Inspection on 18/12/07 for Fair Glen, Gate House & Maurice House

This inspection was carried out on 18th December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Fair Glen, Gate House & Maurice... 11/01/07

Fair Glen, Gate House & Maurice... 27/02/06

Fair Glen, Gate House & Maurice... 06/10/05

Fair Glen, Gate House & Maurice... 31/10/04

Fair Glen, Gate House & Maurice... 06/07/04

Fair Glen, Gate House & Maurice... 02/03/04

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 Fair Glen & Gate House Lancaster Gardens Whitleigh Plymouth Devon PL5 4AB Lead Inspector Kim Fowler Unannounced Inspection 18th December 2007 09:45a Fair Glen & Gate House DS0000036285.V354870.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 Fair Glen & Gate House DS0000036285.V354870.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. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fair Glen & Gate House Address Lancaster Gardens Whitleigh Plymouth Devon PL5 4AB 01752 770358 01752 770358 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) Gyaneshwar Purgaus Santee Sawock Purgaus Gyaneshwar Purgaus Care Home 22 Category(ies) of Learning disability (22) registration, with number of places Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Age 18 - 65 The home may accommodate two service users named elsewhere who have mental health needs 2nd July 2007 Date of last inspection Brief Description of the Service: Fair Glen/The Gate House is a care home providing personal care and accommodation for seventeen people aged 18 - 65, with learning disabilities. Mr and Mrs Purgaus privately own the home. This home is located in the residential area of Whitleigh, close to shops, pubs, the post office and other amenities. The home is at the end of an un-adopted road, close to a housing estate, and overlooking the local playing fields. The home was opened in 1987 and is comprised of two detached two-storey houses. Fair Glen has twelve bedrooms and The Gate House has five bedrooms. All the homes bedrooms are single and none of them have en suite facilities. Both of the houses have separate lounge and dining rooms and Fair Glen has a conservatory off the dining room. The home has large grounds; a patio and all areas are accessible to the Residents. The owners have now extended the property and included another house next to the existing properties and have called this Maurice House. However this house is currently unoccupied. The home is staffed 24 hours a day with sleep in staff in each house at night. The current fee levels range is from £ 325 to £480. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 1 day and was carried out by 2 inspectors. The registered manager and owner Mr Purgaus was available throughout the inspection. The inspector made a tour of the building and spoke to most of the people who live in the home. Documentation relating to the care planning process and the management of the home were examined. Most of the people living in the home, 4 staff members and one professional were spoken with during this inspection. Any comments are in the relevant section of the report. What the service does well: What has improved since the last inspection? What they could do better: No Requirements or Recommendation were made during this inspection. Please contact the provider for advice of actions taken in response to this Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 6 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. Fair Glen & Gate House DS0000036285.V354870.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 Fair Glen & Gate House DS0000036285.V354870.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. This judgement has been made using available evidence including a visit to this service. Prospective new admissions referred to the home can be confident that they will be provided with sufficient information for them to make an informed choice about living at this care home. EVIDENCE: The home has had no new admission since the last full inspection. However discussion with Mr Purgaus, the Registered Manager, confirmed that the home has a procedure in place should a new referral be made. Mr Purgaus stated that the home would provide each new prospective admission with a Service Users Guide and Statement of Purpose. Several visits would be arranged including meal visits and overnight stay before any final decision was made. Fair Glen & Gate House DS0000036285.V354870.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): 6/7/8/9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are now encouraged and supported to make decisions about their own lives to maintain their independence. EVIDENCE: Four care plans for people living at the home were examined and each showed detailed descriptions of each person’s needs and included personal care needs and medication taken. These files contained information to assist the staff in meeting the assessed needs of individuals. Information was recorded that showed regular reviews had been undertaken and included evidence that people living at the home had been in attendance at these review meetings. The Registered Manager stated that specialist input was sort when required and this information was recorded into individual files and included written guideline provided by the specialist support services. Each file also held a Goal Progression sheet that records the tasks required for the staff to meet everyday needs of individual. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 10 The last full inspection reported that some people did not feel that they were able to make decisions about their own and were restricted by the homes rules on going out in the evening and other issues. The requirements made in respect of these restriction have been met and people living at the home confirmed that they now held front door keys, were involved in everyday decisions on the running of the home including meal times and trips out. Petty cash is held for some people in the main office and several people were observed coming into the office to request money from the manager or senior care staff. One person came in to withdraw money and discussed with the staff how they planned to spent their money. One person said “ I come in for my money whenever I wish”. The manager confirmed that all people held a bedroom door key and those who choose to hold a front door key. Previous inspection showed that each person living at the home has their own bank account and care plans recorded evidence that some people had a cash card to withdraw money when they