Inspection on 18/05/06 for Gordena Care Homes

This inspection was carried out on 18th May 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gordena Care Homes 07/08/07

Gordena Care Homes 23/02/07

Gordena Care Homes 06/12/05

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 Gordena Care Homes 16 Overnhill Road Downend South Glos BS16 5DN Lead Inspector Odette Coveney Key Unannounced Inspection 18th May 2006 09:30 Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 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 Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 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. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gordena Care Homes Address 16 Overnhill Road Downend South Glos BS16 5DN 01179 569473 01179147472 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) Mrs Sarah Louise Howick Mr Simon Gordon Parker Mrs Judith Ann Parker Care Home 9 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (2) of places Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. May accommodate up to 9 persons (male and female) aged 19 years and over who have a learning disability. May accommodate one named person with a learning disability who has dementia. This will revert to the original certificate once the person leaves the home. 6th December 2005 Date of last inspection Brief Description of the Service: Gordena Homes was registered with the Commission for Social Care Inspection in July 2005. The home is registered to provide personal care and accommodation to nine people with a learning disability aged 19 years and over. In addition the registration includes one named person who has dementia in addition to their learning disability. Gordena Homes is a large semi-detached Victorian property that is situated in a well established residential area. The road links with Staple Hill and Downend, both areas being within walking distance. Both areas have good public facilities and a regular bus service into Bristol. Communal/shared areas in the home are located on the first and top floors. This home would be only suitable to individuals who are fully ambulant and can use stairs. The kitchen, dining room and one bathroom plus the manager’s office is situated on the top floor. The middle floor has one lounge, a further three bedrooms and a bathroom. The laundry, shower room and five bedrooms are situated on the ground floor. There is a conservatory, which is available for the smokers of the household. There is a small garden at the rear of the property mainly grassed with surrounding shrubs. Gordena Homes is a family business owned by Mr Parker and Mrs Howick. The registered manager is Ms J Parker. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that was conducted in order to look at the requirements and recommendations made at the last announced inspection that took place on 6th and 7th December 2005 and also to monitor the care and services provided to those who live at the home. During this inspection time was spent examining care documentation, staff employment and training records, an examination of health and safety documentation, a tour of the home and also discussion with residents, the duty manager and staff employed at the home. Further discussion took place with the duty manager in respect of the Commission’s commitment to improving service’s through its ‘inspecting for better lives’ programme and talked about how this would inform the inspection process and also the risk assessment completed by the commission about the service. The inspector found that of seventeen requirements made at the last inspection many have been met. The home has been requested to forward further information to the inspector in respect of one of the requirements in order that this can be fully evaluated. Of nine of the recommendations made at the previous inspection seven had been met and part of another recommendation had been met, the remaining recommendation will be reviewed at the next inspection, as this had not yet been fully met. At this inspection a further five requirements and three recommendations were made. At this inspection an immediate requirement was made that the home must ensure the safe temperature of the water in order to eliminate the risk of scalding to residents and the home was given one week to comply. The inspector revisited the home on 2nd June and found that this requirement had been met; the home rectified the problem demonstrating compliance with the regulations. Throughout the inspection process the duty manager, the accountant and staff spoken with were informative and participated fully with the inspection. Resident’s spoken with spoke favourably of the care and attention they receive from the staff at the home. The inspector had the opportunity to speak with a placing care manager and received comment cards from five relatives. Comment cards were received from all of those living at the home and information from these have been incorporated into the body of the report. What the service does well: It was clearly evident that the registered manager and the staff team are committed to ensuring that all of the needs of individual’s at the home are met, this is done through consultation, observation and previous knowledge and an understanding of individuals through a person centred individualised process with information well recorded on care planning documentation. