Inspection on 20/10/05 for Gatooma

This inspection was carried out on 20th 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 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

Gatooma 07/02/07

Gatooma 05/04/05

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

CARE HOME ADULTS 18-65 Gatooma Brandis Corner Holsworthy Devon EX22 7YD Lead Inspector Antonia Reynolds Unannounced 20 October 2005 th 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. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Gatooma Address Brandis Corner, Holsworthy, Devon, EX22 7YD 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) 01409 281778 01409 281764 Atlas Project Team Limited Miss Natasha Stapleton Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Category of Learning Disability (LD) Age range 18 - 65 Date of last inspection 5/4/05 Brief Description of the Service: Gatooma is a care home providing personal care and accommodation for five people, aged 18 – 65, with learning disabilities, who may demonstrate behaviours that challenge services. It is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. The home is in a rural setting on the edge of the small hamlet of Brandis Corner. The nearest amenities, such as shops, post offices, and financial institutions are approximately five miles away in the villages/towns of Holsworthy, Highampton and Shebbear, therefore the home provides transport for service users. The home was opened in 2004 and is comprised of a two-storey detached house, with a two storey extension (the annex). The ground floor is one area, but the 1st floor is divided and can be accessed by separate staircases at each end of the building. All the home’s bedrooms are single, one of which has an en suite bath and toilet. In the main house there are two shower rooms with toilets, therefore the service users have a bathing/showering facility each. In the annex the two service users share a bathroom, but there is an additional toilet on the ground floor. There is a lot of communal space with separate lounge, dining and garden rooms, with a designated smoking area in the conservatory. The home has extensive gardens/grounds including an indoor heated swimming pool. All areas are accessible to the service users. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 9.45am and 11.45am. The Area Manager, Tim Stevens, was present throughout and the Registered Manager, Tash Stapleton, was present for part of the inspection. A tour of the premises took place and three service users (the home had one vacancy at the time of inspection), two staff members, a Care Manager from Social Services and a Community Nurse, were spoken to during the visit. What the service does well: What has improved since the last inspection? What they could do better: No issues were identified at this inspection. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 6 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. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 and 4 The home’s Statement of Purpose and Service User Guide provide service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The organisation had a detailed admissions procedure where all prospective service users are assessed prior to admission by the senior management team within the organisation. They glean as much information as possible from the service user, relatives and representatives, as well as other professionals involved in the person’s care and this was documented. The visiting Care Manager said that the transition period for service users was excellent with plenty of opportunities to visit the home and become familiar with other service users and staff. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 and 9 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Discussions with service users showed that they were encouraged and enabled to make decisions, take assessed risks and participate in all aspects of life in the home. Service users were aware of the reasons for any restrictions of choice or freedom. Each service user had an individual daily programme and were able to explain how these worked and why they were in place. Detailed risk assessments had been carried out relating to various aspects of the service users’ lives to ensure that they were able to participate in anything they chose to do, with the least risk. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 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) 11, 12, 13, 14, 15, 16 and 17 Service users can learn life skills, attend college, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Discussions with service users and the Area Manager showed that people were attending, or planning to attend, various courses of their choice at local further education colleges. Service users were able to go shopping or take part in various leisure activities of their choice when they chose to, unless the risk assessment indicated otherwise. A fun day was held at the home during the summer and service users were involved in organising this. Service users and staff from other homes owned by the organisation attended and service users, staff and management have all commented that it was an excellent day. Service users and the Area Manager confirmed that holidays abroad and in the UK were arranged for all the service users this year, although they were not all able to go because of particular personal issues that arose. The home provided an eight-seater people carrier and a car for use by the service users. Staff were not expected to use their own car to transport service users. It was evident, through observation during the inspection, that service users felt very Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 11 ‘at home’ and were empowered to make decisions, in negotiation with the staff team. Service users were actively participating in preparing meals, drinks and snacks and they confirmed that they chose the menu. The service users were encouraged and facilitated to keep in touch with, and see, family and friends, and the home ensured this happened by providing staff support and transport, at no cost to the service users or their families. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 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 and 19 Service users can be confident that personal support is provided in the way, and at the time, that service users want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Through observation it was clear that all timings were flexible and the choice of the service user, unless a more structured programme was agreed because of the needs of service users. Discussion with the management team, a Care Manager and Community Nurse confirmed that external professional advice and guidance was sought when necessary from local health care professionals or social services. Visits to and from health/social care professionals took place in private although staff were available if required to facilitate communication and because of the needs of the service users. