CARE HOME ADULTS 18-65
Glasshouse Project Wollaston Road Stourbridge West Midlands DY8 4HF Lead Inspector
Ms Linda Elsaleh Announced Inspection 27/09/05 17:00 Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Glasshouse Project Address Wollaston Road Stourbridge West Midlands DY8 4HF 01384 399400 01384399401 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) Ruskin Mill Educational Trust Bernard Feehan Care Home 44 Category(ies) of Learning disability (44), Mental disorder, registration, with number excluding learning disability or dementia (44) of places Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. Service users to include up to 44 LD and up to 44 MD, of which may include services users aged between 16 and 17 years. Registration is subject to the requirements as detailed in our letter of 17 March 2004 to Mr Gush, being met by the 17 June 2004. 2 service users to be accommodated at: 234 Chester Road North Kidderminster DY10 1TE 3 service users to be accommodated at: 64 Gauden Road Pedmore Stourbridge DY9 9HS 2 Service users to be accomodated at: 118 High Street Wollaston Stourbridge DY8 4NY 4 service users to be accommodated at: Old Mill Farm Bromsgrove Road Clent DY9 9QB 4 service users to be accommodated at: Vale Head Farm Kinver DY7 5NJ 3 service users to be accommodated at: Vale Head Flat Kinver DY7 5NJ 3 Service users to be accommodated at: 1 Coalbourn Lane Amblecote Stourbridge DY8 4HQ 2 Service Users to be accommodated at: Glasshouse Flat C/O The Glasshouse College Wollaston Road Amblecote Stourbridge DY8 4HF
DS0000060987.V251304.R01.S.doc Version 5.0 Page 5 4. 5. 6. 7. 8. 9. 10. Glasshouse Project 11. 12. 13. 14. 15. 16. 17. 5 Service Users to be accommodated at: Coach House C/O The Glasshouse College Wollaston Road Amblecote Stourbrdge DY8 4HG 2 service users to be accommodated at: 14 South Road Stourbridge DY8 3XZ 4 service users to be accommodated at: 4 Kenrose Mill, Kinver DY7 6LA 4 service users to be accommodated at: Woodfield New Wood Lane Blakedown Kidderminster 4 Service Users to be accommodated at: Harlestone House c/o The Glass House College Wollaston Road Amblecote Stourbridge West Mids DY8 4HF 2 Service Users to be accommodated at: 12 South Road Stourbridge DY8 3XZ The three bedrooms in the property known as 4 Kenrose Mill, which do not currently have washing facilities, are fitted with wash hand basins within 3 months of this registration. 15th March 2005 Date of last inspection: Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 6 Brief Description of the Service: The Glasshouse college is part of the Ruskin Mill Educational Trust. The college aims to meet the needs of young people between the ages of 18 and 25, whose needs cannot be met in mainstream colleges. There are opportunities for students to develop skills in various areas, including glass making, stone carving, green woodwork, basket weaving, photography, gardening and performing arts. The work undertaken at the college draws inspiration from Rudolf Steiner, John Ruskin and William Morris. All students are encouraged to discover their potential and creativity and to appreciate the cycles of nature. Students are accommodated in the community and on the fringes of the campus in houses that are run by care workers, who provide care and support to the young people placed with them. Students are encouraged to play a part in the running of the household, including cooking and domestic duties as part of their preparation for independence. The college, including the houses, is registered as a care home for younger adults. As part of the range of provision of accommodation, the college also has independent training flats, where students have greater opportunities to develop life skills. Some workers are close by to provide supervision and support to these students. These facilities do not form part of this registration and are therefore not subject to inspection. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 7 SUMMARY
This is an overview of what the inspector found during the inspection. This report is based on the findings of unannounced visits to three premises. The main focus of the inspection was to assess the company’s progress in meeting some of the outstanding requirements. The findings are based on discussions held with staff and young people, examination of relevant records/documentation and the inspectors’ observations. What the service does well: What has improved since the last inspection?
