Inspection on 20/02/07 for Gloscare

This inspection was carried out on 20th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gloscare 08/12/08

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Gloscare 23 Carmarthen Street Tredworth Gloucester GL1 4SX Lead Inspector Mr Paul Chapman Key Unannounced Inspection 20th February 2007 14:00 Gloscare DS0000068238.V326099.R02.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 Gloscare DS0000068238.V326099.R02.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. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gloscare Address 23 Carmarthen Street Tredworth Gloucester GL1 4SX 01452 522335 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) Mr Jonathan Peter Basil Trevarthen Mrs Zoe Ann Lancelott Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Not applicable Date of last inspection First inspection. Brief Description of the Service: The property is a two story terraced house with accommodation for up to two adults with learning disabilities. The home is conveniently situated in Gloucester, which enables access local community facilities. Transport is provided by the home and in addition the local bus service is easily accessible. The home is staffed 24 hours a day, seven days a week. Family and friends are welcome to visit the home at any time. At the time of this inspection one resident was living at the home. They were attending various activities with staff support at all times. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was completed over a period of 3.5 hours from 2 o’clock on a day in February 2007. This was an announced inspection with the registered manager being given 1 weeks notice. The registered manager was present throughout the site visit. The inspector spent some time with the service user taking the opportunity to ask them about living at the home, and observing their interactions with the staff. A tour of the premises was completed with the service user and the registered manager. All of the documentation relating to the service user’s care was examined as well as a number of other documents required to be maintained by these regulations. The home has a Service User’s Guide and a Statement of Purpose. Fees for living at the home range from £1600.00 to £2500.00 What the service does well: What has improved since the last inspection? Not applicable – first inspection. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Gloscare DS0000068238.V326099.R02.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 Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The person living in the home had been thoroughly assessed before they moved in and this minimises the potential risk of the service not being able to meet their needs. EVIDENCE: At the time of this site visit one person was living at the home. Their personal file provided extensive evidence of a thorough assessment before they moved into the home. Reports by the previous carers were present and the manager and staff spoke about going to the person’s previous placement and spending time with them. Gloscare DS0000068238.V326099.R02.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, 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are developed to meet the service user’s needs but these should be developed to ensure they are person centred. Where restrictions are placed on the service user’s freedom there are no guidelines or rationale to support the practice. A number of activities that the service user takes part in have not been risk assessed and this may put them at unnecessary risks. EVIDENCE: Examination of the person’s care file showed that the staff had developed care plans to meet the person’s assessed needs. Care plans present included: • • Gloscare Maintaining a safe environment Behaviour DS0000068238.V326099.R02.S.doc Version 5.2 Page 10 • • • • • • • • • Health and Medication Communication Eating and Drinking Family contact Personal hygiene Oral hygiene Activities Continence Epilepsy Each plan identifies what the aim of the care plan was, what the person’s assets/problems and needs were, and what staff intervention was required. All of the care plans provided a good level of detail as to the service users needs. The manager stated that they intended to make the care plans more person centred. At present care plans do not provide evidence that the service user was involved in the process. It becomes a recommendation that all of the care plans are reviewed with the service user and the format is made more user-friendly using methods that allow the service user to understand the care plans. The manager stated that they intend to start completing monthly summaries of the service users progress towards meeting their goals. It is recommended that the manager use the different elements of the care planning package as titles to be reviewed. Speaking with the manager they explained that when the service user is downstairs alone the kitchen door is locked. They explained that this is to minimise the risk of the service user being injured in the kitchen. The inspector understands that this restriction may be necessary but the manager must write guidelines with a rationale for these actions as they are restricting the service user’s freedom. It is required that the manager also reviews other areas of the service user’s life and where restrictions are in place that guidelines and a rationale are written to support the practice. The manager had completed a number of risk assessments for the service user. Although a number of risk assessments were present the manager must ensure that risk assessments are completed for the activities that the service user is involved in. Examples of these would be when the service user is supported by staff in the community and when they are swimming. Gloscare DS0000068238.V326099.R02.