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 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 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that complaints are always dealt with seriously and any concerns from service users will be listened to and acted upon immediately EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since it opened in 2004. The home had a complaints procedure and the service users explained how they would make a complaint and who they would talk to. The management and staff team were aware of adult protection issues and procedures and training has been undertaken, or is planned, for all staff members. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 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, 26, 27, 28, 29 and 30 The standard of the environment is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home was large, comfortable, safe, clean and well maintained. The home’s lounge and dining rooms were comfortably furnished and there were several rooms for service users. Decoration is ongoing and all the rooms were decorated to a good standard. The home is in a rural setting and two vehicles were provided to enable service users to access local amenities with staff support. It was evident that service users felt ‘at home’ in the environment and each service user had a single bedroom on the 1st floor, which were decorated individually and contained personal possessions. Service users confirmed that they were able to choose the furnishings and décor of their bedrooms. Three of the bedrooms were in the main house, they contained wash hand basins and one had an en suite bath and toilet. There were also two shower rooms with toilets so, effectively, each service user living in the main house had their own bathing facilities. The two bedrooms in the annex did not contain wash hand basins and the service users shared a bathroom, which also contained a free Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 15 standing shower unit, and toilet on the 1st floor, but there was a separate toilet on the ground floor. Discussion with a service user confirmed that this arrangement was satisfactory. Bedroom and bathroom/toilet doors were fitted with appropriate locks and service users were provided with lockable storage space in their bedrooms if required. The service users said that they participated in keeping the house clean and in the upkeep of the gardens, but confirmed this was their choice. Responsibilities for housekeeping tasks were written up in the service users’ personal programmes and they were able to explain what these were. The home had portable telephones for service users to have private conversations. Staff members confirmed that some of them have qualified as life-savers so that service users can use the swimming pool. The home had an office where staff could store belongings when on duty and where staff could sleep in at night if required. Kitchen and laundry facilities were satisfactory and service users were encouraged to do as much as possible for themselves. The home did not have a call alarm system or any specific aids and adaptations, apart from hand rails, as these were not required for the service users. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 16 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) 31, 33 and 35 Service users benefit from high staffing levels and a well supported and supervised staff team, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: Discussion with staff, as well as observation, confirmed that they were clear about their roles and responsibilities. Regular house meetings took place, which service users could also attend, and regular individual supervision sessions took place. The organisation had a training officer who maintained an overview of what the organisation required, as well as ensuring that individual staff members received the training they needed. Training records sent to the Commission for Social Care Inspection confirmed that staff were enrolled on various courses including National Vocational Qualifications and were expected to participate in training as required by the organisation, for which they were paid. Training included induction, emergency first aid, health and safety, food hygiene and adult protection as well as training specifically related to the service users, such as behavioural management courses and strategies for crisis intervention including defusion/distraction techniques as well as physical restraint. The organisation operated an ‘on call’ system whereby members of the management team were available both in and out of office hours and the staff team confirmed that this worked well. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 38 and 42 The management approach of the home is open and positive and provides clear leadership, with the management team believing in leading by example. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has been in post since the home opened in 2004 and was managing the home effectively. She was in the process of completing a level 4 National Vocational Qualification and the Registered Managers Award. Staff members confirmed that they were consulted with, and included in, decisions regarding the running of the home. One staff member also commented that the organisation’s management made him feel a valued member of the team. Lines of accountability were clear and the organisation had a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. Discussion with the Area Manager showed that the quality of care is constantly under review and any poor practice issues were addressed immediately. Monthly provider visit reports were being carried out and copies of the reports sent to the Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection. No health and safety issues were identified at this inspection. Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 19 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 3 3 x 4 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 4 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gatooma Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 4 x x x 3 x D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 20 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 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. 1. Refer to Standard Good Practice Recommendations Gatooma D54-D07 S62141 Gatooma V232171 201005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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