Inspection on 11/05/06 for Chosen Court

This inspection was carried out on 11th May 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

Chosen Court 02/12/05

Chosen Court 11/01/05

Chosen Court 07/06/04

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 Chosen Court 139, Hucclecote Road Gloucester GL3 3TX Lead Inspector Kath Houson Unannounced Inspection 11th May 2006 09:30 Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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 Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Chosen Court Address 139, Hucclecote Road Gloucester GL3 3TX 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 616888 01452 616888 chosencare@btconnect.com Chosen Care Limited Miss Dawn Tracy Field Care Home 10 Category(ies) of Learning disability (9), Mental disorder, registration, with number excluding learning disability or dementia (1) of places Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2005 Brief Description of the Service: Chosen Court provides accommodation for ten people with learning difficulties. There are five bedrooms with en-suite facilities on the ground floor suitable for those with physical disabilities. The house has a further five en-suite bedrooms on the first floor. The property is a large detached house in a popular part of Gloucester close to local amenities. The house has a large garden to the rear of the building that is maintained to a high standard. There are plans to complete the programmed building working which was ongoing during the current inspection. The home is proving extra capacity for service users with learning disabilities. In addition to this a new summerhouse will be built in the large garden. This summerhouse will increase outdoor space for service users who enjoy the use of the garden area during the summer and autumn months. All building work will be completed towards the end of the summer. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place one morning in May 2006. The manager/owner was available throughout the inspection and able to assist and provide all relevant documentation on request. 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 experience(s) of those individuals who use the service. Twenty-four of the core standards were assessed and include an examination of documentation; three residents’ records were case tracked, a short and informal discussion was conducted with residents’ and staff team, a tour of the environment and a short succinct feedback was given to conclude the inspection visit. The inspector would like to thank the providers, staff and service users 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: The home continues to function at a good standard. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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 Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 and 5 The quality for this outcome is good. This judgement has been made using available evidence including a visit to this service. The admissions procedure is detailed and individualised which would ensure that individuals whose needs can be met are admitted into the home. The manager is active in the admissions process and will discuss with other healthcare professionals service users needs. EVIDENCE: The home continues to function within the requirements of their admissions procedure. This entails that the manager will coordinate a full assessment of needs for prospective service users and that the home can provide the appropriate care. The manager ensures that the staff team are aware of the changing needs and aspirations of service users during the admissions process and shares this information with members of staff. This is detailed in each individual care plan and client’s daily records. These documents were seen during the inspection and reflect the individualised process for each service user. For example a service user who is non -verbal would therefore have access to a speech therapist to assist with communication. Each service user each has an individual written contract that details the terms and conditions within the home. The manager felt that such Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 9 sensitive information should be kept in a confidential file that is personal to each service users. The manager said that the Statement of Purpose and the service users guide is being updated which will include the changes within the home and to notify the commission of the new revision. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 The quality for this outcome is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure that service users are appropriately risk assessed and that their personal goals are reflected in their care plans. Service users benefit from making decisions about their lives with support from staff members. EVIDENCE: Three service users’ care plans were examined. Each service user file provided clear and appropriate guidance for staff team to follow and offer suitable and individualised care. Three service users files were case tracked to reflect that their needs were changing and being assessed. The evidence demonstrated that the recording of care plans are reviewed on a regular basis and service users key workers note Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 11 those changes. Files contained an ability to consent flow chart which outlines the service users capability to consent. This can be seen as good practice that would ensure that the correct assistance is given to service users. Discussions with staff members indicate that staff was aware of service users needs. Members of staff were able to describe how choice had been offered to service users and what steps were taken to meet those choices. For instance a service user enjoys aromatherapy, the home ensures that the service user participates in regular aromatherapy sessions. The manager and the staff team have good understanding and knowledge on the health conditions of the service users and are additionally aware of what to expect in later life. Risk assessments are evaluated on a monthly basis to observe any changes that may occur. The home does well with the management of risks that promote and empower service users to lead an independent lifestyle that is based on choice and individuality. As a result the manager will put in place the necessary steps to ensure that service users are kept safe during activities. