Inspection on 10/01/06 for Cintre Community

This inspection was carried out on 10th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cintre Community 03/08/07

Cintre Community 19/12/06

Cintre Community 21/06/05

Cintre Community 30/12/04

Cintre Community 22/04/04

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 Cintre Community Cintre Community 54 St Johns Road Clifton Bristol BS8 2HG Lead Inspector Karen Walker Unannounced Inspection 10th January 2006 10:00 Cintre Community DS0000026532.V276585.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 Cintre Community DS0000026532.V276585.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. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cintre Community Address Cintre Community 54 St Johns Road Clifton Bristol BS8 2HG 0117 9738546 0117 9467842 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) Cintre Community Management Co Mr Gordon Charles MacDonnell Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 7 persons, aged 18 - 45 years. Date of last inspection 21st June 2005 Brief Description of the Service: The Cintre Community is registered with the Commission for Social Care Inspection to provide care for 7 adults who have a learning disability. The property is a large detached house in a residential location within walking distance of local amenities. There are 7 single bedrooms set over three floors. One of these rooms consists of an independent living flat. There is a large lounge divided into a homely seating area. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A variety of staff members including the manager and deputy manager had the opportunity to contribute to the formulation of this report. The inspector also met with the training manager and the administrator. Residents were willing and able to make comments regarding service provision and two residents gave permission for the inspector to view all records held in respect of them. They were knowledgeable of their own care needs and how they were being supported. Other records regarding the management of the home and competencies of the staff team were also examined. What the service does well: What has improved since the last inspection? All of the requirements of the last inspection have been met and improvement has been noted in record keeping regarding the terminology used. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 6 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. Cintre Community DS0000026532.V276585.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 Cintre Community DS0000026532.V276585.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): X EVIDENCE: These standards were assessed and met at the last inspection. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 9 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): 6,7,8,9,10 Residents are encouraged to participate in assessments and plans about their care and are satisfied that information held about them is held in confidence. Residents are consulted on all aspects of life in the home and are supported to maintain an independent lifestyle. EVIDENCE: Permission was given by two residents to examine documentation held in respect of them. Both were knowledgeable of their own care needs and the support they received. It was noted that where necessary care plans and risk assessments had been reviewed or implemented to ensure the adequate support and minimal risk of the resident. One resident discussed her tendency to make false allegations towards others and this was adequately recorded and supported. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 10 Residents’ are also supported by way of ‘supervision sessions’ either daily or weekly depending on need. It was noted that these sessions are a way of spending quality time with key people to discuss anything from sharing memories to making concerns known and reviewing behaviours. The residents agreed that these sessions are beneficial and help to alleviate any pressures or worries that build up. It was also noted that there has been an improvement in the terminology used to describe residents ‘behaviour’ and actions. Residents also confirmed that they were asked how they wish to be referred to and had changed the terminology used from clients to residents. One resident said ‘we have regular meetings and we talk about all sorts of things like holidays and menu planning; staff always write it down’. Another resident said ‘my key-worker helps me to do things like go to concerts, its brilliant’. It was noted that one resident had his care plan review and appropriate parties were invited to attend. The review focused on the positive achievements made and used positive terminology. One staff member confirmed that there was a confidentiality policy in place and said; ‘information passed on to you may need to be disclosed in the residents best interest, you must be aware of your conversations’. It was noted that the office remained locked when not in use and all records were appropriately stored. One resident when asked said ‘ I cant come into the office on my own because of all that paperwork stuff and information’. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 11 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): 11-17 Residents are supported to be take part in the local and wider community and are supported to make and maintain relationships. Residents are offered a healthy varied diet and are able to influence the menu. EVIDENCE: Residents were observed helping out in the kitchen and confirmed they had a choice in meal planning. The food was plentiful with fresh salad and ham or cheese, homemade soup and melon. Lunch was a sociable affair with residents talking about their day and generally chatting. One resident said out of the blue ‘this is the best care home ever’. Residents confirmed they were actively involved in the local and wider community and one resident had many paintings and drawings that he had done on display. He attended ‘art and power’ which he thought ‘was brilliant’. His timetable showed a varied activity plan, which he confirmed, was reviewed. It included horse riding and cooking. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 12 At the last inspection relatives confirmed via questionnaires that the environment was a ‘stimulating one’. Comments received include “ we can’t speak highly enough about the level of care, the stimulating environment and the efforts made to ensure residents develop to their full potential”. New relative feedback forms will be sent to the home to seek updated views. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 13 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): 19,21 Residents physical and emotional health needs are assessed and met. Changes must be made to the statement of purpose and service user guide to ensure residents are clear that Cintre is not a home for life. EVIDENCE: The manager confirmed there is a death and unexpected death policy in place, which is in need of review. It is not made clear in the service user guide or statement of purpose whether residents can expect to be cared for through terminal illness. After discussion the manager felt this would not be appropriate and will review the statement of purpose and service user guide. It was noted that ‘quick view’ health care appointment sheets are kept. This made it easier to review care given. The general practitioner and other health care professionals are accessed appropriately and residents confirmed this. One resident said ‘I saw the dentist and had a filling and I see other doctors and stuff when I need to’. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Residents feel their views are listened to and are protected from abuse, neglect and self-harm. EVIDENCE: After discussion with the manager and observing a staff member make petty cash transactions it was noted that the finances are now checked twice daily. The balance was checked and was correct on the day of inspection. Receipts were kept and numbered. There was evidence to show that residents’ bank accounts were checked on a monthly basis and key-workers had signed as checked. Staff confirmed that they were aware of the ‘No Secrets’ in Bristol DOH document and the manager added that the booklets were now more accessible. There was a protection policy also available to staff that linked with the whistle blowing policy. The manager is aware of the need to revise and review some of the policies in place. The complaints file was examined and one resident said ‘of course I know how to make complaints’. Complaints logged were dealt with appropriately with satisfactory outcomes. The manager added that all residents have a copy of the complaints procedure in their rooms. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X EVIDENCE: These standards were assessed and met at the last inspection. However the environment was noted to be clean and tidy, and residents’ bedrooms were individualised and suited to their needs. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31-36 Residents’ benefit from the support of a competent staff team who attend training sessions to support residents assessed needs. Residents’ benefit from a well-supported staff team who are appropriately recruited however Personal ID must be kept to better assure resident safety through recruitment. EVIDENCE: Staff members confirmed regular supervision and one staff member added ‘you can always have extra if you need it’. Supervision sessions were booked in advance and dates displayed in the office. Staff confirm they are aware of their roles and responsibilities within the home and discuss training needs at supervision sessions. It was noted that staff were well trained in crisis prevention and diffusion techniques and there was a rolling programme of training staggered throughout the year. The training manager was available at the inspection and shared information held in the ‘training report’ and costs generated. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 17 A discussion was held regarding statutory training and it was noted that manual handling training was not given to staff. The training manager confirmed that this will now appear on the rolling programme of training and will soon be delivered to staff by a person qualified to do so. This will be monitored at the next inspection. An ‘employee opinion survey’ is also carried out and the results are used to ensure staff satisfaction which in turn leads to job satisfaction and the retention of staff. This is good practice. The administrator offers support to all four homes within the Cintre community and is based at Cintre itself. She was able to explain the recruitment process and record keeping practices regarding personal identification (ID) and Criminal Record Bureau (CRB) checks. It was noted that the newer staff members’ files did not contain personal ID although CRB checks had been carried out in respect of them. It is a requirement that all staffing records contain copies of ID as dictated by schedule 4 of the Care Standards Act 2000. It was explained that when CRB’s are received the information is stored electronically and the paper copy destroyed. Other records evidence that recruitment practices are sound with 2 references being sought for all staff. Staff confirmed they could not start work without a POVA first check and a CRB in place. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 41,42,43 Record keeping practices have improved and residents will further benefit from records that do not contain correction fluid thus enabling transparency. The health and safety of residents is promoted with any deficiencies noted and corrected. EVIDENCE: It was noted that tippex (correction fluid) was used on one staff members statement when responding to a ‘false allegation’ made by a resident. Tippex must not be used on any care documentation and the manager will address this issue with the staff member in question. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 19 The fire logbook was examined and it was noted that fire training did not take place on a 6 monthly basis. The manager had provided some training by way of questionnaires but this is not sufficient. The training manager said a staff member would be nominated to attend fire marshal training and updates to enable them to offer up to date fire training. It is recommended that the manager contact the Fire Brigade for a logbook and to request that they check and agree the fire risk assessment. All other fire checks and drills are up to date. It was noted that the acting RI has not carried out any regulation 26 visits since taking up this position. These must be recommenced and carried out unannounced. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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 X 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 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 3 32 3 33 3 34 2 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 X 3 X 3 X X X X 2 2 2 Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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. 1 2 Standard YA41 YA34 Regulation 18(1)(c) Schedule 4 6(a-f) 26 23(4)(d) Requirement Cease the use of correction fluid on documentation used in the home. Instruct all staff. Obtain all staff personal identification as dictated by schedule 4 and store in the home. Recommence regulation 26 visits. Ensure fire training is carried out within the timescales dictated by the fire brigade. Timescale for action 10/01/06 01/02/06 3 4 YA43 YA42 01/02/06 01/02/06 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. 2 Refer to Standard YA6 YA42 Good Practice Recommendations Change the service user guide and statement of purpose to ensure residents know that Cintre is not a home for life. Contact the Fire Brigade for a logbook and to request that they check and agree the fire risk assessment. Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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. Extracts may not be used or reproduced without the express permission of CSCI Cintre Community DS0000026532.V276585.R01.S.doc Version 5.1 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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