Inspection on 24/10/05 for Conifers

This inspection was carried out on 24th October 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 24/05/05

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 Ms Sally Walker Unannounced Inspection 24th October 2005 Conifers DS0000028218.V253689.R01.S.doc Version 5.0 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 Conifers DS0000028218.V253689.R01.S.doc Version 5.0 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. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Conifers Address 48 Avenue Road Trowbridge Wiltshire BA14 0AQ 01225 776855 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) Mrs Ann Elizabeth Leonard Mr Peter James Leonard Mrs Ann Elizabeth Leonard Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2005 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 to the rear of the property. Currently Mr and Mrs Leonard provide the care and support for one resident and no staff are employed. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.15am and 11.15am. Mr and Mrs Leonard were present during the inspection. The resident was involved in their morning routine. The care records, reviews and menus were inspected and a tour of the communal space 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 DS0000028218.V253689.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Conifers DS0000028218.V253689.R01.S.doc Version 5.0 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 the following standard(s): 2&3 Prospective residents can be sure that the home will assess their needs to make sure that the home is suitable for them. They and their families will have opportunities to discuss their needs and visit the home before making any decisions to live there. EVIDENCE: Mrs Leonard carried out full assessments of potential residents to make sure that the home can meet their individual needs and in consideration of the current resident. Respite care can also be offered. Mrs Leonard will meet the potential resident either in their own home or current placement and gain information from the resident, their family and any healthcare or social care professionals involved in their care. Potential residents and their families or representatives can visit the home to view the accommodation and to meet Mr and Mrs Leonard and the current resident. The statement of purpose provides information about what prospective residents can expect from the home. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 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 the following standard(s): 6, 7 & 9 The resident has benefited from a review of their care. Strategies for communication are enabling the resident to make more choices. Risk assessment does not appear to restrict the resident from experiencing new activities. EVIDENCE: The requirement that the resident’s care plan must be kept under regular review to reflect their current needs had been actioned. Mrs Leonard reported experiencing difficulties in locating the resident’s current care manager the previous one having left. The care plan was very detailed with all aspects of the care needs identified including social care and activities as well as physical and healthcare interventions. The daily report detailed areas of the care plan for comments including, activities, communication and comprehension, attitude and mood, self-help and personal care. Risk assessments for daily living supported the care plan. Mr and Mrs Leonard had developed aids to communication and the resident was making some choices on a daily basis. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 13, 15 & 17 Opportunities for personal development are being encouraged particularly with communication and choice. The resident can experience a range of activities in the locality and these are to be expanded. The resident has regular contact with family. A healthy diet is offered and nutrition monitored. EVIDENCE: The resident is encouraged to have a daily routine. Mr and Mrs Leonard had sought advice from the speech and language therapist with regard to communication and a communication board had been provided. This was being trialled together with gestures and use of the resident’s own methods of communication being built upon with significant results. Mrs Leonard said that the resident was making their needs known, making some decisions and understood what was being said. It was clear from the records and from observation of this progress; the resident clearly understood what was being said and what was going to happen. Mrs Leonard gave further examples of this progress and explained how she intended to develop this further. Mrs Leonard said that she was able to distinguish different sounds and actions to establish when the resident was in pain linked to their condition. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 10 The resident had recently been on a week’s holiday with Mr and Mrs Leonard to Linton, which they know well from previous visits. The resident also made regular weekend trips to stay with family. Mrs Leonard said she was considering extending the range of activities in the community as the resident had refused one of their activities. They attended some of the sessional day services, for example, a relaxation class. The resident also regularly went to local venues and places of interest, for example, swimming, Longleat, Stourhead, the canal, the cinema or a country park. Mrs Leonard said it would depend on the likelihood of crowds, which the resident did not like, at the venues. The resident had at least one walking trip each day. There was a daily menu, which reflected what the resident had eaten. There were also more details of nutritional monitoring in the daily record. All of the meals were home cooked with fresh ingredients and fresh fruit being available. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 11 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 & 19 Personal care is provided by Mrs Leonard taking into consideration the resident’s preferred routines. The resident has good access to healthcare. EVIDENCE: Mrs Leonard provided the intimate personal care and Mr Leonard was involved in daily support. There was clear written guidance on the resident’s preferred routines for the giving of personal care. The care plan identified the resident’s needs in mobility, healthcare, nutrition and eating, emotional wellbeing and social activities. Mrs Leonard reported that the resident was now doing more for themselves, for example, dressing and taking a cup to the kettle and switching it on to indicate that they wanted a drink. Mrs Leonard said that she believed some minor behaviours had decreased or ceased as the resident was more in control of their environment and able to communicate their needs and be understood. The district nurse was involved in providing two invasive treatments each week. Mrs Leonard had sought specialist advice on diet and supplements from healthcare professionals and this advice was being followed with significant results. The residents had access to dentist and other healthcare professionals as needed. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 12 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 inspected. EVIDENCE: Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 13 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): 24 & 30 The home is very comfortable, safe and clean. The home is decorated to a high standard in keeping with the original Victorian building. The bedrooms are large and residents have access to all the communal areas. EVIDENCE: The home was very well maintained with furniture and fittings of a good standard. The home was warm, light, airy and homely. Mr Leonard makes sure that the home is well maintained. The home was clean and no unpleasant odours were detected at any time during the inspection. The resident has 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. Mrs Leonard reported that the resident enjoyed using the garden which had been made safe with restricted access to the front of the property. A stair gate at the top of the stairs had been approved by the Fire Authority and was an extension of the banister rails opposite the resident’s bedroom. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 14 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): None of these standards were inspected as no staff are currently employed. EVIDENCE: Although no staff were employed at present they had been in the past and Mr Leonard said that when other residents came to live at the home staff would be employed again. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 15 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 The home is run in the best interests of the residents. Mr and Mrs Leonard were clear about their aims to provide a quality service. EVIDENCE: Mr and Mrs Leonard set up the home in 1999. Mrs Leonard has over 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 a good knowledge of people with learning disabilities and has NVQ Level 2 in care. Mrs Leonard said she was going to progress her plans to complete the NVQ Level 4 and registered managers award. She said she kept herself up to date with current events through the Association for Real Change, an organisation which supports providers of services to people with learning disabilities. Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 16 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 3 3 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Conifers Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000028218.V253689.R01.S.doc Version 5.0 Page 17 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 YA37 Regulation 10(3) Requirement Mrs Leonard must progress her plans to undertake the NVQ Level 4 and registered managers award. Timescale for action 31/01/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Conifers DS0000028218.V253689.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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 DS0000028218.V253689.R01.S.doc Version 5.0 Page 19 - 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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