wished. The care plans examined showed that the home has several advocates involved to assist people were needed. Observed throughout the day were people coming and going freely with several people going to the local shops and two going out to a Christmas party. Risk Assessments are in place and held on each file and these risk assessments includes people accessing the community and assisting with cooking, ironing and guidelines are in place for those people who may challenge the service. The previous full inspection reported showed that guidelines were not in place and each file held minimal details on risk. The requirements made for these standards have been met. Discussions with people who live in the home and the staff team confirmed that personal care is maintained. The people who live in the home said they can bathe/shower when they choose to and are encouraged to be as independent and make as many choices as possible. They said they are involved in the day-to-day running of the home and these discussions confirmed that independence is encouraged and promoted. Fair Glen & Gate House DS0000036285.V354870.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): 11/12/13/14/15/16/17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that the home will provide support for them to access the local community and many leisure activities. This promotes the their independence. EVIDENCE: Discussions with people who live in the home confirmed that they are encouraged and supported to participate in a range of work, leisure, and educational opportunities. Several people in the home currently are undertaken college courses including computer course and adult literacy. Many people confirmed that they use the local amenities, such as shops and pubs and there are no restrictions on timings of going out and coming home. There is a range of activities that people can participate in, should they wish to, but most people seemed quite happy to decide what they wanted to do on a day-to-day basis. On the day of inspection there was a lot of talking, Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 12 socialising and laughter in the home between the people who live there, as well as the staff. One person who lives in the home said that there is a pool table available should they wish to use it. There have been various trips out for example, to a pub for a Christmas lunch and a trip to The Pavilions in Plymouth to see ‘Beauty and the Beast’ was taking place the next day. The people who live in the home are looking forward to a Christmas Party within the next few days to which friends and family were invited. The people, who live in the home are able to keep small, caged pets, such as birds and fish. The residents of The Gate House have three caged budgerigars and a fish tank in the lounge. Where possible people who live in the home are involved in daily routines and domestic activities in the home, including cleaning and tidying their own rooms and doing their own laundry. The development of personal relationships is encouraged, both with friends and family. The people who live in the home said that they visit their families and family members visit them on a regular basis. People who live in the home said that they liked the food provided in the home and can choose what they want to eat. Meals and menus are discussed at the residents meetings and the records of these meeting showed these were discussed at each meeting held. Wherever possible people who live in the home are enabled to prepare and cook their own meals, with staff assistance if required. Some people who live in the home said they buy some items of food, which included tea bags, butter (or spread) and bread, because they do not like the ‘Tesco Value’ products. The owner/Registered Manager, Mr Purgaus, agreed to find out what the residents would prefer and purchase these basic items for them. The previous full report made requirements that included that people are able to access the community, must have access to a range of age appropriate activities and choose who they want to see and when. The entire requirement made for these standards have now been met. Fair Glen & Gate House DS0000036285.V354870.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): 18/19/20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home health, personal and social care needs are being met and people are treated respectfully. EVIDENCE: Discussion with people who live in the home confirmed that they visit the dentist regularly and see doctors and other health and social care professionals when required. External professional advice and guidance is sought when necessary from local health care professionals or social services. On the day of inspection a speech and language therapist from the learning disability service was visiting the home. She said that one of her colleagues had confirmed that staff at the home always follows any guidance and advice given by other professionals. Discussions with people who live in the home showed that timings of individual routines are flexible and the choice of the individual. The home uses the Blister pack system for medication and a local chemist is used to assist with staff training. Medication is stored safely, records are well Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 14 maintained and that staffs with responsibility for medication administration has received training from the local pharmacist ensuring they have knowledge of safe medication practices. Currently two people living at the home self medicate and the manager confirmed that risk assessments are in place and staff monitor were needed. Fair Glen & Gate House DS0000036285.V354870.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): 22/23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home can be confident that any complaints or concerns raised will be listened to. EVIDENCE: The home has a complaints procedure and people who live in the home are aware of how and to whom they can make a complaint and, generally, feel free to do so. Concerns and issues can also be raised at the service user meetings that are held every two months or so with the owner/Registered Manager, Mr Purgaus. One file examined showed that the home and advocacy service are supporting one person to made a complaint to another agency. The homes complaints book recorded a recent complaint made by one person living at the home about another person also living at the home. This book recorded the action taken and the outcome of the complaint made providing evidence that peoples complaints are acted upon. Most staff has completed the POVA (Protection of Vulnerable Adult) training with the local authority and the home has also purchased a video to update staff when required. