Inspection on 18/01/07 for Chapel View

This inspection was carried out on 18th January 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Chapel View St Whites Road Cinderford Glos GL14 3HA Lead Inspector Mr Simon Massey Key Unannounced Inspection 18th January 2007 10:00 Chapel View DS0000068131.V324705.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 Chapel View DS0000068131.V324705.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. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Chapel View Address St Whites Road Cinderford Glos GL14 3HA 01594 546505 01594 546506 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) Step-a-Side Care Limited Mr Mark George Carwardine Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection First inspection of new service registered September 2006 Brief Description of the Service: Chapel View provides accommodation for three adults with Learning Disabilities and is situated on the outskirts of the town of Cinderford in the Forest of Dean. The house provides good access to local facilities. The home comprises of a kitchen/diner and communal living room and individual bedrooms for the service users. The home has a large garden to the rear of the property. The home provides 24 hour staffing and is run by the Step-a-side care Organisation. The current scale of charges is £2280 to £2678 per week. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first full inspection of the home since its registration in September 2006. This visit focused on the key National Minimum Standards. The inspector met with the Registered Manager and Provider, members of the care staff and all of the service users. Records relating to care planning, medication, staff recruitment, health and safety were examined. Parts of the environment were also inspected. At the time of this visit the home had just successfully applied for a variation to its conditions to accommodate one service who, for a brief period of months, will be under 18 years of age. This was a positive inspection of a new service that has begun to establish, in a relatively short time, a professionally managed care service. The service users were able to communicate their opinions clearly and were able to express positive views about their support and the caring environment in which they live. The inspector was grateful to the staff for their co-operation with the inspection and also to the service users for their input and time. What the service does well: What has improved since the last inspection? What they could do better: Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 6 The home has been well planned in advance and many professional practices are in place and the next challenge is for this to be maintained and built upon. With a move into adult services there is a need for the development of a slightly more person centred approach to care planning, which clearly identifies longer term goals of independence and the obstacles to this. Also there is s need for the recording of any limitations and restrictions, that have been risk assessed and agreed withy the service user, to be clearly stated in their care plans. 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. Chapel View DS0000068131.V324705.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 Chapel View DS0000068131.V324705.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): Standard 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an admission policy that complies with the regulations and should ensure that the home can meet the needs of service users moving to the home. EVIDENCE: All three service users living in the home were previously accommodated in other registered accommodation run and staffed by the same Provider. The service has been developed initially, specifically for these people, and their transition and move has been managed in a structured and professional manner. The home has used the ongoing involvement of outside professionals and their own assessment processes, to try and ensure the move is part of the service users ongoing development. All the service users were positive about how their move had been organised and all appeared to have settled in well in their new home. At the time of this visit the home had just successfully applied for a variation to its conditions to accommodate one service, who for a brief period of months will under 18 years of age. This service user confirmed they were supported to make the move and said they were pleased with their new accommodation. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 9 Chapel View DS0000068131.V324705.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): Standards 6, 7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Detailed assessments and the involvement of outside professionals ensure that care plans contain details about the support and care needs of the service users. Changes and refinements being made should provide for a more person centred approach. People are being supported to work towards risk-managed independence but clearer recording could be provided over limitations and restrictions that are agreed with the service users. EVIDENCE: All service users have placement plans that have been drawn up in conjunction with the organisation Studio Three, which also provides the specialist challenging behaviour training for the staff team. The plans cover all aspects of behavioural, emotional and practical needs. The professionals for this organisation have known the service users for several years, having been involved with them at the previous placement. All the placement plans are Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 11 reviewed every six months as part of the home’s agreement with the placing authority. The home are in the process of developing in-house care plans which will have a more person centred focus and provided more information on short term goals and guidance for staff. It is planned that these will fully involve the service user and the key-worker All three service users are currently risk assessed as needing supervision whilst out in the community. These limitations have been agreed with the service users and are reviewed as part of their placement review with the placing authority. These plans give guidance on risk-managed independence. The levels of supervision required are discussed at these meetings and the final plan is agreed and signed by the service user. This plan also clarifies that the aim is to move to towards independence with the appropriate levels of supervision in place, and ensuring that service user are not put at risk. It is recommended that the care plans being developed in the house give clearer guidance on this limitation, that the service user have agreed to this and that there is a goal of greater independence. These plans should give reference to where the detailed recording around these limitations and associated risk assessments are located. Recording in one file suggested that a service user’s personal money was being used as an incentive to encourage them to complete certain tasks. Clarification was provided that people were receiving all their personal financial allowance. When particular needs are met by placing any sort of limitation on a person, this should be clearly stated and the service user’s agreement recorded. The manager stated they would provide guidance to the staff over how this incentive is managed and recorded. . Chapel View DS0000068131.V324705.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): Standard 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. Service users are supported to develop their interests and have a lifestyle that incorporates choice and encourages the learning of independence skills. Service users are supported to maintain appropriate contact and relationships with families. Service users are encouraged to have a healthy diet whilst respecting their choice and preferences. EVIDENCE: All service users have a weekly timetable of activities they are supported to follow. This is a mixture of college courses, work experience, paid employment and vocational activities supported by the care staff. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 13 The service users were positive about the current range of daytime and leisure activities and had a good understanding of their aims and objectives in relation to these. Service users confirmed that they are supported to maintain, and have appropriate relations with families and relatives. Contact arrangements are recorded in the personal files. The inspector received feedback from one parent about the care being delivered and this was very positive. They also stated that the care staff and manager home communicated well with them, and kept them up top date and informed about any relevant issues. The home was well stocked with fresh and packaged food at the time of the visit and the menus showed that varied and healthy meals are offered. Service user expressed satisfaction with choice and variety of food provided and their opportunities to be involved in shopping and food preparation. Chapel View DS0000068131.V324705.