Inspection on 21/06/05 for Cintre Community

This inspection was carried out on 21st June 2005.

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

Cintre Community 03/08/07

Cintre Community 19/12/06

Cintre Community 10/01/06

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 54 St Johns Road Clifton Bristol BS8 2HG Lead Inspector Karen Walker Announced 21 June 2005 09:30 st 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 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 Stationary 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 D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cintre Community Address 54 St Johns Road Clifton Bristol BS8 2HG 0117 9738546 0117 9467842 Telephone number Fax number Email 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 PC Care home only 7 Category(ies) of LD Learning disability (7) registration, with number of places Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 7 persons, aged 18 - 45 years with a learning disability. Date of last inspection 30 December 2004 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 D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector spoke with residents’ and examined their plans of care and relevant documentation relating to them. Discussions were held with members of the staff team including the manager and the deputy manager. General records were examined as was the pre-inspection documentation and feedback questionnaires from 2 relatives. The inspector was also invited to attend lunch with staff and residents’. What the service does well: What has improved since the last inspection? Residents’ are empowered to make their views known and have an impact on the daily running of the home. Residents’ are involved in their own care planning and feel able to influence the support they receive. There will be an updated and renewed policies and procedures folder that will ensure residents benefit from policies and procedures relevant to their support needs. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 standard(s) 1,2,3,4,5 Prospective residents’ have the information needed to make an informed decision about accepting a place at the home. They also have the opportunity to ‘test drive’ the placement. EVIDENCE: The statement of purpose contains all relevant information needed to inform residents’ and placing authorities of service provision. This document along with the service user guide information is in the process of being reviewed and made more user friendly. Contracts were seen alongside information on how to make a complaint. Residents’ spoken with were aware of their assessed needs and had signed documentation relating to them. A discussion was held with the last person to move in who said they are ‘very happy’ and will soon be ‘working harder towards independence’. The manager explained that the process had begun to fill the current resident vacancy and emphasis was put on the necessity of getting the right person to fit in with the current group. There would also be a trial period. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 standard(s) 6,7,8,9 Residents are encouraged to participate in assessments and plans about their care. Some of the terminology used by staff may not encourage them to treat residents respectfully. EVIDENCE: A discussion was held with 2 residents regarding the ‘rules’ of the house. Both agreed that they were necessary and would be happy to abide by them. Residents reported that they had input into care plans and had signed them as agreed. Residents’ are supported by way of ‘supervision sessions’ once a week and report that they enjoy them. 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. The manager agrees that these sessions are beneficial to all parties. A discussion was held with the manager who agreed that some of the terminology used in documentation could be thought of as negative. An example of this is the ‘absconding’ policy and the term ‘kicking off’. A Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 10 recommendation was made to change certain terminology to be more positive seeking opinions from residents were possible. Individual risk assessments were seen and one resident confirmed she agreed with those in place to support her. Residents’ meetings are held on a regular basis and staff act on comments made, an example of this is a change in the way menus are planned. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 standard(s) 11,12,13,14,15,16,17 Residents’ benefit from participating in appropriate activities in the local and wider community and at the home. Residents enjoy a varied healthy diet. EVIDENCE: Residents’ confirmed they had an array of leisure opportunities offered that were relevant to their needs. One resident was delighted to have spent his birthday in Majorca and confirmed that other residents chose activities more suited to them. There were pictures of residents’ enjoying a limo ride with champagne and others had attended the theatre. One resident said the holiday ‘was brilliant’. 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”. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 12 “I couldn’t be happier with the care, support and opportunities given to my son”. The inspector was invited to stay for lunch with residents and staff members. This was informal and a range of food was on offer. One staff member confirmed that lunch was usually in ‘buffet’ style so that residents had plenty of choice. Today there was fresh salad with a choice of meats, cheese and egg. Dessert was a fresh fruit salad. The food was fresh and well presented and residents’ confirmed their input. The menu book was examined and it was noted that a variety of foods were on offer. Residents confirmed they enjoyed the food offered and decided they would like to have more input into menu planning in the future. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 standard(s) 18,19,20 Residents’ healthcare needs may not always be met. Residents are empowered to administer and control their own medication. EVIDENCE: The medication administration record sheets were examined. These were found to be in order. Records were kept in this folder relating to healthcare visits. It was noted however that not all visits had been adequately recorded and there was no record of dental visits for one person or opticians for another. It was suggested that a ‘quick view’ chart be devised highlighting all visits required. Residents’ were individually dressed and their clothes and hairstyle reflect their personality. Staff confirmed that any personal support given would be given in private and in a way that maximises dignity and respect. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 standard(s) 22,23 Residents’ views are listened to and acted upon. Systems are not in place to ensure residents are protected from differing forms of abuse. EVIDENCE: Relatives comment cards evidence information is given regarding the ‘complaints procedure’. Residents also confirmed they could complain and make their concerns known. The complaints procedure was made available to all residents and was kept in their personal files both in the office and in their bedrooms. There was a ‘reminder’ for staff on the office wall regarding ‘what is considered as abuse’. This compliments the fuller protection of Adults policy. In June one resident chose to make an allegation of a serious nature relating to her time in a previous home and the manager made contact with the placing social services. The inspector has since sought advice from the ‘Care Direct team’ for Bristol and it is required that this incident be referred to them. The manager is waiting for a report from the placing authority. This incident will not be referred to in full through this inspection report but will be followed up by the inspector at a later date. The residents’ personal allowances and financial records were examined. It was noted that ‘bank records’ were not checked against ‘personal allowance’ records. This was discussed with the manager who said he would be checking the bank statements from now on. Records need to be kept of all transactions made with clear recording as to where the money came from initially i.e. ‘paid in from bank’. All residents’ have bankcards and personal identification numbers, which are known by staff. The petty cash balance was incorrect at Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 15 the time of this inspection and a recent staff meeting highlights a number of ‘discrepancies’. The way in which staff members record balances was discussed and a different way of checking suggested. All findings were discussed with the manager and a requirement is made to ensure residents’ are protected from financial abuse. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 16 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 standard(s) 24,25,26,27,28,29,30 Residents’ live in a homely comfortable environment and bedrooms are suited to the individual. EVIDENCE: This home is bright and airy and residents were observed to be at ‘ease’ in their home environment. The large living room has adjoining doors leading into the craft room. Staff said there were plans to refurbish the kitchen and this would be done when the residents’ were on holiday. The sluice room and laundry area is located through the kitchen and a risk assessment has been put in place with advice sought from the environmental health officer for the transportation of linen. There are plans to make changes to the garden area adding a patio, bar-b-que area and a summerhouse. Residents’ bedrooms are individualised and there are sufficient bathroom facilities. All areas were found to be clean and tidy. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 There are sufficient staff on duty at one time to support the current resident group. EVIDENCE: The manager is looking to recruit 1 full time support worker and interviews took place on the day of inspection. The rota shows 3 staff members on duty at each shift and 2 staff on sleep-in duties. Staff feel this is sufficient to support the current resident group. The recruitment policy was not examined at this inspection nor were staffing records. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,43 Residents’ benefit from a well run home with a clear management structure. Residents’ best interests are safeguarded by policies and procedures that are being reviewed and developed. EVIDENCE: The respectful way that staff interacted with each other and the residents was evident. Residents expressed their opinions during the day and were relaxed and responded to the staff positively. There are weekly house meetings, which encourage the residents to influence the way the home is run and how they spend their leisure time. Policies and procedures are going through a review process. Quality Assurance questionnaires have been given to residents’ and are due to be sent out to relatives and interested others. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 19 All records of a confidential nature are locked in the home’s office or in the head office, which is also in the same building. The Public Liability insurance certificate on display was in date. At the last inspection the inspector viewed the financial records for the home. This showed realistic figures for expenditure and that the home is within budget and making a profit. There is a business and financial plan available for the Commission for Social Care Inspection to view. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 4 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cintre Community Score 3 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 x 3 D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 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. Standard 19 Regulation 13(1)(b) Requirement Arrangements must be made for residents to recieve where necessary , treatment,advice and other services from any healthcare professional including dentist and opticians. A referral must be made to care direct regarding a serious allegation made. Residents must be protected from financial abuse. Records must provide an audit trail. Timescale for action 31/07/05 2. 3. 23 23 13(6) 13(6) schedule 4 (9)(a) 30/06/05 30/06/05 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. 3. Refer to Standard 6 19 23 Good Practice Recommendations change certain terminology to be more positive seeking opinions from residents were possible. a ‘quick view’ chart be devised highlighting all healthcare visits required. petty cash to be balanced after each transaction and balance signed over at handover. Cintre Community D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 22 Commission for Social Care Inspection 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 D56_D05_S26532_Cintre_V224715_210605_Stage4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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