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): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service user leads an active lifestyle that is led by their needs and staff support them to do this safely. The menus seen provided evidence of a good selection of meals being provided that were chosen by the service user. EVIDENCE: Speaking with staff and the service user they gave examples of the activities they currently complete. Staff support the service user to complete all activities with staffing being at least 1 to 1 and 2 to 1 on some occasions. Activities being completed regularly at the moment include playing snooker at a local club, swimming, ten-pin bowling and darts. In addition to this they go shopping in Gloucester, walking in a local park, attend social clubs and go on various trips to attractions in the local area. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 12 The service user sees their family regularly and staff support them to make phone calls and send cards, etc as required. The CSCI received a completed survey from the service user’s parents which was very positive about the service being provided. The manager explained they sit with the service user and discuss what food/meals they would like. At present the menu runs over a 4-week period, the manager said that this is under constant review. A copy of the current menu showed that some alterations had been made. The menu is produced in written format and the manager stated that there was no need to produce in an alternative format as the service user can read it. The menu provided showed a good selection of meals were prepared. The inspector asked whether a 4-week rota was necessary and whether meals could be chosen on a day-to-day basis. The manager stated that due to the needs of the service user the current method used allowed the service user to know in advance what they were eating and helped to maintain a low anxiety level. The manager stated that at present the service user does not have any cultural needs with their diet. It should be recorded in the service user’s care plan entitled “eating and drinking” that this has been assessed; this should be kept under review. Gloscare DS0000068238.V326099.R02.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, 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The service user’s personal care needs are addressed appropriately in line with their needs assessments. Health needs are addressed by the appropriate professionals which minimises the risk of the service user’s health needs increasing. Medication is being re-dispensed by the staff team and this increases the potential risk to the service user. EVIDENCE: Assessments and care plans in the service user’s file showed that they only require promotes by the staff to complete their personal care. The manager stated they are going to implement a health assessment for the service user that will identify important information for other professionals to be aware of when they are meeting the service users needs. The service user’s Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 14 file showed involvement of other care and health professionals. The service user is registered with a local GP. When examining the activities completed by the service user it showed that they regularly attend music therapy. Examination of the medication administration showed that records were accurate and no errors were seen. The manager and staff have been preparing the service user’s medication into another container (from that of the original packaging). The manager spoke to the inspector about this practice explaining that this allowed it to be checked by more than one person and therefore minimised the risk of medication errors. The inspector appreciated this but the safe handling of medication guidelines classify this as “re-dispensing” and the manager was told that this practice must cease. This becomes a requirement of this report. Whilst examining the service user’s file it was identified that the manager must address the service users needs to meet the criteria of standard 21. This standard states that service users wishes concerning illness, ageing and death are recorded. This becomes a requirement of this inspection report. Gloscare DS0000068238.V326099.R02.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. The home has a complaints procedure that enables the service user to make a complaint if they are unhappy. Staff need to complete training in the protection of vulnerable adults to minimise the potential risks to the service user. EVIDENCE: The home has a complaints procedure. All staff are asked to read the procedure and sign to confirm that they understand it. The complaints procedure is part of the Service User’s Guide and the inspector recommends that the procedure is produced as a separate document. When speaking with the manager the inspector suggested that the complaints procedure should be developed to meet the individual needs of the 2 service users for which the service will be provided. The home has a whistle-blowing procedure and all staff had signed agreeing that they had read and understood it. The staff team have not completed protection of vulnerable adults training as yet and this becomes a requirement of this inspection report. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 16 As appointees the service user’s parents manage their finances. The manager explained that the service user is then sent an allowance each month. Records maintained by the staff evidence all transactions with a description of the spending supported by a receipt. All finances are checked at each handover between shifts and the manager monitors spending each week. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is decorated to a high standard and the current facilities provided meet the needs of the service user living there. EVIDENCE: As part of the site visit a tour of the building was completed with the manager. On the ground floor there is a good-sized lounge, dining room and kitchen. The rear garden can be accessed through the kitchen. Upstairs are two bedrooms and the bathroom. All areas of the home were well maintained and decorated to a high standard. Personal touches by the staff and service user have given the home a “homely” feel. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 18 The bedroom of the service user currently living at the home was personalised with their possessions, at the time of this inspection they decided that they would like to put lots of their photos on the walls. The home was clean, hygienic and there were no offensive odours. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The service user is protected by the home’s recruitment process but shortfalls identified mean this is may be putting the service user at unnecessary risk. Training records are poor and this makes it impossible to confirm that staff have received training to meet the needs of the service user EVIDENCE: The recruitment records for staff employed since the home opened were examined. The majority of the files contained all of the information required by these regulations, but some files did not contain proof of the person’s address. The manager must ensure that all staff files have this information and this becomes a requirement of this inspection report. Staff files contained copies of the staff’s previous training but there were no records of training since the home opened last year. The manager stated that some training had been completed in the previous month, this included: Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 20 • • • Health and safety (3 staff) First aid (2 staff) Food hygiene (2 staff) One staff member is completing their NVQ level 2 in care at present. The manager stated that all of the staff will receive training in the mandatory topics i.e. food hygiene, health and safety, protection of vulnerable adults. It is impossible to confirm that the staff had received the appropriate training to meet the needs of the service user. The manager must ensure that records of staff training are accurate and supported with certificates that the course has been completed. This becomes a requirement of this inspection report. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 40, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The staff’s monitoring of health and safety around the home minimise the risk to the service user. Quality assurance must be addressed ensuring that service users views are central to the development of the service. Good health and safety practices minimise potential risks to the service user. EVIDENCE: The manager has completed her Registered Managers Award and the CSCI’s registration process. The manager has experience of working with this client Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 22 group having previously managed another home for adults with learning disabilities in Gloucestershire. Completed surveys from staff made comments like “the home is well run” and “I wouldn’t change anything”. Quality assurance systems must be developed that enable the service user/s to be able to give their opinion and be part of the services development. This becomes a requirement of this inspection report. A good practice identified as part of this visit was the manager asking staff to sign confirming they have read a document and understood it. The CSCI have received regulation 26 forms completed by the provider for the months January and February 2007. Policies and procedures required by these regulations are in place, but examination of them showed that some need to be made specific to Carmarthen St. The manager stated that these documents are under review at present and will be made specific to the home. This becomes a requirement of this inspection report. Health and safety is maintained by the manager and her team, the following documents were seen to support safe practices: • • • • • • • Information about fire safety was available for staff to refer to. C.O.S.H.H. information/data sheets were available. Information about good food hygiene practices. Gas safety certificate Fridge and freezer temperatures were recorded twice daily. Hot water outlet temperatures were monitored and recorded. A food probe was used to record the temperature of cooked meat. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 3 3 X 2 2 X 3 X Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? N/a 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 YA7 Regulation 17 (1)a schedule 3 (3)q 13(4) Requirement Timescale for action 13/04/07 2. YA9 3. 4. YA20 YA23 13(2) 13(6) 5. YA32 18(c) 6. YA34 7, 9, 19 schedule 2 7, 9, 19 schedule 2 24 7. YA35 8. Gloscare YA39 The registered manager must ensure that they provide a rationale and guidelines for staff of any restriction placed on the service user. The registered manager must 13/04/07 ensure that comprehensive risk assessments are to support the activities undertaken with the service user. The registered manager must 06/04/07 ensure that medication is not “re-dispensed”. The registered manager must 01/06/07 ensure that all staff complete protection of vulnerable adults training. The registered manager must 01/06/07 ensure that all staff receive training to meet the needs of the service user/s. The registered manager must 04/05/07 ensure that all the documents required by these regulations are present at future inspections. The registered manager must 04/05/07 ensure that training records for all of the staff are present at future inspections. The registered manager must 01/06/07 DS0000068238.V326099.R02.S.doc Version 5.2 Page 25 ensure that the home’s quality assurance system puts the service user/s views as central to the development of the service. 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. 2. 3. 4. 5. 6. 7. Refer to Standard YA6 YA6 YA17 YA18 YA21 YA22 YA40 Good Practice Recommendations The registered manager should ensure that the service user’s care plans are person centred. The registered manager should use the titles of the care plans to complete their regular reviews of the service user’s needs. The manager should assess and record the service user’s cultural needs. The registered manager should implement health action plans. The registered manager should develop a care plan that identifies the service user’s wishes relating to illness and ageing. The registered manager should develop a more user friendly complaints procedure to meet the needs of the service user. The manager should review the home’s policies to ensure that they are specific to Carmarthen Street. Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gloscare DS0000068238.V326099.R02.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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