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): Standards 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides the service users with the personal care and support that is appropriate to their needs. EVIDENCE: The majority of personal care is provided in the way of reminders and encouragement, and this is documented n the care plans. Service users stated that they considered they were receiving appropriate support from the care staff in this area. The service user and staff also have input from outside professionals in relation to meeting emotional needs and supporting personal development. Recording showed that health needs are monitored and that support is provided to attend various appointments. Service users confirmed that they receive sufficient support in this area. Medication storage and administration were examined and found to be in order. Little medication is administered at present and some staff have Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 15 completed medication training. Staff should not administer medication until they have completed the training. There is a need for the home to develop a homely remedies policy. Chapel View DS0000068131.V324705.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): Standards 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are encouraged and feel able to express their opinions on all aspects of their care. Service users are protected by staff training in Protection and the management of challenging behaviours. EVIDENCE: All staff receive accredited training in the managing of challenging behaviours. This focuses on descalation and low arousal techniques and the home has a policy of not using restraint. All the staff who moved with the service users from the previous placement have completed Child Protection training, and Adult Protection training is being provided within the current setting. Service users appeared comfortable and confident in their home, and appeared to relate well to the staff on duty. Service users confirmed that staff treat them with respect and that they are able to voice any concerns or complaints that they may have about any aspect of their care or support. People commented that staff, “always listen, even if they do not agree with you”, and that they also felt confident about speaking to or approaching other Directors of the company. Another commented that if anything was worrying him, they “would mention it straight away, as staff will always talk to us about things”. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 17 Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 18 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): Standard 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a clean, homely and comfortable environment. EVIDENCE: All service users have individual rooms, which they said they were pleased with. They are supported to maintain their rooms and personalise them as they wish. The home was refurbished and decorated prior to the service user moving in before registration. The home is homely and comfortable and provides good access to the local community. All service users said they enjoyed living in the home and were pleased about making the move from their previous accommodation. All parts of the home were clean and hygienic and appeared to be maintained to a high standard. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 19 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): Standards 32, 34, & 35. Quality in this outcome area is good with some parts being seen as adequate. This judgement has been made using available evidence including a visit to this service. A well-trained and motivated staff team provide support to the service users, who know several of the staff from their previous placement. Service users are protected by the home’s recruitment policy, but there is a need for some additional staff information to be kept in the home. EVIDENCE: At the time of the inspection there were three staff on duty including the manager and the rotas showed that staffing levels are being maintained to provide the correct level of support and supervision for the service users. The main staff files are kept in the Provider’s main office, which is away from the home. These files were examined and found to be in order with all necessary checks being completed and the correct information being recorded. The home should keep a current staff list in the home, which contains basic information such as contact numbers and a photo. All staff who have transferred from the home where the service users were previously placed, have undertaken Child Protection training. Training in Adult Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 20 Protection has been completed by some staff and will be done by everyone eventually. The majority of the current staff team, approximately 90 , are trained to NVQ level 3 or above. Staff were observed communicating professionally with service users who appeared to relate well to the staff, and appeared confident in their surroundings. All the service users were very positive about the staff team and the support they receive. People gave examples of how their key-workers helped them organise things or discuss issues. These ranged form organising trips out to planning their college courses and communicating with families and relatives. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well organised home that has established a professional basis from which to deliver care and meet the needs of the service users. When the quality assurance systems are established they should provide important feedback and monitoring for the management of the home. Service users are provided with an environment in which health and safety is promoted. EVIDENCE: The home has been registered since September 2006, and the move to the new home for the three service users was planned in advance. The move, and Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 22 the opening and establishing of the new home, appears to have been professionally and sensitively managed and organised. The home is currently run by the Registered Manager, who is also the Provider and is also still the registered Manager of the home were the service users were previously placed. This is located nearby. The manager is suitably qualified and experienced to perform the role, and the home appears to be efficiently and professionally managed during its inaugural period of registration. The Deputy Manager is currently undertaking the NVQ 4 Registered Managers Award, and it is the plan of the Provider for this person to become the Registered Manager when this training is completed. All fire safety recording and checks have been completed and the home has a contract with an agency to provide an annual audit of their health and safety procedures and checks. Due to the short time the home has been opened this procedure has not yet started. The home was renovated before the service users were admitted, and it appears to be a safe and well maintained environment. The home has begun establishing its quality assurance processes. Regulation 26 visits are undertaken by two directors of the Company and reports have been supplied to the Commission and to the home. Questionnaires have been circulated to parents and relatives and the placing authorities. The home also has regular clinical input from outside professionals around care issues and this information can be used to inform how care is delivered. Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 23 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 3 33 3 34 X 35 3 36 X 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 3 15 3 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 24 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA7 Regulation Requirement Timescale for action 31/03/07 12(2)(3)(4)(c) The home must ensure that all limitations and restrictions are clearly risk assessed, recorded and that service user agreement is recorded. 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 YA20 Good Practice Recommendations The home should develop a homely remedies policy Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 25 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 Chapel View DS0000068131.V324705.R01.S.doc Version 5.2 Page 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. 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