CARE HOME ADULTS 18-65
Coates Garden House High Street Patrington Hull East Riding Of Yorks HU12 0RE Lead Inspector
Sarah Sadler Unannounced Inspection 16th March 2006 10:15 Coates Garden House DS0000019660.V286918.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 Coates Garden House DS0000019660.V286918.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. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Coates Garden House Address High Street Patrington Hull East Riding Of Yorks HU12 0RE 01964 630716 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) steve.turley@bleakhouse.org Bleak House Limited Mr Steven Turley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st July 2005 Brief Description of the Service: Coates Garden House is a registered care home for up to 8 adults of either gender, with learning disabilities. It is owned by Bleak House Ltd. The home is located in the village of Patrington, close to local amenities; including shops and the post office. Service users gain access to public transport via a short walk to the main road. The home consists of a detached property that is well maintained offering comfortable and homely accommodation. All bedrooms are single and are not en-suite. There is not a stair lift. The home has a small parking area/garden at the front of the property and a rear garden. All personal needs are met by the home with access to other professionals for example, the GP as necessary. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was undertaken over five hours by one inspector, with a previous one hours preparation time. The inspection was part of the annual inspection programme from April 1st 2005 to March 31st 2006. A member of the business services team, (administration) was an observer at this inspection, this was with the permission of the service users, registered manager and registered person. During the inspection a tour of the premises was undertaken and several service users were spoken to. Service user files and other records within the home were read. What the service does well: What has improved since the last inspection?
Staff have undertaken training in moving and handling and equal opportunities. There is now a Skills for Care induction, a staff training audit has been undertaken and Learning Disability Award Framework (LDAF) training has commenced. Undertaking and updating training assists in ensuring that service users needs continue to be met by a well trained and competent staff team.
Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 6 Staff now receive a minimum of 6 supervisions in a year; ensuring that they can be fully supported in the meeting of service user needs. There is now an up to date Fire risk assessment, which assists all to be fully aware of the fire risk and procedures within the home, enhancing the protection of the service users and staff if a fire were to occur. Service user contracts include details regarding holidays, ensuring that service users can be aware of the conditions for residing in the home and are able to make choices. 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. Coates Garden House DS0000019660.V286918.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 Coates Garden House DS0000019660.V286918.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): 5 Service users are informed of the terms and conditions for residing in the home. EVIDENCE: Service user files continue to include a copy of their contract for residing within the home. The contract details that an annual holiday is not included within the fees paid for residing within the home. The registered manager confirmed that should a service user wish to go on holiday, and then the home will provide the staff to support that service user. Coates Garden House DS0000019660.V286918.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): None of these standards were assessed at this time. EVIDENCE: Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 10 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): 16,17 Service users are able to undertake activities of choice. Service users are supported with their dietary needs. EVIDENCE: The registered manager confirmed that although service users do undertake tasks whilst residing in the home, for example feeding the pet chickens, this is an activity of choice and is not an activity that is part of the persons conditions for residing in the home or their individual plan of care. Service users confirmed that they shop for and cook their own meals with assistance from the staff as necessary. This may be on the occasions when the service users wish to have a large meal, for example a roast dinner and it is not feasible for all the service users to cook individually. One service user confirmed that staff assist them to make healthy choices and another service user confirmed that they had been supported to attend a dietician and then make decision about their lifestyle and diet. A service user commented, “ The doctor told me to get plenty of roughage and that is what I
Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 11 get”. They further discussed the support they were given for cooking their own meal. Service user care notes and monthly review notes reflect monitoring of a persons diet for example, “ Diet improved” and “ has eaten well today”. There are records of the menus and food provided and weight monitoring charts. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 12 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): 18,20 Service users personal and medical needs are on the whole well met. EVIDENCE: . Service users confirmed that they are supported with any personal care needs. However due to the high level of ability of the service users only limited support is required with this. A service user confirmed, “ Yes staff help me with my hair, I have been to the hairdressers.” They also confirmed that they could have a member of staff of the same gender if they requested this, for assistance with any personal care. The registered person confirmed that the home is working with a local College to ensure that all necessary staff complete accredited medication training. The registered person confirmed that the training had been requested and that a date for undertaking this was awaited from the college. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 13 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): None of these standards were assessed at this time. EVIDENCE: Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 14 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): None of these standards were assessed at this time. EVIDENCE: Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 15 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): 32,34,35,36 Service users are supported by a well recruited and supervised staff team who are on the whole well trained. EVIDENCE: The registered person has developed the staff training, undertaken a full audit of the training needs of the staff and completed a year plan for training to be implemented. She has gained the Skills for Care induction pack and has commenced working through this pack with a staff member; with the aim that all staff will undertake this package. The registered person confirmed that equal opportunity training is undertaken as part of the staff induction. Training records reflected that staff have undertaken moving and handling, food hygiene, fire drills, adult abuse, Health and Safety and first aid training. Four staff have completed the NVQ level 2 in care. The registered person also confirmed that one member of staff has commenced the Learning Disability Award Framework (LDAF) training. Staff files included applications for employment, references and an enhanced Criminal Record Bureau checks (CRB). Staff are issued with details of the working time directive, contracts of employment and the General Social Care Council (GSCC) code of conduct.
Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 16 The registered manager confirmed, and staff files included details that staff receive a minimum of 6 supervisions per year. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 17 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): 37,39,42 Service users live in a home that is on the whole well run. EVIDENCE: The registered manager confirmed that he has completed the NVQ level 4 in care and the Registered Managers Award. In addition he has completed an appointed person first aid course. The registered manager has amended the quality assurance system to include feedback form the relatives of the service users. However only a small amount of responses have been received. The registered manager is to further develop this system to include, where possible the views of other stakeholders, for example, GP’s or other visiting professionals. The fire risk assessment has been reviewed and updated in January 2006.The registered manager confirmed that he is continuing to develop the risk assessments for safe working practices. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 18 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 1 X 3 X 1 X X 2 X Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 19 Yes 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 YA39 Regulation 24 Requirement The registered provider must ensure that the quality assurance systems seeks the view of all persons recommended within the standard and that a report is produced from the review of the service. Timescale for action 13/06/06 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 2 Refer to Standard YA20 YA32 YA42 Good Practice Recommendations The registered person should ensure that staff undertaken medication training which is accredited. The registered person should ensure that 50 of the staff team hold an NVQ level 2 in care. The registered person should ensure that risk assessments for safe working practices are in place. Coates Garden House DS0000019660.V286918.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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