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 6 Residents said they enjoyed life at the home and spoke with warmth about staff that work at the home and of the lifestyle they live. What has improved since the last inspection? There have been a number of significant improvements since the last inspection and it was evident that the manger and staff team have worked diligently in order to meet the requirements and recommendations of the previous inspection. Residents can be fully aware of the terms and conditions of their placement as the home has ensured that each individual has in place a contract, which outlines individual’s rights and obligations. Policies and procedures have been reviewed and these reflect the structure of the home and the care needs of residents. Potential new residents into the home can be assured that the home will be able to cater for their needs as the home has developed a clear statement of purpose and also as the home has in place an assessment of need for prospective residents that covers all aspects of their placement and these record individuals support requirements with individuals care documentation being well ordered. Residents can be assured of their safety and protection as the home have developed risk assessments which reflect the activities of residents and outline how they are to be supported without limitations and also that individuals now have in place an inventory of their belongings and clear information is recorded that the manager acts as an appointee for some residents who live at the home. Residents can be assured that they have been consulted about their healthcare as the home has developed records of how the home is meeting the health care needs of individuals. Residents can be confident that their end of life wishes will be respected as the home has consulted with individuals and has recorded their choices. Residents have been provided with improved detail on how complaints would be responded to by the home and therefore they now have the information they need should they wish to complain. Residents can be assured that the requirements made at the last inspection in respect of medication administration, storage, recording and staff training have been met, however a requirement was made at this inspection that record keeping in this area must be improved. Residents will be supported by competent staff as the home has ensured that staff undertake an induction into their role within the first six weeks of employment, staff have also undertaken training to support those who exhibit Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 7 behaviour that challenges. The home has certificates in place to evidence staff participation at training courses. Health and safety for both staff and residents has improved as data sheets in respect of COSHH (control of substances hazardous to health) are in place, the environment is also safer as the home has fitted radiators guards. What they could do better: Residents would be assured that their care plans contain accurate information if these were kept under review by the home. Residents would be assured that staff had been selected following robust recruitment and selection processes if records relating to staff employment were maintained at the home and if evidence was in place to demonstrate that all staff have had a Criminal Records Bureau check. In order that residents can be assured that the home is undertaking sufficient fire safety checks it is required that the home ensures that fire records of checks undertaken are sufficiently detailed. Residents can be assured of the appropriate use of a ‘listening’ device if a risk assessment was completed to record the decision making process for the use of this equipment. To ensure that contract work undertaken by residents is equitable this must be reviewed and decisions made should be recorded. Residents would be better assured that staff training was being provided with future needs being identified if individual training records were developed with an audit of all staff training also recorded. The home has been requested to forward evidence that staff have undertaken protection of vulnerable adults training. Residents would benefit if the home reviewed the staffing to ensure that residents have the opportunity to go out in the evenings as detailed in the statement of purpose. This has been outstanding since the inspection undertaken in December 2005. Those living at the home would be assured of a consistent approach in respect of their healthcare if records of health support were better maintained and if behaviour strategies include details of medication for use ‘as and when required’. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 8 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. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 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 Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 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): 1, 2, 3, 4, 5 The quality outcomes in this area are good; the home has ensured that prospective residents to the home are provided with sufficient information and individual’s can be assured that their needs will be assessed and that clear contracts of placement will be in place outlining the terms and conditions of the placement. EVIDENCE: A requirement was made at the previous inspection that the home must expand on the statement of purpose to ensure that it contains all information specified in schedule 1. A review of this document found that it was fully comprehensive and outlined the services and facilities available to those who live at the home and provided full information in order that prospective residents can be assured that the home will meet their needs and their expectations. A requirement was made at the last inspection that the home must develop an assessment of need for prospective residents that reflects the needs of an individual with learning disabilities, the assessment in place covers aspects of personal support, communication and emotional support needs and how staff would support residents in the manner most appropriate to them. The duty manager Judy Parker told the inspector about the admission process of a potential new individual into the home. The home had in place a full care management assessment that provided information in order to inform staff and Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 11 guide them to support residents in line with their assessed needs. Mrs Parker demonstrated an understanding of the complex needs of individuals and the importance of ensuring that staff have