Inspection on 05/04/05 for Gatooma

This inspection was carried out on 5th April 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 20/10/05

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 Announced 05/04/05 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 V210931 050405 Stage 4.doc Version 1.20 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 V210931 050405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Category of Learning Disability (LD) Age range 18 - 65 Date of last inspection Not Applicable 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 V210931 050405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this home and took place between 10am and 5pm. The Registered Manager, Tash Stapleton, was not available due to personal reasons, but the Area Manager, Tim Stevens, was present, as well as Mandy Smale, Training Officer and Jackie Mitchell, Deputy Manager, who are sharing the management responsibilities in the absence of Ms Stapleton. A tour of the premises took place and some of the care, staff and home’s records were inspected. The four service users (the home had one vacancy at the time of inspection) as well as two of the four staff on duty, were spoken to during the day. What the service does well: What has improved since the last inspection? This was the first inspection of this home since it was registered in 2004. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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 V210931 050405 Stage 4.doc Version 1.20 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) 2, 3, 4 and 5 Whilst individual service users may not always have a choice of where they live (due to the nature of their needs), the management team makes every effort to ensure that they only admit people whose needs they can meet, and who are compatible with existing service users. Where possible, prospective service users are given opportunities to visit the home to decide whether they would like to live there and to meet the other service users and staff. EVIDENCE: The organisation has 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 is documented. Individual records are kept for each of the service users and these contained detailed assessments, care plans and risk assessments. Information in the home’s visitors book confirmed that a prospective service user has been visiting the home regularly. Contracts with purchasing authorities are kept in the organisation’s head office, but statements of terms and conditions are available for each service user. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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) 6, 7, 8, and 9 The service users were enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Service users’ plans were detailed and staff were fully aware of the needs of each person. Any restrictions on choice or freedom were documented and had been agreed with the service user and other people involved in the person’s care. Service users were able to describe how their individual programmes worked and explain why these 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. Records relating to service users’ money were up to date and accurate. From these it was evident that service users only had to buy personal items and toiletries, as well a contribution to the occasional takeaway meal. Other costs, such as transport, were met by the organisation. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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: Information in care plans, as well as talking with service users, 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. 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 ‘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. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 11 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 V210931 050405 Stage 4.doc Version 1.20 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, and 20 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: Service user plans provided detailed information about personal and health care needs. Through observation it was clear that timings were flexible and the choice of the service user. Individual risk assessments had been carried out regarding whether or not service users were able to keep their own medication, the result being that no-one self administered medication. The organisation has its own system for the administration of medication which they have tried and tested over many years, and believe that it is the most appropriate system for them. The records of this were clear, well kept and accurate. Medication prescribed to be taken ‘as required’ was only administered by staff following consultation with a senior manager. Where an invasive procedure was required, such as the administration of rectal diazepam, designated members of the staff team had received training from the District Nurse. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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. Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since it opened in 2004. Service users can be confident that complaints will always be dealt with seriously and any concerns from service users will be listened to and acted upon immediately. EVIDENCE: The home has 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. A discussion took place about the wording of the home’s adult protection procedure as it is a little ambiguous in places and may need to be clearer. Each service user has their own building society account in the local town, which they are enabled to access with staff support. Because of the complexity of the benefits system, the organisation has appointed one of the management team to act as the Appointee for state benefits for those service users who cannot manage their own money, and where there is no-one else available, such as family members, who can take on this role. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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 home is large, comfortable, safe and clean. Service users were ‘at home’ in the environment and clearly felt they belonged. Service users benefit from lots of space and a variety of rooms for different activities. The garden and grounds are extensive, well kept, and accessible to the service users. EVIDENCE: Each service user has a single bedroom on the 1st floor. Three of these are in the main house, all of which have wash hand basins and one of which has an en suite bath and toilet. There are also two shower rooms with toilets so, effectively, each service user living in the main house has their own bathing facilities. The two bedrooms in the annex do not contain wash hand basins and the service users share a bathroom and toilet on the 1st floor, but there is a separate toilet on the ground floor. Bedroom and bathroom/toilet doors were all 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 has portable telephones for service users to have private conversations and an adapted Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 15 ‘phone is being provided. Service users also had certain jobs outside the house, such as feeding the hens and collecting eggs. The home also had cats, which they had inherited with the property. Staff members were in the process of obtaining life saving certificates because these are necessary before the swimming pool can be used. Once enough staff are properly qualified, risk assessments will be carried out with service users prior to using the pool. Service users commented that they liked the quiet of living in the countryside. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 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, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: Staff files inspected showed that the organisation has a robust recruitment procedure and all the required information was available. Criminal Record Bureau checks had been carried out but were kept in the organisation’s head office, however the Area Manager confirmed they will be available at the next inspection. Staff confirmed that regular group meetings took place, which service users could also attend, and regular individual supervision sessions took place and were documented. The organisation has a training officer who maintains an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. Staff confirmed that they 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. Staffing rotas were available in the home showing that there were usually three or four staff on duty during the day and evening, reducing to two between 9pm and 10.30pm. At the time of inspection there was one waking staff member on duty at night but, if an Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 17 additional sleeping in staff member was required, a bed was available in the office. Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 18 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) 38, 39, 40, 41, 42 and 43 The management approach of the home is open and positive and provides clear leadership, with the management team believing in leading by example. Providing quality care is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: Despite the Registered Manager being absent, the home was still being managed effectively. This is because the organisation has a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. The organisation has introduced a ‘trainee management’ scheme over the last two years and this has worked well. The Registered Manager was in the process of completing NVQ 4 in Care and the Registered Managers Award. The members of management and staff who were spoken with confirmed that they are consulted with and included in any decisions regarding the running of the home. All documentation relating to service users was detailed, up to date and accurate. Records relating to Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 19 health and safety issues, such as risk assessments, the accident book, fire log book, insurance certificate, gas safety and electrical appliance tests were available and up to date. The use of hot water has been risk assessed and thermostatic valves to control the temperature have been fitted where required. The organisation has devised a quality assurance system which will be implemented in due course. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 Gatooma Score 3 3 3 Standard No 24 25 26 27 28 29 30 Score 4 3 3 3 4 3 3 Version 1.20 Page 20 D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc 9 10 LIFESTYLES 3 x Score STAFFING 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 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 4 3 3 3 3 3 Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 21 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 None 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 None Good Practice Recommendations Gatooma D54-D07 S62141 Gatooma V210931 050405 Stage 4.doc Version 1.20 Page 22 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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