Inspection on 08/12/08 for Gloscare

This inspection was carried out on 8th December 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gloscare 20/02/07

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 13/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gloscare 23 Carmarthen Street Tredworth Gloucester GL1 4SX     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tim Cotterell     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Gloscare 23 Carmarthen Street Tredworth Gloucester GL1 4SX 01452522335 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Jonathan Peter Basil Trevarthen Name of registered manager (if applicable) Mrs Zoe Ann Lancelott Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: There will be an additional toilet on the ground floor in accordance with section 13 (5)(b) ogf the Care Standards Act 2000 and Regulation 23 (2)(j) of the Care Homes for Younger Adults. Date of last inspection Brief description of the care home 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 to the 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. 2 Over 65 0 care home 2 Care Homes for Adults (18-65 years) Page 4 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. One inspector undertook the inspection over two visits. The first visit for a whole day the second visit for half a day. During the inspection the registered manager,staff on duty and both residnets were seen. We looked at the accommodation, some care plans and the records for the management of medication. We also saw details of the last staff appointment and two records of the personal allowances, which were being held and managed by the home. Care Homes for Adults (18-65 years) Page 5 of 26 All of the records were complete. We found the atmosphere in the home relaxed with each resident having some arrangements for various activities for that day. During the morning there were two care staff to include the Registered Manager, during the afternoon there were three. The staff had a good knowledge of the needs of the residents together with a good relationship, which was clearly evident during the many exchanges seen during our visits. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. When the Service users guide is updated the home will be able to provide adequate information for prospective residents. The individual needs are clearly identified before admission and this should enable the home to ensure they are met. Evidence: The home has a Statement of Purpose, Aims and Objectives and Service User Guide. These are given to prospective residents and relatives/advocates/social workers before admission. As the Aims and Objectives are seen as Part of the overall statement of the home about what they do, it is recommended that they form part of the Statement of Purpose. The information for the residents is in two formats to include pictorial and this helps the residents who may need some help with the normal form. The Service User Guide does not contain all of the information required (see Regulation 5 (1)) and this Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: includes the need to include the telephone number and address of the Commission. The home takes considerable time over new placements and assessments are undertaken by the provider and registered manager. Specialist services are used and it is anticipated that the local Community Learning Disability team will offer support on both residents soon due to a transfer of responsibilities from Swindon to Gloucester. There are no short-term placements. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The individual plans of care which identifies specific goals should result in measurable achievement for the residents. Evidence: Residents have individual plans of care and they are with other carers and relatives able to contribute to specific objectives and outcomes in the plan. The plans are reviewed every six months or more frequently if needed. The plans are based on activities of daily living model and were relevant and comprehensive. Where there was an additional plan through the Partnership Trust (NHS) this was available and the manager had ensured that any action was implemented. It was recommended that individual procedures for dealing with challenging behaviours was included in the plan of care and a strategy for expected and Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: unexpected events be included. Residents are able to make decisions and exercise choice over how they spend their day. We saw an example of this when one resident had changed his mind about an activity and wanted to stay in the home. This was agreed without formality by the staff on duty. Responsible risk talking is encouraged and the home has risk assessment and risk management strategies. At the time of the inspection residents were supervised when out of the home and the issue of the level of supervision is reviewed at regular intervals. During the supervised trips out residents are given personal safety training in an attempt to increase the level of independence. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides appropriate stimulation and encourages links with family and friends and the local community. The rights of the residents are respected. Evidence: The home has made great efforts to secure supported employment however Gloucestershire Industrial Services indicated that there were few opportunities at the moment. One resident has a part time job volunteering at a local charity shop and attends a local day club where he is making jewellty items. It was evident that he enjoyed the activities and showed us an example of his work. The manager has also enquired about college places and hopes to find placements in the near future. The home is in the centre of a community in the centre of Gloucester and staff and residents are encouraged to use the community facilities wherever possible. Residents Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: and staff use the locals shops and told us they had a good relationships with their neighbours. Both residents have maintained contact with families and the staff provide support and guidance and where needed practical assistance to maintain the links residents want. Visitors are welcome in the home at any time. The rights of the residents were seen to be respected and the daily routines are flexible to reduce any restrictions and based on what is best for the individual residents. During the inspection a meal was prepared and considerable time was given to this process. Whilst healthy eating is a priority the home attempts to balance this with choice to ensure that residents enjoy the meals. The manager has discussed the menus with a dietician. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health care needs are identified and they are able to have access to all of the community services. Staff are always available to offer any support needed. Evidence: The support given to residents by staff was seen by us as dignified and privacy was offered when appropriate. Life styles were flexible and reflecting the wishes of the individual. Specialist advice from health care professionals had been obtained and the records provided evidence of this. The records showed us that health care needs were being addressed and that residents were able to access all community health care provision. There was a record of any treatments/advice and the staff were proactive in dealing with health issues. An important factor was that support was always available from staff when health care treatment was needed. We saw staff explain forthcoming treatment in a sensitive and calm manner. Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: There is a record of the receipt, administration and disposal of medicines and the records of this were inspected. At the time of the inspection all medication was managed by the staff. Any adminsiatrion of non prescribed medication could only be done after consultation with the manager of the home. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home, which protects them from abuse and is an open environment where they are encouraged to comment. Evidence: The home has a complaints procedure and this is written in two formats to enable the residents to have a greater understanding. Both residents have a social worker from the their county/unitary authority and also families they are in contact with. Whilst the home appreciates the requirement for a complaints procedure they believe that their relationship together with the involvement of the resident in running the home would reduce the needs for any formal compamts. We witnessed a number of discussions between staff and residents and it was clear that this consultation led to agreement about the matter. Staff were seen to respond quickly to any issue raised and one of the residents felt that this informal way of a resolution to problems was swift and satisfactory. The question of the suitability of independent advocacy was discussed with the manager. The records of the personal monies held on behalf of residents was inspected. There was a record of the receipt and expenditure together with receipts. Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: All staff have been trained in the identification of abuse and had a good understanding of the various aspects and causes. Verbal and physical aggression by residents was understood by staff and is being dealt with appropriately. Any physical intervention would be as the last resort and again staff training has been provided. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean, pleasant and comfortable physical environment Evidence: We saw all of the accommodation in the company of the Registered Manager. The home has been well maintained, is in good decorative order with appropriate domestic furniture. On the ground floor there is a dining room, lounge, kitchen and toilet. The manager is hoping to have a wooden floor fitted in the communal area and the proprietor is considering this. On the first floor residents have single bedrooms and are able to lock their doors if they wish. There is a bath/shower and toilet on this level. The bedrooms had been personalised and reflected the interest of the individual resident. There is a small garden at the back of the property and this has been developed and now provides a pleasant and level area for residents to enjoy. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staff are competent and caring and provide a safe and stimulating environment for the residents. Evidence: The home has a registered manager and a number of full and part time care staff. At the time of their inspection two carers were on maternity leave and their hours were being covered by other staff and if necessary staff from the homes bank. The registered manager told us that they will be advertising for further bank staff to cover any shortfalls. Three members of the care team were seen by us individuality and it was evident that they are competent and keen to provide a flexible service that met the needs of the individual residents. During the inspection we saw many interactions between residents and staff and it was clear that staff had a good understanding of the complex needs and were seen to provide a service which ensured residents were provided with dignity and privacy. They responded to residents without delay in a calm and pleasant manner and were seen to be approachable and prepared to take time to listen. Two of the three care staff had completed NVQ level 2 and were hoping to undertake Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: NVQ level 3. Staff told us that they had completed all of the mandatory training which included food hygiene health and safety and fire. They also told us that they felt comfortable working in the home and that they felt competent to undertake all of the tasks. It is the practice of the home to employ new carers on a bank system initially and if they prove satisfactory they will be provided with employment on a permanent basis. We were told this enables the manager, other staff and residents to make decisions about the suitability of the new member of staff. During the waking day there are usually two members of staff on duty 0930-1600 . The home has a waking night carer and there was some discussion with the manager about the type of cover provided. There is no dedicated sleeping area in the home and we discussed options if this cover were to be provided. The registered manager confirmed hat there was still need for a waking person at night and that at all times cover would respond to the needs of the residents. There are times when day care staff are required to undertake waking duties at night and this results in a continuous shift of up to sixteen hours. The registered persons must ensure that the arrangements continue to be satisfactory and provides a service to meet the high and complex needs presented. The records of the last appointment were seen and it was evident that the required information is recorded and held safely however it was noted that CRB checks are undertaken by an agent who in turn confirms any disclosure. We think that reasonable practice would include the home having sight of the original documents to ensure they are happy with the appointment and the fact that this document must be retained in the home (see Schedule 2 Regulations 7 9 and 19). It is the responsibility of the registered persons to meet such requirements as opposed to any agent acting on their behalf. The registered manager provides supervision for care staff and there are records of the meetings. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a well run home which is managed by a competent and suitably qualified person. The home encourages residents to comment and if necessary offer criticism. Evidence: The registered manager was present throughout the inspection and was seen interacting with staff and residents on many occasions. We felt that the manager was competent and providing a service based on the principles of individualiuity and choice and in an open and inclusive manner. This meant that each resident was seen as different and would be treated in a dignified manner and could take an active part in the day-to-day running of the home. We also felt that staff in the home understood the difficult behaviours presented and that the registered manager provided an excellent example for staff on how to deal with problems. The provider undertakes the monthly reports for the home and there are copies of the reports available. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: There are a number of ways quality assurance is measured and this includes getting the views of the residents and relatives/advocates. The frequency of the surveys was discussed during the inspection and is left to the home to determine. It was recommended that the Community Learning Disability Teams are included in future quality assurances surveys as they may have an important input in the home. The proprietor visits the home regularly and the registered manager felt she was offered adequate support. The visits required under Regulation 26 are undertaken by the proprietor and the record of the visits are held in the home. Health and Safety matters were seen as important and some staff have received training. The fire procedures were discussed and the registered manager was asked to ensuetr that the night fire procedures are adequate. The home has all of the required policies and procedures. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 34 18 The regsitered persons must 31/01/2009 ensure that all CRB/POVA disclosures are seen by them To protect residents Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 33 Review the practice of staff shifts, which include waking nights followed by day shifts. To ensure that assessed needs are met by an effective staff team. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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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