appropriate. The care plans contain information about likes and dislikes and things residents like to do when they feel anxious and are written in a way that promotes dignity and respect and encourages independence. Staff encourage residents to make choices about what clothes they would like to wear. Residents are referred to specialist healthcare professionals as needed. Each resident has a designated keyworker. One member of staff explained the keyworker role. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 13 The medication administration charts were inspected and found to be satisfactory. All medication is administered and signed for by two members of staff to ensure there are no mistakes. There is a list of approved nonprescribed medication. The list tells staff what the medication is, the dose, how often and any warning signs or areas that staff need to be aware of. Records of visits to G.P.’s and the relevant health care professionals was seen and showed that residents are getting the appropriate support. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good Residents views are listened to and taken seriously by the acting manager and staff of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One of the residents spoken to said that if she had any complaints she would talk to the manager, her mum or her social worker. A resident’s relative stated that if he had any concerns he would talk to any of the staff about it and had done so in the past. He was also aware of the Commission but had never seen an inspection report for the home. The manager stated that she would ensure that a copy of the report is made available to all of the service users and their families/representatives. All staff have training in the protection of vulnerable adults. Staff spoken to on the day of the inspection were aware of the procedure to be followed if they thought any of the residents were being abused. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30 Quality in this outcome area is excellent The residents live in a bright, homely and comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All areas of the home were clean, hygienic and free from offensive odours. The communal areas are homely and comfortable. One resident showed the inspector his bedroom and when asked indicated that he liked his bedroom especially his stereo. Resident’s bedrooms are individual and reflect their personality. One resident stated that she had not been asked about the colour of her room but thought the colour was ok but that the curtains were ‘a bit old fashioned’. However she did not wish to change them as she thought she may be moving out in the near future. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is good Residents are supported by competent staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One staff file of a new member of staff was inspected. There is a very detailed induction pack, which has to be signed by the employee and the manager to indicate that the subject has been discussed during the induction. The appropriate recruitment procedure and checks were in place for new staff. However one of the references stated that they could not comment on the applicants suitability, as they had not worked regularly due to ill health. If a negative reference is received this should be followed up and a third reference requested. Staff have attended various training courses including food hygiene, infection control, non-abusive psychological and physical intervention body wrap technique, first aid, protection of vulnerable adults, administration of Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 17 medication and skills for care induction. The acting manager also stated that they plan for all staff to complete the LDAF Training. All staff are receiving regular supervisions. Staff observed working with the residents had obviously built up a warm and caring relationship and were aware of the individual residents needs. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42 Quality in this outcome area is good. Resident’s benefit from a well run and organised service This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is an acting manager who stated that she will be applying to the commision to become the registered manager. The acting manager has to complete weekly activitites reports about any staff and residents issues and also completes a weekly management checklist to ensure all health and safety matters are dealt with. The evidence from the inspection indicated that the outcomes for service users are positive and the home is well run. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 19 The residents and staff stated that they could talk to the manager about any concerns if they needed to. Regular staff and residents meetings are held. The fire records, accident reports and risk assessments were checked and found to be satisfactory. Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 20 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 X 3 3 X Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: 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 © 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 Cardinals Gate 55 DS0000063088.V333001.R01.S.doc Version 5.2 Page 23 - 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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