Inspection on 07/02/07 for Gatooma

This inspection was carried out on 7th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 20/10/05

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 Anita Sutcliffe Unannounced Inspection 7th February 2007 10:00 Gatooma DS0000062141.V323648.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 Gatooma DS0000062141.V323648.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. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gatooma Address Brandis Corner Holsworthy Devon EX22 7YD 01409 281778 01409 281764 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) Atlas Project Team Limited Miss Natasha Stapleton Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Category of Learning Disability (LD) Age range 18 - 65 Date of last inspection 20th October 2005 Brief Description of the Service: Gatooma is a care home providing personal care and accommodation for up to 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 homes 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. Current fees range from: £2,134 - £2,782 Additional charges are made for hairdressing, toiletries and some activities, such as the cinema. The most recent inspection report is available on request. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information toward this key inspection has been gathered since April 2006. The home provided current information about its service. Each staff member had the opportunity to complete an anonymous survey and comment about the home. Two health and social care professionals, associated with the home, also provided information. The visit to the home was unannounced and most service users met. There are currently four resident at the home. Staff were spoken with. Most of the premises were visited, records examined and staff observed in the course of their work. The deputy manager, a recently recruited support worker and representatives from the organisation were present. The registered manager provided additional information following the home visit. What the service does well: Gatooma is a safe place to live. Staff know what they are doing. They will listen to residents and help them learn, have a good life and fun. Management and staff take every opportunity to support service users toward a fulfilled and meaningful life. They have knowledge, skills and expertise in their work. The environment is of a high standard. Food provision is good. Risk is well managed and the safety and well being of service users is a high priority of the organisation. What has improved since the last inspection? What they could do better: No requirements or recommendations have been made. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Gatooma DS0000062141.V323648.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 Gatooma DS0000062141.V323648.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 excellent. This judgement has been made using available evidence including a visit to this service. The needs of service users are the priority of the home and organisation. EVIDENCE: The home currently chooses to provide residence for four service users and not the five for which it is registered. The most recently admitted service user came to the home early 2006. His assessment was detailed and his admission well managed. He has settled well into the home, being supported to develop as a person. A senior member of the management team would assess any new admission and each current service user has their needs regularly and fully reviewed. Gatooma DS0000062141.V323648.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 excellent. This judgement has been made using available evidence including a visit to this service. Service users are listened to, their needs understood, challenges well managed and they are supported to meet their potential. EVIDENCE: One service user showed his room and talked about being at Gatooma. Two were briefly met in the kitchen and lounge. One remained in her room choosing not to be involved in the inspection. A particularly challenging aspect of one service user’s life was discussed with the deputy manager; records concerning that behaviour were seen. They outlined how much is involved in helping a service user when a difficult situation adversely affects their happiness and well being. Strategic planning leads to a structured approach, in full consultation with the service user. A staff member said: “We don’t mollycoddle. We don’t teach bad habits. We give them (service users) pride and confidence in themselves”. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 10 A social worker confirmed that they are always informed or involved in situations that arise, adding: “Staff at Gatooma cope with a very difficult situation very well indeed”. A community nurse also confirmed that they have “an excellent standard of support and are always very forthcoming with any information that I need”. Staff understand how to reduce behaviour that adversely affects a service user’s life, enhance positive behaviours that enrich their lives and teach new skills. Discussion with one service user confirmed their involvement in how this is achieved. Gatooma DS0000062141.V323648.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 excellent. This judgement has been made using available evidence including a visit to this service. Residents have the opportunity to benefit from a quality lifestyle, being supported to reach their full potential. EVIDENCE: Although the home is rural there are frequent trips to the city and local towns. Where a service user prefers individually tailored activities this is arranged, one having visited a ‘posh hotel for pampering’. Social events are shared with another Atlas home in the vicinity and all Devon Atlas homes share the swimming pool at Gatooma. Service users also have a holiday each year. In 2006 these included trips to Cornwall. Hobbies and interests are very well promoted. Skills are developed. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 12 The home goes to great lengths to help maintain positive family connections for service users. In addition they help with their transport. A service user said how much he likes the food at the home. They are able to influence the menu, which was varied and well balanced. They take turns choosing, buying and preparing food in the well equipped and pleasant kitchen. They also enjoy a regular ‘take away’. Gatooma DS0000062141.V323648.