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24/25/26/27/28/30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at Fairglen and the Gate House benefit from a homely, comfortable, clean home that is regularly upgraded. EVIDENCE: The home is comfortable, safe and clean with a reasonable standard of décor and furnishings. Both houses were well decorated for Christmas at the time of inspection and the people who live there were looking forward to the Christmas festivities. A designated staff member is responsible for maintenance and he confirmed that repairs, maintenance and redecoration are ongoing projects. In both Fair Glen and The Gate House, there are lounge and dining rooms on the ground floor. These are popular places for people who live in the home to congregate, talk to each other and staff and participate in activities, such as drawing, cards and board games. Each person has a single bedroom with space for individual needs and lifestyles. In The Gate House, these are all on the 1st floor and in Fair Glen, they are on both the ground and 1st floors. All the bedroom doors are fitted Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 17 with appropriate locks that can be locked from the inside by people who live in the home and locked from the outside by using a key. Most people who live in the home have their own key and some of them always lock their bedroom doors when they go out. All the bedrooms contain wash hand basins but none of them have en suite facilities. Bedrooms are individually furnished and personalised by or for the person whose room it is, depending on their wishes. The owner, Mr Purgaus, confirmed that bedrooms are repainted every four years and each person is enabled to choose the colour and décor of their bedrooms. The type and quantity of furniture varies dependant on the wishes and needs of individuals. People who live in the home said that they are responsible for cleaning their own bedrooms if they wish to and the home has domestic staff that make sure that bedrooms are kept clean. The bathrooms and toilets are in good condition and discussions with people who live in the home, as well as observation, indicated that there are enough facilities to meet the needs of the people who live in the home and staff. All bathrooms and toilet doors are fitted with locks that can be opened from the outside by staff in an emergency. The laundry room was found to contain industrial washing facilities and Mr Purgaus stated that people are assist to do their own washing. Fair Glen & Gate House DS0000036285.V354870.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): 33/34/35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home are supported by well-motivated and caring staff in sufficient numbers to meet the needs of those currently living at the home. Staff training and supervision are carried out regularly to all staff to ensure that all assessed needs of the people living at the home are met. EVIDENCE: Discussions with people who live in the home and the staff on duty confirmed that there is always enough staff on duty to meet the needs of the people who live in the home. There is usually three staff on duty during the day and three staff who sleep in at night (two in Fair Glen and one in The Gate House). Observation showed that the staff members on duty were aware of people who live in the home’ needs and how to support them. People who live in the home confirmed that the staff team are very good, saying they are “lovely” and “friendly”. It was evident from the amount of conversation and laughter in the home that there was a good rapport between people who live in the home and staff. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 19 Examination of staff files showed that all had the required pre-employment checks, including CRB (Criminal Record Bureau Disclosure) in place ensuring as far as possible unsuitable staff are not employed. The requirement made in the last full inspection report has been met. Discussions with four staff members confirmed that all staff are expected to participate in various courses and training sessions. Training includes induction, adult protection, first aid, fire safety, medication, food hygiene, National Vocational Qualifications (NVQs) and courses related specifically to working with people who live in the home with learning disabilities. These include topics such as working with people with challenging behaviour and communication skills. Staff training files were examined and showed recent certificates of courses completed and undertaken including medication and fire safety. Fair Glen & Gate House DS0000036285.V354870.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): 37/39/42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Manager and owners of the home has the respect of the staff team and is highly thought of by the people who live in the home. EVIDENCE: Mr Purgaus has owned and managed this home for a number of years and this inspection showed that many improvements had been undertaken after the last full inspection and Mr Purgaus had listened to, carried out and met all requirement made in the last full inspection. Quality assurance forms completed provided evidence of further improvements including more involvement of the people who live at the home in making decisions about many areas in the home including food and trips out. All results were discussed at the residents meeting held on a regular basis. Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 21 Sampling of servicing records indicated that most equipment is serviced regularly and maintained in good working order, including the fire alarm system. Certificates were available on all Health and Safety equipment i.e. hoist ensuring all have been checked. Electrical appliances were being routinely serviced and checked. The fire protection system was well maintained. Maintenance checks are being carried out by the home maintenance person. Staff are receiving appropriate fire protection training to ensure they have the skills to deal with emergencies. Fair Glen & Gate House DS0000036285.V354870.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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Fair Glen & Gate House DS0000036285.V354870.R01.S.doc Version 5.2 Page 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!