Inspection on 22/12/06 for Cathedral View

This inspection was carried out on 22nd December 2006.

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

Cathedral View 15/02/06

Cathedral View 04/10/05

Cathedral View 23/03/05

Cathedral View 02/12/03

Cathedral View 18/11/02

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

CARE HOME ADULTS 18-65 Cathedral View Archdeacon Street Gloucester GL1 2QX Lead Inspector Kath Houson Key Unannounced Inspection 22 December 2006 10:00 nd Cathedral View DS0000032190.V324459.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 Cathedral View DS0000032190.V324459.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. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cathedral View Address Archdeacon Street Gloucester GL1 2QX 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) 01452 303248 01452 505073 debbie.ewers@gloucestershire.gov.uk www.gloucestershire.gov.uk Gloucestershire County Council Mrs Deborah Ewers Care Home 9 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (9), Physical disability (1) of places Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th February 2006 Brief Description of the Service: Cathedral View is a nine-bed unit, which provides planned and emergency respite care for adults with learning disability. The facility is owned and operated by Gloucestershire Social Services and would accept referrals countywide. The premises are situated close to Gloucester Cathedral and are within walking distance of the docks and town centre. The accommodation has equipment and adaptations to meet the needs of service users with mobility difficulties and can accommodate one wheelchair user at a time. The premises consist of single well-furnished rooms on both upper and ground floors and residents have the use of a lift. There is also a separate quiet lounge, landscaped gardens to the rear of the building, a dinning hall and recreation area. There is a well-maintained and organised laundry room. There is plenty of quiet space within various parts of the building for residents to have time alone or with visitors. The home maintains and encourages residents to continue to participate and attend day centres as part of their normal daily routine. Accurate information about fees were provided at the time of inspection and range from £54.70 per week. Weekly fees are agreed during admisson to reflect individual needs. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of the guests using the service. The term “guest’s” will be used throughout this report, as this is what they would like to be known as rather than the term “residents.” The unannounced inspection took place in December 2006 very close to the Christmas period in which the service closes for a number of days and reopens in the New Year. The registered manager was available for the entire part of the inspection and was able to provide assistance and provide all relevant documentation on request. Twenty-one of the core key and one non core key standards were assessed and included an examination of documentation; the guest’s records were case tracked, (this is a method used to carefully examine and link various aspects of the care the guests receive in the service). A short and informal discussion was conducted with the guests’ a tour of the environment and a short succinct feedback was given to conclude the inspection visit. The inspector would like to express her thanks to the users of this service, staff and manager for their time and assistance during the inspection. What the service does well: What has improved since the last inspection? What they could do better: No requirements were made on this occasion. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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 Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a good admissions procedure and makes steps to meet the needs of the guest’s admitted into the home. EVIDENCE: The most recent admissions file was examined to ensure that correct procedures are being followed. During the inspection the manager was able to describe the admissions procedure for this respite service. The staff would refresh the care plans and amend or update if there are any changes. The staff would additionally gather information from a number of sources and would expect to be given a reliable care plan from the social workers. During the Christmas period the service is closed and another service within the Gloucestershire Social Service Department would be made available on “take” for emergencies only basis. Once admission has been accepted the guests’ of the service would be encouraged to choose their room for that length of stay. The manager described the assessment stage as information gathering process in which a care plan would also be complied based on the information obtain from relevant sources. The manager is additionally aware that resources from Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 9 the specialist social work team would assist with any ethnic needs identified. For instance the manager would obtain help for an interpreter if required. The manager has stated that previously there has been limited information in care plans received namely form social workers and from hospitals. The manager is aware that it is useful to have the correct information when providing care especially to a guest who is new to the service. The manager also said that they were more inclined to conduct their own evaluation, as the information cannot be relied upon. The care needs assessment forms part of the service agreement; this was seen as evidence during the recent admission. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The guest’s are given support that ensures that their individual needs are met. An effective structure, which assists the guest’s in their decision-making, promotes independence and autonomy. Good systems are in place for care planning and for assessing and managing risk. EVIDENCE: The guest’s have protocols and written statements about their identified individual needs. The service has frameworks in place to ensure that for instance users of the service can self medicate and participate in activities in a safe manner. Another example was a seizure chart was designed to monitor epileptic episodes. The service additionally has positive contact with family, friends and Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 11 other healthcare professionals. Selected care plans were examined during the inspection. Documents were recorded appropriately and contained relevant guidance for care staff to follow. Discussion with a recent guests’ of the respite service commented on “ they discuss with me my needs, it’s a shame I got to go as this it was a stop gap.” The service provides support with assisting guests with decision-making. The guests of the respite service are encouraged to lead an independent life as far as possible and support is provided to ensure that this occurs. In addition the manager is taking steps in readiness to meet the needs of users from minority groups who may have need of the service. In addition to meeting diverse needs the manager was able to describe how communication with users with limited or no speech could be met. The service was able to show a number of resources used to aide communication. Additionally the staff team are able to read, understand body language and facial expression combined with the added use of some sign language. The guests’ of the service are encouraged to continue with their activities during their respite stay. The manager ensures that risk assessments are planned, up to date and flexible to guest’s changing needs. During the inspection guests continued with their activities programme this was evident during the inspection. All risk assessments are reviewed and updated. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The guests’ are encouraged and supported to participate in culturally appropriate activities in a variety of venues. Contact with family friends and advocates are promoted assisting the guests’ to develop and maintain important relationships. The guests have flexible routines that reflect their individuality and choice. A balanced healthy diet is encouraged and maintained. EVIDENCE: The inspection took place a few days before Christmas prior to closure of the service for the Christmas holidays. The service ensures that guests with existing activities programmes are continued. Activities programme were seen Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 13 as evidence. Additionally the service provides in-house activities and has on the premises a games room that the guests can enjoy. Comment such as “I’ve being doing lots of things, music, TV.” Were received from the guests. The service additionally ensures that routines are uninterrupted during respite stay and encouraging choice and flexibility. It was good practice to witness that the manager was aware of the issues surrounding the provision of personal care to female guests by male staff and ensuring that same sex carers when necessary provided adequate and appropriate support. Thus promoting reassurance to the guests’ and catering to their need. The service now provides a menu that is based on individual choice. The guests can request their choice of foodstuff in which a cook has information of specialist diets and provides meals according to guest’s choice. Healthy and balanced meals are encouraged and were evident during the inspection. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support is provided with personal care and healthcare that promotes dignity and wellbeing. Good frameworks are in place to ensure that the safe handling of medicines is maintained. EVIDENCE: Daily records for selected care files demonstrate that guests can inform the staff team of their needs. The staff team are able to provide this support and encourage choice and flexibility. The manager was able to describe how personal and healthcare is provided. Selected care files evidenced this combined with a discussion with the guests’ of the service. Guest’s comments were “ I get myself up with the use of the hoist and get support from staff.” The service additionally has positive links with the local General Practitioners (GP) and District Nurses who assist with complex clinical procedures thus ensuring that healthcare needs are met. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 15 The medication cabinet is placed in a secure place and away from the communal areas within the home. A good medication fridge was seen for the storage of complex medicines and the recording of temperatures were consistent and up to date. The service has a good medication recording sheet followed by a good medication audit trial in which the manager can keep track of the medicines for the service on a regular basis. The service additionally has an internal risk self-assessment form that is shared with the guests who are competent with self-medicating. The form asks a number of questions that test the knowledge of the guests.” Such questions range from; Does the service user know what to do if they take too much of this medicine? Does the service user know what time the medicine has to be taken? Does the service user know why this medicine has to be taken? This can be seen as good practice as it promotes independence and empowerment. This service is additionally aware of its secondary dispensing procedures and understands the concepts. The number of medication errors has decreased and is reviewing its procedures on a regular basis. The prescription sheet was well recorded with no omissions detected and detailed in content. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a clear complaints procedure that is accessible. The guests are able to share their views and opinions on a regular basis. The service has good frameworks in place that ensure that the guests in the are safeguarded from harm and abuse. EVIDENCE: This service has a complaints procedure that has been placed in each individual file. This service has a complaints procedure that has been placed in each individual file. The service uses the Gloucestershire County Council Social care complaints policy that provides clear and detailed guidelines of procedures to follow. The home is currently dealing with a complaint and will inform the Commission for Social Care Inspection (CSCI) of the outcome. The positive note is that there are frameworks in place for concerns to be raised and for the matters to be dealt with appropriately. On the whole the response from users of the service is “it’s a like a holiday house.” Comments made during the inspection. The service continues to accept and receive regular complements from relatives who require a respite service. The home actively seeks to maintain staff training that safeguards the guests from abuse and harm or neglect. A training matrix was evident and the training programme for 2007 is being currently being arranged. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is homely comfortable and promotes independence. The service continues to maintain high environmental standards that meet the needs of the guests during their respite stay. The home is fresh and clean thus encouraging their quality of life. EVIDENCE: Cathedral View is a nine-bed unit, which provides planned and emergency respite care for adults with learning disability. The facility is owned and operated by Gloucestershire Social Services and would accept referrals countywide. Users of the service spend their respite time in a safe and comfortable environment, the décor, fixtures and fittings are of good quality. The home is free from any of any offensive smells at the time of inspection. Specialist equipment is maintained and regularly checked. There is a specialist bedroom with en-suite facilities that has been adapted to accommodate physical disabilities. The home is located in the heart of Gloucester City centre and the Gloucester Cathedral is close to the service. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team are effectively skilled for the tasks they perform. A robust recruitment and selection procedures exists in the home. Members of staff who are supported well and regularly supervised support the guests. EVIDENCE: There currently exist committed long-standing, staff who deliver good levels of support to the guests and who have an understanding of their needs. There was a robust staff training procedure in place that additionally incorporates equalities and diversity issues. Managerial support involves taking steps to ensure that ethnicity needs are met. The proactive steps include, making links with the specialist social services department, approaching training organisations, researching the area for diverse foodstuff, hair products and places of worship for instance. The manager describes and demonstrates awareness of this issue and has planned Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 19 staff training for this year in order to meet those needs. This will be monitored during the next inspection. Guests of this service are protected by the home’s recruitment and selection procedure. The manager additionally described the importance of checking references and accounts from the Criminal Records Bureau (CRBs) for potential employees. The internal process varies and follows the pathway of Gloucestershire Social Services recruitment procedure. Selected files appear to evidence that correct procedures have been followed. On the whole this service supports the guests via regular supervised staff team. Supervision notes were seen as evidence. In addition comments from guests include “ the staff are better here compared to the last place they give me lots of support.” Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is well managed promoting positive outcomes for the guests which results in an effective team of staff. The service has a good system in place that monitors the service provision. The health and safety is managed well, which further promotes the well being for both staff and the guests. EVIDENCE: The manager has a strong commitment to partnership working with the Commission for Social Care Inspection (CSCI) in order to maintain a good standard of care within the respite service. The manager has completed the National Vocation Qualification level 5 (NVQ) in management. This added qualification provides the current manager with new and improved skills to Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 21 achieve the aims and objectives of the service it provides and thus make improvements where needed. The service appears to be well managed and has established links with other service of the same category. This is good practice as the knowledge and skills between other homes are shared and offer consistency in care. The service has a good system for quality assurance. Regular monitoring of the service was evident dates of October and November 2006 show positive feedback from the carers demonstrating that the majority of the relatives who use the service were satisfied and would use the service again. It would also appear that the staff team and relatives’ have a good rapport and regular users’ frequently return to Cathedral View. A random selection of health and safety checks was performed during the inspection. The recordings of the water temperatures, and electrical appliance checks were found to be consistent and well recorded. This would suggest that the environment is a safe place to work for both staff and the guests of the respite service. Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 22 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 23 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 Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 Cathedral View DS0000032190.V324459.R01.S.doc Version 5.2 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. 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