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 The quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Residents take part in activities that reflect the lifestyle of each individual. Service users are active during the day and participate in stimulating interests. Contact with family, friends and advocates are promoted and regular which assist in the development of important relationships external to the home. The menus reflect healthy eating options and wide-ranging menu options. EVIDENCE: Each resident has an activities programme that is based and designed on choice. One service user enjoys jewellery making and attends a course regularly during the week, this is outlined in the service users care plan. One service user expressed how much she enjoys attending the variety of activities that is on offer. The home has access to a range of activities to suit individual tastes and interests. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 13 Service users are encouraged to maintain contact with their families’ friends and advocates. Such contact that is external to the home promotes healthy and independent relationships as part of the local community. The home operates an “open door” approach to visitation in which many visits occur on an ad hoc basis. Many of the service users will exercise their choice and will make clear decisions on when contact with family friends and advocates are likely to happen. This was clearly detailed in the care plans and during discussions with service users throughout the current inspection. The staff team provide support to meet the wishes of the service users and thus enhance their independence. All members of staff enter service users bedrooms with the individual’s permission and normally in their presence. This would result in privacy and respect being maintained at all times. Evidence was observed during the current inspection, service users are treated with consideration and respect from the staff team and was witnessed throughout the inspection to be regular practice. The home operates a four-weekly menu option. The menus appear to offer a healthy and alternative balanced choice of foodstuffs. Fresh fruit and vegetables were seen during the inspection. One service user describes the food as being “fantastic, yes superb.” The home additionally caters for special dietary requirements, and offer alternative menu options. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 and 20 The quality for this outcome is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal assistance in the manner they prefer. The staff team provide sensitive and flexible approach when service users are in crisis. Appropriate support is provided with personal health needs promoting wellbeing and independence. Good systems are in place for handling medication that has resulted in no errors being found. EVIDENCE: Care plans describe support individuals need with personal care and how this is to be offered. References were made to issues of consent and the ability to give consent. Each personal file had a consent flow chart which service users can give consent. This can be seen as good practice and provides clear guidance to staff. One service user’s behaviour was being monitored as part of managing care. The care plan had clear descriptors of the triggers that may cause a service user to become agitated. The staff team had worked with the service user with Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 15 the aim to lessen triggers and thus improve any negative behaviour patterns. There has been an improvement in positive behaviour patterns of the service user who is now able to discuss and deal with issues. PRN protocols were put in place with clear guidelines for use and to establish a consistent approach when defusing situations. The outcome has been positive that the service user has become more able to handle situations independently. Care plans provided evidence that residents are supported to access routine and specialist services according to their need. An appointment sheet outlined every healthcare appointment the service user had and when the next appointments were due. Information on complex conditions such as epilepsy was provided in which detailed information and guidance are available for all members of staff. Up to date health action plans were available for each service user and reviewed regularly to coincide with changing needs. All members of staff are qualified to administer medication. Documentation for medication was seen and there have been no errors with medication which is a clear indication that medication is administered according to protocol that is of benefit to service users. The service additionally has a missing persons procedure. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Clear complaints procedure and an open culture help residents to feel that their views are taken onboard. Residents have the opportunity to discuss concerns and have their views heard. Specialist training to safeguard service users ensures protection is maintained. EVIDENCE: The home has a complaint procedure in place to deal with any concerns that may arise. Residents have regular meetings to discuss any issues of concern. Residents discussed that they would like more days out and that many of the ladies would like to go to the bingo. The manager is considering a new scheme in which residents are supported to go for a meal with key workers. This is being developed with residents to explore how this plan would be implemented in the home to form an additional activity. The residents meeting for May 2006 contained a number of issues such as the ladies wishing to attend bingo. Additionally, comment cards and discussion with a service user provided evidence that they felt listened to and able to raise concerns. The registered Owner/manager ensures that all members of staff participate in specialist training to safeguard service users from abuse and neglect. Care plans and guidelines were in place around the management of challenging behaviour, which include the traffic light descriptions. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The quality in this outcome is good. This judgement has been made using available evidence including a visit to this service. Observation of the environment is that it is clean, homely and safe. The manager and staff adding little touches such as placing flowers on the dining room table to enhance the homeliness of the home and thus further improve the quality of life. EVIDENCE: The home is situated in a popular area of Gloucester with easy access into the town centre via a bus route. There are a variety of local amenities such as the local shops the parish church, a social club; local library that additionally has information on activities in the area. The home is being decorated throughout and some major structural building work is currently taking place to increase capacity. There are additional plans to build a summer- house in the rear section of the garden that will increase outdoor space for the residents. The Manager said that some of the residents enjoy being outside. The Manger said that all building working and decorating would be completed in the next few months. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 18 The communal areas such as the lounge and activities room with the conservatory attached are attractively decorated and comfortable for both residents and visitors. The manager has recently installed CCTV cameras to the external part of the home to ensure residents are kept safe. Resident’s rooms are spacious with en-suite facilities and attractively coordinated and complimenting individual lifestyles. The room sizes far exceed the national minimum standards and the fixtures and fittings are of a good standard and quality. Each room has its own entertainment system and the residents have their own room keys. The home is clean hygienic and free from any offensive smells. The home has a maintenance programme in place and a regular domestic who attends to the home three times per week. The evidence is based on a tour of the environment. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 The quality for these outcomes are good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the homes policy and recruitment procedure. In addition competent and qualified staff team supports residents and are effective in their duties. Clear staff roles and responsibilities are of benefit to residents within the home. EVIDENCE: The home has committed team of support workers who have demonstrated an awareness of service users needs. This was evident in the care of a service user who is unwell. The service user’s key worker has good knowledge of the service users needs. One service user said that if they had any problems they would “go to my key worker” All members of staff have completed their mandatory training. Some of the staff had completed their specialist training on abuse. The staff meeting for May 2006, in which training issues were discussed, ensured that all staff members were included in training programmes. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 20 Guidance on observations of service users had been shared with members of staff and any comments on changes to medication formed part of some the items for discussion at the staff meeting. Staff members commented that the manager of the home operates a fair system to maintain high standards. The staff members are aware of the whistle blowing policy to ensure that any malpractice is reported immediately. Staff members additionally comment on how well the service users are cared for and that the manager keeps up to date with staff personal development. The home has a good recruitment procedure to ensure that service users are supported and protected by the homes practices. The staff team are encouraged to pursue their NVQ level 2/3 is given the support from the Manager. All staff members receive supervision every six weeks to maintain and continue staff development. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 The quality for these outcomes is good. This judgement has been made using available evidence including a visit to this service. The home is managed well and the staff are effective in their role. Service users benefit from and are confident that the home is safe and functions to a high standard. Service users are protected by the homes stated purpose and objectives. The Manger and staff team listen to the voice of the residents and respond accordingly. EVIDENCE: The owner/manager has several years experience within the care industry and has a strong interest in mental health. One service user said, “ I like having a manager like…she is good.” Service users are aware of to whom to approach in times of crisis. The staff team have managed to improve the behaviour of one service user, this is an achievement for the team within the home and the service user said “I’m more able to discuss more rather than lose my temper.” The staff team respect that the environment is the home of the residents and an element of respect is fundamental. The home’s health and safety Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 22 procedures are up to date, well maintained and documented. Feedback from residents comment cards, suggests that the residents are content with their place of residence and always have support from the staff team. Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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 3 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 4 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 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. 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 Chosen Court DS0000036066.V294708.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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