Inspection on 09/01/07 for Coates Garden House

This inspection was carried out on 9th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Coates Garden House 16/03/06

Coates Garden House 11/02/05

Coates Garden House 27/07/04

Coates Garden House 18/03/04

Coates Garden House 08/01/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Coates Garden House High Street Patrington Hull East Riding Of Yorks HU12 0RE Lead Inspector Rob Padwick Unannounced Inspection 9 January 2007 12:30 th Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 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 Mrs Sheila Margaret Turley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th March 2006 Brief Description of the Service: Coates Garden House is a registered care home for up to 8 adults of either gender, with learning disabilities. The home is located in the village of Patrington and is close to local amenities; including shops and the post office. Residents gain access to public transport via a short walk to the main road. The home consists of a detached property, which is well maintained and provides 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. The home is privately owned and run by Bleak House Ltd. The standard fee charged by the home ranges from £317.50 to £374.03 with additional charges made for hairdressing, chiropody, toiletries etc. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit for this service lasted for 5.25 hours and included a tour of the building and checking the progress in implementing the requirements and recommendations from the previous inspection. During the visit, time was spent with the residents, observing their daily lives and talking with them. Other time was spent reading care plans and files and talking to staff. A Pre Inspection Questionnaire asking for information about the home was sent to the manager before this visit and information from this was included as part of the inspection process. Other information that was used included notifications received by the Commission for Social Care Inspection about any serious incidents that had taken place in the home. Questionnaires were sent out to relatives and Health and Social Services staff associated with the home. Three replies were received from the relatives who were contacted and all of these made favourable comments about the home. Three comment cards were also returned from Social Services staff and the replies from these were also equally good. Residents completed questionnaires as part of the inspection process and their views have been included within the report from this visit. What the service does well: What has improved since the last inspection? The manager had written to relatives and professional people who knew the residents, in order to obtain their views about the quality of the service provided. The staff had received training about medication, in order to ensure that the residents were kept safe and more staff had finished a qualification to show that they were properly trained to do their jobs. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 6 Checks for the equipment and building had been developed in order to ensure that the residents were kept safe. 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. The summary of this inspection report can be made available in other formats on request. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Residents had been involved in the process of deciding to move into the home and they had received assessment, in order to ensure that the home could satisfactorily meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with residents indicated that they had been involved in decisions about moving into the home and case files inspected confirmed that this process had included an assessment of their needs, in order that the home could satisfactorily meet them. The case files inspected contained evidence that the residents had participated in the above process and discussion with staff indicated that residents were able stay for a few nights, in order that they could to try out the home and make an informed decision about whether to move into it. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. Staff were supporting residents appropriately to make choices and decisions about their lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with residents indicated that they were aware of their care plans and inspection of a sample of these, confirmed that they had been involved in the construction and development of them. Areas of need and identified development for each of the residents were included within the care plans inspected, together with guidance to staff in how to support and maximise the residents individual skills in respect of these. The home operates a key worker system and discussion with staff indicated that they had sound levels of understanding concerning the needs of the individual residents allocated to them. Relevant assessments of risk that had been identified for each of the residents were included within the care plans inspected, along with guidance and strategies for staff in how to deal with these and observation of the care practices indicated that staff were providing appropriate support to the residents, in relation to this aspect of practice. Case files contained evidence of regular monitoring of the residents with daily recordings of the support Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 10 given to each of the residents and monthly summaries and reviews of the care plans, in order to ensure that they continued to be appropriate to meet identified needs. Residents confirmed that they were able to make decisions about their lives and staff were observed providing appropriate guidance and assistance in respect of life choices with examples of this recorded in the case files inspected. Residents said, “ You can chose what you want to do. I can shop when I like and visit my family when I like.” Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. The residents were being supported to participate in a lifestyle that was appropriate to their individual needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with residents indicated that they were supported to lead lifestyles that were appropriate to meet their individual needs and wishes. Recording in the care plans and discussion with staff indicated that a person centred approach to meeting need was being adopted and discussion with residents confirmed that a good range of opportunities and assistance were being provided. Some of the residents returned from college during the afternoon of this visit and discussion with them confirmed that they enjoyed meeting friends and learning new skills there, whilst discussion with others indicated that they attended local day centres and adult education classes. Other residents told Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 12 how they were helped by staff to pursue interests that they were interested in doing. Care plans indicated that residents were supported to take part in the life of the local community and residents confirmed this by giving examples of how they used the visiting library service, going to the cinema or simply going shopping or the visiting the pub. The home has an open visiting policy and encourages the involvement of friends and family and a comment card returned from a relative confirmed that the writer was “very happy with the home” and that staff “keep me in touch” about the needs of his loved one. Case files contained examples of the how staff supported the individual residents emotional and psychological needs with professional help being sought when this was needed. The daily routines in the home are kept as flexible as possible, in order to enable the residents to pursue a lifestyle that was appropriate for them. Staff were observed to have very positive relationships with all of those accommodated and an atmosphere of mutual regard was apparent throughout the home during this inspection visit. Residents confirmed that staff assisted them to undertake and develop their skills in independent living, with support given with things like cleaning their rooms and budgeting. Observation of the staff and discussion with them indicated that residents were generally encouraged and supported to shop and prepare their own meals and residents were keen to provide examples of how they did this. Case files contained evidence that staff were monitoring the residents’ dietary needs, in order to ensure that their nutritional needs were being met with entries for individual weight and daily intake recorded as appropriate. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The staff were appropriately supporting the residents, in order that their emotional, personal and healthcare needs were met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents confirmed that staff were supporting their health and personal care needs. In practice, the residents accommodated at the time of this visit were largely independent in relation to their personal care and discussion with the residents and staff and inspection of case files indicated that this was largely being met via a system of verbal prompts with physical and psychological support being given from staff as required. Case files documented the health care needs of the residents, with evidence that these were being monitored with appropriate action being taken as needed. Residents confirmed that “staff help me to attend my appointments” and staff demonstrated a good knowledge of the needs of the individuals accommodated; this was also confirmed in a questionnaire returned from a member of Social Services staff. A recommendation from the previous inspection report was that staff undertake accredited medication training, in order to ensure that the residents are kept safe in relation to this aspect of practice. Information supplied by the Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 14 manager indicated that this recommendation had been implemented and discussion with staff confirmed that nearly all of them had completed a course on the safe handling and use of medication and that they were awaiting certificates to show that they had passed this. A random sample of the residents’ medication records checked confirmed that these were being maintained appropriately, and that the medication stored in the home accorded with that that was shown on these. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. The residents concerns and complaints were being taken seriously and staff had received training, in order to ensure that the residents were safeguarded from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with residents indicated they were happy with the service and that they felt that staff listened to any concerns that they might have. An acceptable complaints policy was available for residents to use if they wanted to raise any concerns or issues formally, although discussion with residents and staff indicated that in practice these were resolved before they became a problem. The complaints book was inspected and contained no entries since the last inspection. Comment cards received from residents stated that “I would talk to the assistant manager or the manager” and “ I would talk to my keyworker”. Policies and procedures were in place; in order to safeguard the residents from abuse and inspection of the homes records indicated that staff had covered this aspect of practice as part of their training. Discussion with staff confirmed that they had a sound understanding of issues relating to the protection of vulnerable adults, however staff files inspected indicated that the homes recruitment procedures needed strengthening, as the recent operation of these procedures placed the residents potentially at risk from harm (See Staffing). Discussion with the manager indicated that the home looks after most of the Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 16 residents’ money, and a check of the records for these confirmed that satisfactory systems were in place to ensure that they were being safeguarded. Records documented the signatures of two staff members for monies given out or received and a random check of the residents’ monies accurately accorded with these. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The residents’ environment was clean, comfortable and safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The building was a normal domestic home and was warm and comfortable and provided the residents with a safe environment. The maintenance book contained evidence of regular entries for work that had been carried out discussion with the manager confirmed that the recommendations of a recent visit from the Environmental Health Department had been undertaken. Information submitted as part of this inspection indicated that relevant health and safety training relating to the environment had been delivered to staff. The building was clean, hygienic and free of offensive odours. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 Quality in this outcome area is poor. The residents were being supported by staff that had received training to help them do their jobs. However the recent operation of the recruitment process placed the residents potentially at risk from harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation and discussion with staff indicated that they were a committed team with little turn over experienced, except for a few recent exceptions. The mixed gender staff group employed reflected the needs of the residents and all those spoken with were enthusiastic and motivated to meeting the needs of those accommodated. Staffing levels were good and staff confirmed that they had been provided with training, in order to help them do their jobs. Information submitted by the manager in respect of this, indicated that 7/12 of them had obtained an NVQ in care at level 2 or above and discussion with him indicated that another two were in the final stages of completing this level of award with a further member of staff being entered for it. The minimum ratio recommended in the National Minimum Standards for staff possessing this qualification is 50 and the progress made in respect of this is therefore commended. The deputy manager indicated that she was in the process Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 19 undertaking an audit of the individual training needs of the staff and that she had obtained the latest Skills for Care induction pack due to start working through this with two staff members who had recently been recruited. Information from the previous inspection indicated that one staff member had started Learning Disability Award Framework (LDAF) Training. Recommendations are made in these matters. The home had a recruitment policy and procedures in order to safeguard the residents. However, inspection of the files of the two latest staff members employed indicated these were not being followed robustly. Whilst references and identity checks identity had been carried out for the staff members concerned, up to date Criminal Records Bureau checks had not been obtained, although these had been sent for. Similarly, no formal request before they had commenced work had been made by the Registered Person to ensure that their names were not included on the Protection of Vulnerable Adults (POVA) list. This situation is unacceptable and will be monitored at the next inspection visit, in order to ensure that the inspector can have a clearer picture that practice in this matter has been improved. A requirement is therefore made, in order to ensure that the residents are kept safe from harm. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. The home was being well managed with maintenance checks appropriately carried out to ensure the health and welfare of service users and staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with residents and staff indicated that the home was being well managed and all of the relative and professional comment cards returned confirmed that the respondents were satisfied with the overall level of care provided at Coates Gardens. The manager confirmed that he is suitably qualified to manage the home and staff indicated that he had an open style of management. The home had some quality assurance systems in place and evidence was seen that residents were consulted about developments effecting them and that efforts had been made to obtain the views of relatives and professionals associated with the home, as part of this process. However a recommendation is made that the quality assurance systems are further Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 21 developed, in order to enable the monitoring and performance of the home against its stated aims. Inspection of a random sample of the homes records indicated that satisfactory checks were being carried out in respect of the homes equipment, in order to ensure that the health and welfare of the residents and staff was being safeguarded. However, as previously noted the manager needed to strengthen the staff recruitment procedures, in order to ensure that the residents were protected from risk of potential harm. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 3 34 1 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA34YA34 Regulation 19 Requirement The registered person must ensure that an up to date Criminal Records Bureau check is obtained is obtained for all staff before they are deployed to work in the home. In exceptional circumstances, the registered person may allow a newly recruited staff member to work in a supervised capacity, once a satisfactory Protection of Vulnerable Adults check is obtained. Timescale for action 09/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA35YA35 Good Practice Recommendations The registered person should ensure that the audit of individual staff training needs is completed and actioned in order to ensure the welfare of the residents. The registered person should ensure that newly recruited Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 24 2 YA39YA39 staff undertake accredited Learning Disability Award Framework training. It is strongly recommended that the registered person develops the quality assurance systems within the home, in order that it is possible to monitor the performance of the home against its stated aims. Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Coates Garden House DS0000019660.V324426.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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