the skills and training in order to meet individuals identified needs. The home has a clear admissions policy. The home currently has one vacancy, Mrs Parker said that an individual who had expressed an interest has visited the home on a number of occasions and that when they make the decision to move into the home this will be over a period of time incorporating visits for meals, a day visit and possibly an overnight stay. It was clear that admissions are tailored to the needs of the individual and that those already living at the home will be consulted to ensure compatibility. A requirement was made at the previous inspection that residents must have a contract of care that is signed by the individual or their representative. The inspector reviewed the contracts for four residents and these evidenced that this requirement has been fully met by the home. The duty manager showed the inspector a number of resident’s contracts, these had been well written and outlined the service providers rights and residents obligations, information also included fees, and any ‘extra’s’ that residents may be expected to pay for and information of the termination of placements. Documents had been signed by the resident and a representative of the home. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 12 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 The outcomes in this quality area are poor; Care records are well written and residents are supported to make decisions with their life and the home respects the importance of confidentiality, however care plans must be kept under review and changes must be recorded. Identified areas of risk to residents are well recorded, however one risk assessment is required in order to demonstrate the appropriate use of a listening monitor. EVIDENCE: Four care plans were reviewed at the inspection, the care documentation in relation to the meeting the needs of residents were found to be well ordered and it was easy to identify the assessed needs of individuals with well written records that provided direction for staff and outlined how identified needs would be met. Therefore, concluding that the home has met the recommendation from the previous inspection for the home to review the logical sequence of recording and storing of resident information making it accessible. A requirement was made at the last inspection that the home must ensure that care plans are kept under review at least six monthly and more frequently for residents who are getting older. This requirement has not been fully met and although staff were fully conversant with the current and changing needs of residents this must be recorded and monitored in Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 13 individual’s care plans, therefore the requirement remains and will be reviewed at the next inspection. Prior to the inspection the inspector received six comment cards completed by residents who live at the home. All responded positively that they receive the care and support they need, that staff always listen and act on what they say, that staff are available when they are needed, and also that individuals knew how to make a complaint and they knew who to speak with if they were unhappy. Residents reaffirmed these comments when the inspector spoke with them during the inspection and on a follow up visit to the home on June 2nd. On the day of the inspection one of the residents was involved in a review meeting in order to discuss their care plan and how the home is meeting their assessed needs. The reviewing care manager said that staff were supportive and encouraging, however he was disappointed that the resident was not fully enjoying an active social life due to insufficient staffing levels on an evening in order that the resident could go out socially at night as outlined within their care plan. This has been highlighted within the staffing standards contained within this report. Personal risks arising from activities are well assessed and recorded, care plans detail the support residents need for the risks to be managed without limiting or restricting the lives of residents. The assessments seen were noted to include supporting individuals in the community and with aspects of daily living. It was further noted that when a new risk had been identified a full recorded assessment had been completed. Judy parker also told the inspector that risks are discussed with residents and action plans are agreed where possible. A requirement was made at this inspection that a risk assessment should be completed in respect of a listening monitor, this is to demonstrate the purpose of this equipment’s use and that it is not used as an invasion of privacy. Daily records, routines of individuals and observations during the inspection showed that residents are encouraged and supported to make decisions and choices about areas within their life. This included day to day decisions, lifestyle and future planned choices. Evidence showed that individual’s wishes are respected and met where the home is able. It was noted that records are held securely in a room that can be locked. Staff were aware of talking about individuals in a confidential private manner and this was not done in the presence of others. The home has a clear policy in respect of the importance of confidentiality Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 14 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, 14, 15, 16. The quality outcomes in this area are good; residents have opportunities for personal development and are able to take part in appropriate activities with individual’s rights being respected. EVIDENCE: Individuals are supported to maintain contact with their family. A good example of this is that the home arranges to take a resident in the home’s mini bus to visit their family; this is undertaken on a regular basis. Five comment cards were received from relatives of individuals who live at the home and overall recorded that staff/owners welcome them into the home. They can visit