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. Personal and health care needs are understood and met. Medication is handled diligently, with strict controls in place to ensure service user well being. EVIDENCE: Service users rely completely on staff support to ensure their health care needs are met. They are supported to make choices. Emotional health needs are well managed through detailed care planning and support management. Physical health care needs are well met. Staff say that no service user has the ability to safely handle their medicines, so this is done for them. Medicines are securely stored; records clearly kept. Staff work within the organisation’s very strict guidelines and practice when handling medicines. In line with other Atlas homes in Devon, because of ‘previous errors by some dispensing chemists’, the organisation chooses a ‘third person’ (senior staff Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 14 member) to dispense medicines from their original containers into the home’s own. They feel this is safer, will reduce the likelihood of mistakes and is in the best interest of service users. They report that there has never been a medication error within Atlas homes. This practice does, however, add extra risk factors and should be reconsidered. Gatooma DS0000062141.V323648.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. Residents can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through strong leadership and the culture of the organisation. EVIDENCE: Service users would be unlikely to use a formal complaints procedure but staff have the skills to communicate well with service users. There is regular opportunity for discussion, one to one or within a ‘house meeting’. The home report no complaints made within the last year. The Commission have received no complaints about the home. A social worker report that staff at Gatooma handle complaints well. There is strong management within the organisation with a passion for the protection of service users. Prevention of abuse is a standard part of staff training. The registered manager described correctly how she should respond if staff raised a concern. A support worker was fully aware of her responsibilities and what measures she should take. The home has effective policies and procedures in complaints and the prevention of abuse. Gatooma DS0000062141.V323648.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home, which is clean, well furnished, warm, safe, comfortable and meets their individual needs. EVIDENCE: All communal areas and one service user bedroom was visited. The home was warm and comfortable throughout. The furnishings and décor are modern and in a good state of repair. A service user said she liked her bedroom very much and had chosen the bedding and colour scheme herself. She was later seen using the laundry room. The laundry facility is adequate to meet the needs of current service users. Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 17 The outside of the home is varied. It includes a patio barbeque area. There is an outbuilding containing a heated swimming pool used by Gatooma and other Atlas homes. The home is well maintained and in a good state of repair. Gatooma DS0000062141.V323648.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): 31, 32, 33, 34, 35 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice. EVIDENCE: Service users benefit from a staff which is well trained and work to a high standard. When discussing staff support a recently employed staff member said: “We get a lot of support. They’re (the management) available all the time”. She confirmed that there were always sufficient staff on duty to provide whatever care was necessary. A community nurse also commented on the “excellent standard of support” staff are able to give service users. A staff member described her recent recruitment and showed her induction records. She did not work unsupervised until it was assured she was safe to work with vulnerable adults, and had sufficient skills to work safely and effectively. The registered provider ensures staff are in no doubt as to what is Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 19 expected of them. A staff member said: “They keep a very close watch on you and feed back to you how you are dong”. Staff training provides them with the knowledge necessary to deliver a high standard of care to the service users, and it helps keep staff safe. It includes fire safety, food hygiene, behaviour management and prevention of abuse. Training is of good quality. Gatooma DS0000062141.V323648.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, 38, 39, 40 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, run in the bet interest of residents, and their health and safety are properly attended to. Providing quality care is the focus of the organisation. EVIDENCE: Service users can have confidence in the way the home is managed. Gatooma has an experienced manager and there is an effective management structure within the organisation. Service user welfare is the prime concern of the organisation and there is very strong leadership and support for staff. Staff are clear what is expected of them. When asked what the home does best one member of staff said: “It is refreshing to work for a company that is Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 21 ultra professional and so well organised”. Another said: “Atlas are completely different. They are very prepared to listen to other people’s views and don’t mind being challenged. It’s very much an open discussion”. The health, safety and welfare of service users are met through effective care planning and support, competent staff, good management and administration and investment in the building. Gatooma DS0000062141.V323648.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 4 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 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 4 32 4 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 4 X 3 X Gatooma DS0000062141.V323648.R01.S.doc Version 5.2 Page 23 N/A 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 Gatooma DS0000062141.V323648.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. 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