There is more stability within the staff teams and a reduction in the use of agency staff has been reported. Arrangements are made for staff to be available at the homes during college times whenever necessary. Regular meetings take place to enable staff from each of the homes to discuss common issues and areas of concern. There has been an increase in staff attending NVQ courses and inspectors were informed that adult and child protection training has been arranged. Suitable formats have been produced for identifying young people’s care needs and for recording information. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 8 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 9 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 Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 10 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. However, discussions held included references to Standard 1 & 4. Written information about the service, facilities and arrangements for prospective residential students are not easily available. EVIDENCE: A copy of the Statement of Purpose was not available at the homes. Young people stated they are provided with information about the college, but were unaware of a Service User Guide for the residential provision. Staff stated they receive little information about prospective residential students. A member of staff commented “I was surprised to find I had a student for assessment when I came on shift.” And a young person said “I feel uncomfortable having someone I don’t know in the house.” Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 11 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 & 10 Care plans and risk assessments are not sufficiently detailed to enable staff to meet the young person’s needs. There are no procedures for managing the residential assessment of prospective students. Suitable arrangements must be made to ensure all information is kept in a manner that maintains confidentiality and respects privacy. EVIDENCE: The inspectors intended to examine the records of six young people. However, staff on duty at one home did not have access to the records of two young people. The structure of the files, compilation of care plans and formats for recording information had been revised to enable information to be easily retrieved. There was no evidence of initial care plans being produced. The care plans that were available on the files were in various stages of completion. One young person’s partly completed care plan included his signature and that of the member of staff completing the plan of care with him. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 12 A partly completed risk assessment was available on one young person’s file. The care plan for another wrongly stated that a completed risk assessment was available on his file. There were no written risk assessments for the other young people. The inspectors observed staff and young people discussing meals and activities. Records provide little information about the consultation that takes place with young people in respect of the day-to-day running of the home. Staff stated they were familiar with the college’s policy on confidentiality and the young people’s records are appropriately stored. However, the facsimile machines, in two of the houses visited, are sited in a communal room. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 13 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Young people are encouraged to develop their social skills by participating in a wide range of activities in the community. Mealtimes are viewed as social occasions. Staff support young people in maintaining contact with their family and friends. EVIDENCE: All young people attend the college on a full time basis. Support is given to young people attending external work placements. There are opportunities for paid work to be undertaken at the college in the evenings and weekends. One young person stated he would be attending football training at the college one evening a week. The home supports young people to access facilities within the local community. Young people were observed preparing to go ten-pin bowling. Another young person stated he intended to join a local swimming class. Some of the homes do not provide televisions, preferring to encourage young people to participate in more active and educative pursuits. This issue has
Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 14 been discussed with the registered manager at previous inspections. There is no evidence of young people being informed of the particular arrangements for the home they will be living in. Most young people return to their family during college holidays. Young people felt they were well supported by staff in maintaining positive relationships with family and friends. Examples were given of staff attending meeting with young people where parents are present. At one home, staff and young people stated they were in the process of discussing ways in which they can development their independent living skills. It is understood that this process is to being carried out in each of the homes. The homes have an account with the college shop for purchasing natural and wholesome food. During weekdays, lunch is available in the college coffee shop. Although some young people stated they preferred to make their own arrangements. The college has a Healthy Eating Plan, with recipes and examples of menu planning, which is available in each of the homes. However, nutritional assessments and likes and dislikes are not recorded on most young people’s records. Three young people stated they enjoy doing the weekly shop with staff and one young person said he would like the opportunity to do this. Meal times are flexible, depending on young people’s plans. Emphasis is placed on mealtimes being a social occasion providing an opportunity to discuss the events of the day and plan activities and outings. Young people gave examples of meals they had prepared for themselves and for other people in the house. Staff confirmed that basic Food Hygiene training is provided. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 15 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 20 The college must ensure all information about young people’s health care and medication is recorded in their care plans. Staff must be suitably trained to ensure young people’s needs are being met. EVIDENCE: The standard of the quality, and quantity, of the information kept of young people’s healthcare varies. Of the four files examined only one file contained the majority to the following information; contact details of relevant healthcare professionals, reports of healthcare assessments, information of on-going health care needs, details of prescribed medication and outcome of appointments. Staff stated information on health care issues are available to young people from the college. Advice can be sought from the college nurse and support is provided to young people who wish to stop smoking. Staff stated arrangements are made for young people who are unwell to be cared for at the homes. The medication administration records kept for two young people are well maintained. There was confusion over the management of one young person’s medication. This demonstrated the importance of training staff in all aspects of the safe handling of medication, regular monitoring of practice and the importance of identifying how staff are to monitor young people who ‘self
Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 16 medicate’. This matter was brought to the attention of the responsible Neighbourhood Head at the time of the inspection. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 17 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. The inspectors were informed that adult and child protection training had been arranged for staff. EVIDENCE: N/A Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 18 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. Inspectors were informed locks were not fitted to all bedroom doors and not all young people had been provided with lockable facility. EVIDENCE: One young person said he had requested a lock for his bedroom door. Staff confirmed this request had been forwarded to their maintenance section, however, it would probably not be fitted until December. Another young person stated he did not have a lockable facility in his bedroom. There are no records of discussions taking place with regards to young people being issued with a key to the front door key, a key to their bedroom or being provided with a lockable facility. The inspectors have not been informed of any decisions being made for these facilities to be with held following the outcome of a risk assessment. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: N/A Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection. EVIDENCE: N/A Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 1 1 2 1 2 Standard No 24 25 26 27 28 29 30
STAFFING Score X X 2 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Glasshouse Project Score X 2 1 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000060987.V251304.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? YES 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 YA1 Regulation 4 Requirement The college must produce a Statement of Purpose that contains all the required information, including what it specifically sets out to do for young people under the age of 18. (Not assessed at this inspection) The college must provide each young person with a Service User Guide that contains all the required information and is in a format accessible to the young people. (Not assessed at this inspection) The college must devise a more structured and formal process for assessments in relation to residential provision. (Not assessed at this inspection) The college must review the information provided to representatives’ of prospective students to ensure it meets NMS
DS0000060987.V251304.R01.S.doc Timescale for action 31/12/04 2 YA1 4 31/07/05 3 YA2 15 31/12/04 4 YA5 15 31/07/05 Glasshouse Project Version 5.0 Page 23 5 YA6 15,17 6 YA6 15 7 YA6YA7YA8 15,16 8 YA9 15 9 YA9 13 10 YA14 16 11 12 YA17 YA19 16 12, 13 5.2. (Not assessed at this inspection) Completed Service User Plans must be produced for each young person based on their pre-assessed needs and be kept available in the home. The college must ensure outcomes of reviews are kept available on the young people’s files. (Previous date for action was 15th July 2005) The college must ensure that records are maintained of the consultation process with regards to: • Day to day living arrangements • Movement between houses • Involvement of young people in the development and review of the policies, procedures and services. (Previous date for action was 15th July 2005) Individual risk assessments must be completed on each young person and appropriate records kept. The college must ensure facsimile machines are appropriately sited to ensure that confidentiality is maintained. (Previous date for action was 31st November 2004) Young people and their representatives must be made aware of the college’s arrangements for televisions in its individual homes. Young people’s nutritional needs, likes and dislikes, must be recorded on their care plans. The college must ensure suitable arrangements are in place for
DS0000060987.V251304.R01.S.doc 25/01/06 25/01/06 25/01/06 25/01/06 25/01/06 25/01/06 25/01/06 25/01/06
Page 24 Glasshouse Project Version 5.0 13 YA20 13 ensuring health care information is recorded promptly on young people’s files and a policy/procedure is produced for caring for young people who are ill. (Previous date for action was 15th July 2004) Policies and procedures for the safe handling of medication must be reviewed to ensure it addresses all aspects of receiving, administering and storing medication. A process for regularly monitoring practice must also be developed. 25/01/06 14 YA20 13 15 YA22 22 16 YA23 13 Staff must receive appropriate training in the safe handling of medication. (Previous date for action was 15th July 2005) 25/01/06 Information about the handling of young people’s medication must be included in the care plan and, in the case of selfmedicating, in the risk assessment, and a copy of medical consent, where applicable, kept available on files. (Previous date for action was 15th July 2005) Detailed information, in suitable 31/12/04 formats, in relation to complaints must be made available to young people, their relatives and representatives. (Not assessed at this inspection) The college must ensure its 31/12/04 procedures for protecting adults and children comply with the LA procedures. All staff must receive adult and child protection training. (Not assessed at this inspection)
DS0000060987.V251304.R01.S.doc Version 5.0 Page 25 Glasshouse Project 17 YA23 13 18 YA24 23 19 YA26YA16 16 Policies & procedures in relation to counter bullying and absences without authority must be available. Staff must receive suitable training. (Not assessed at this inspection) An annual programme for maintenance and renewal of the fabric and decoration of the houses must be produced. (Not assessed at this inspection) Suitable locks must be fitted to bedroom doors and young people provided with the key for their room. (Unless a risk assessment has identified this is inappropriate) (Previous date for compliance 15th July 2005) Lockable facilities must be provided in young people’s bedrooms and the key provided. (Unless a risk assessment has identified this is inappropriate) All toilets and bathrooms must be fitted with suitable indicator locks. (Not assessed at this inspection) A review must be undertaken of recruitment and supervision of volunteers and their roles must be clearly defined. This information must be provided to all staff. (Not assessed at this inspection) A training programme that meets with the Sector Skills Council for Social Care must continue to be developed. (Not assessed at this inspection) A review must be carried out of staffing levels to ensure they
DS0000060987.V251304.R01.S.doc 01/07/05 15/07/05 25/01/06 20 YA27 23, 12 30/11/05 21 YA31 18 31/12/04 22 YA32 18 31/12/04 23 YA33 18 30/09/04 Glasshouse Project Version 5.0 Page 26 24 YA34 18 25 YA36 18 26 YA39 24, 26 meet the requirements of the placing authority. (Not assessed at this inspection) The selection procedure for staff must be reviewed to ensure all elements of this standard are met. (Not assessed at this inspection) Staff must receive at least six planned and recorded supervision sessions each year and an annual appraisal. (Not assessed at this inspection) A system for quality assurance & monitoring must be produced. Arrangements must be made to carry out visits to the homes, in accordance with Regulation 26Visits by Registered Providerreports prepared and copies forwarded to CSCI. (Not assessed at this inspection) Policies & procedures, listed in Appendix 3 of NMS and any relevant policies & procedures for young people under the age of 18, must be available in the homes. (Not assessed at this inspection) 31/12/04 31/12/04 31/12/04 27 YA40 18 30/06/05 Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 27 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 YA8 Good Practice Recommendations Young people should be consulted with regard to prospective students being accommodated in the same house as them and due consideration given to their views and feelings. Glasshouse Project DS0000060987.V251304.R01.S.doc Version 5.0 Page 28 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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