Inspection on 24/05/05 for Conifers

This inspection was carried out on 24th May 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Conifers 18/12/07

Conifers 11/10/06

Conifers 24/10/05

Conifers 17/11/04

Conifers 29/04/04

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 Conifers 48 Avenue Road Trowbridge Wiltshire BA14 0AQ Lead Inspector Sally Walker Unannounced 24th May 2005 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. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Conifers Address 48 Avenue Road Trowbirdge Wiltshire BA14 0AQ 01225 776855 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) Mrs Ann Elizabeth Leonard Mrs Ann Elizabeth Leonard Care Home 3 Category(ies) of LD Learning Disability (3) registration, with number of places Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17th November 2004 Brief Description of the Service: Conifers is registered for 3 younger adults with learning disabilities. The home is a large semi-detached Victorian house close to the centre of Trowbridge. Mr and Mrs Leonard live on the premises. The residents accommodation is all single bedrooms and all are to the first floor. There are 2 large sitting rooms, a dining room, kitchen and bathroom with toilet to the ground floor. On the first floor there are the staff sleeping in room, a large bathroom and separate toilet. There is a large enclosed garden rear of the property. Currently Mr and Mrs Leonard provide care for the one resident. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place between 9.00am and 11.35am. Mr and Mrs Leonard were present during the inspection as was the resident. The care records were examined together with the medication records, risk assessments and complaints procedure. A tour of the building was made. What the service does well: What has improved since the last inspection? 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. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 6 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 Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 7 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) None of these standards was inspected as no new residents had been admitted to the home for some time. EVIDENCE: Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 8 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 & 9 The resident had not benefited from a recent review of their care plan, however the resident was being encouraged to make some decisions, and risk assessments did not stop residents from being involved in a range of activities or prevent them from having new experiences. EVIDENCE: Mrs Leonard provided any personal care and Mr Leonard was also involved in supporting the resident with activities and meals. The care plan and daily report showed that the resident’s routines for getting up and going to bed were based on Mr and Mrs Leonard’s experience of caring for them over a number of years. The care plan was very detailed and showed all aspects of the resident’s care needs. It was clear from the daily record that the care plan directed the care. The daily report had heading related to activities, communication, attitude/mood, self-help and food and fluid intake. Although the resident did not have speech, they were able to communicate some choices and show understanding with facial expression and behaviour. It was clear from observation that the resident and Mr and Mrs Leonard had developed a range of different methods in communicating with each other. Mrs Leonard said that a communication device recommended by the speech therapist had been ordered. The resident’s family were also involved in the resident’s care with regular weekend visits and information sharing. However, Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 9 the care plan had not been formally reviewed since January 2004. Mrs Leonard said there had no significant changes to note. Risk assessments accompanied the care plan and covered all aspects of the resident’s needs, tasks they were involved in, the home environment and going out. The risk assessments did not appear to restrict the resident from experiencing new activities. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 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 standard(s) 14, 15 & 17 Residents have access to a good range of leisure activities. Residents retain contact with their families. Residents benefited from a range of healthy meals. EVIDENCE: The resident was involved in a range of activities in the local area. Mrs Leonard said they had their regular activities like swimming and going for walks. They also went to all the local festivals, events and facilities including the Bath and West Show, Longleat, National Trust properties, shopping, garden centres, the cinema and a Music Festival. Activities would depend on how the resident was feeling, whether crowds were present or their level of interest. The resident enjoyed the home’s garden and there was various sensory equipment together with music and television. Mrs Leonard said that she had sought courses from the local college but none on the current programme met the resident’s needs. The resident maintained contact with their family with regular weekend visits The resident was having their breakfast as the inspector arrived at the home. The meal was a selection of fresh fruit with cereal biscuits and a hot drink. Mrs Leonard said that the resident was supported to eat a nutritious diet with some treats including meals in restaurants. Meals taken were recorded each day. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 11 Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 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 standard(s) 18, 19 & 20 Care and support is offered to residents with their own preferred routines taken into consideration. Residents have good access to specialist healthcare professionals. Medicines were kept safe and given at times noted by the prescriber, with records maintained. EVIDENCE: The care plan gave details of the residents preferred routines, health monitoring, behaviour management, pain management, continence and personal hygiene and mobility. The district nurse visited regularly and their notes were available describing progress with their intervention. The resident’s healthcare was being closely monitored by Mr and Mrs Leonard with prompt referrals to healthcare specialists when necessary, this would also include dental appointments, behavioural nurse and speech therapist as necessary. The resident did not administer their own medication which was administered from a locked store with either Mr or Mrs Leonard signing a log to show this. Records were kept of all unused and unwanted medication returned to the pharmacy. There were no controlled drugs being administered. Data sheets were on file with information about prescribed medication. Mr and Mrs Leonard ensured that residents’ medication was regularly reviewed with their GP. The previous requirement that all medication, including those administered by a hospital did not now apply as that resident had moved. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 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 standard(s) 22 & 23 Policies and procedures were in place to reduce the risk of abuse of residents and to enable them and their representatives to comment on the service. EVIDENCE: The home had a complaints procedure dated August 2002 which had been reviewed in January 2004. Mrs Leonard reported that this document had been given to the resident’s family and their care manager when the placement commenced. There were copies of the local Vulnerable Adults procedure entitled “No Secrets in Swindon and Wiltshire” in the policy file. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 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 standard(s) 24, 25 & 30 Great efforts have been made to make a comfortable and safe environment for residents. The home has benefited from extensive re-decoration of a high standard. The resident’s bedroom was personalised and comfortable. The home was very clean and no unpleasant smells noted. EVIDENCE: The environment was very well maintained with furnishings and fitting of a good standard. It was homely in nature, warm, light and comfortable. Mr Leonard was nearing completion of redecorating all the rooms and maintenance was kept up to date. The home was very clean and no unpleasant smells were detected at any time during the inspection. The resident had a large bedroom which had been personalised to reflect their personality and the tastes of a younger person. The other 2 bedrooms were also very large and were in the process of being redecorated. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were inspected as currently Mr and Mrs Leonard employed no staff. EVIDENCE: Although no staff were currently employed as there was only one resident, Mr Leonard said that agency staff or previously employed staff would cover in an emergency. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 16 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, 41 & 42 The home is run in the best interests of the residents. Mr and Mrs Leonard are clear about providing a good service. Some attention needs to be given to reviewing and revising if necessary some of the paperwork. Mr and Mrs Leonard ensure residents health and safety. EVIDENCE: Mr and Mrs Leonard set up the home in 1999. Mrs Leonard has more than 30 years experience of working with people with learning disabilities both as a teacher and in care homes. Mr Leonard comes from a business background but has been involved in the home since it opened and has NVQ Level 2 in care. The care plan was in need of a formal review. Mr Leonard ensured that maintenance and repairs were addressed. Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 17 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 x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 x x x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Conifers Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 2 3 x D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 18 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 YA6 Regulation 15(2)(b) Requirement The person regisitered must keep the service users plan under review and make any chnages to reflect the current needs Timescale for action 24th May 2005 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 Good Practice Recommendations Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 19 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Conifers D51_D01_S28218_CONIFERS_V210264_240505_Stage4.doc Version 1.30 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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