their relative in private, they are kept informed of important matters affecting their relative and that they were satisfied with the overall care provided at the home. The home’s statement of purpose states that the home has an ‘open door’ policy and that individuals are encouraged to maintain contact with family and friends if it is their choice to do so. A recommendation was made at the previous inspection that the home should review the payment of contract work undertaken by individuals in order to Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 15 ensure it is equitable; Judy Parker said that the home had made some progress in this area and that this would be fully explored with the residents during a residents meeting, this will be reviewed at the next inspection. From discussion with residents and information seen in individuals daily records it was clear that residents are supported to participates fully in daytime activities of their choice such as swimming, arts/crafts, making use of community facilities, bowling, and visiting places of local interest. Some of the residents attend day centres and further education college developing their communication and numeracy skills. The home has recently appointed a support worker whose role is specifically to discuss with residents their wishes and choices in respect of their own personal development, individuals social inclusion into the community, education and leisure, to discuss the options available and to suggest new ideas. This is a proactive step in ensuring that individuals are encouraged and supported to pursue their own interests and hobbies and progress in this area will be reviewed at the next inspection. The inspector saw that residents have in place information which is essential to them in order to live their life in an individualised person centred way, these recorded individual’s general preferred routines, ‘what I would like to achieve’, ‘things staff need to know in order to support me’, ‘things which upset me or make me angry’. These are kept under review, are signed by the residents with an acknowledgment that residents had given their consent for confidential information to be shared with the staff team. When talking with the duty manager about what she felt the home did well Judy Parker said that she believed that the residents were ‘far, far happier’ and that ‘resident are more aware of and are using their rights’, that ‘residents are being offered more choices and are listened to and as a result residents are more assertive and have come on in leaps and bounds and individuals are more confident and secure in what they wish to do’. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 16 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): 18, 19, 20, 21. The quality outcomes in this area are adequate; residents are well supported with their personal, physical and emotional needs being well met, however the home must ensure that healthcare plans are followed as needed. EVIDENCE: Individual daily routines, care planning information, intimate care statements and risk assessments seen demonstrated that there is clear information about how residents want to be supported in areas of their personal care, the information in place is clear and provides clear guidance for staff to follow. A requirement was made at the last inspection for the home to maintain a record of how the home is meeting the health care needs of the residents, the home has developed health action plans for all of the residents. These were written in a person centred way, were well written and will provide important information in order that individuals are supported appropriately and in a way they have chosen. The documents clearly show that individuals have accessed healthcare services for their ongoing healthcare and also when a specific area had been identified. It was noted that one resident had recently been diagnosed as being a diabetic and that the home should record blood sugar levels and monitor accordingly. There was no evidence to show that this had been completed. It is required that health care records are better maintained Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 17 in order to demonstrate that individuals needs are being met with a consistent approach undertaken by staff to ensure continuity of care. The home has in place well recorded strategies for individuals who exhibit behaviour that challenges, these outline what form of behaviour may be exhibited, trigger factors and which immediate response is most helpful and what action should be avoided. It was noted that there are individuals who are prescribed medication to be taken ‘as and when required’ in order to reduce their stress. It was recommended that the use of such medication is recorded on behaviour strategies and these are cross referenced into medication records to ensure a consistent approach by all. The duty manager told the inspector of the processes for administering, recording, storage and disposal of medication. The manager was fully conversant with their role and responsibility and was able to demonstrate a sound understanding in this area. Since the last inspection the home have changed the pharmacist who supplies medication to the home and a different monitored dosage system is in place. There are no residents at the home who self medicate and individuals are supported in this area by staff at the home. A number of requirements were made at the last inspection in respect of medication administration, storage and staff training and all of these had been met. The home has a lockable trolley for medication storage, the home has a clear recording process for mediation both entering and leaving the home and staff have undertaken medication competency training A recommendation was made at the last inspection for the home to record resident’s wishes in the event of their death seeking views of the residents and their representatives where relevant and those records reviewed evidence that the home had sought individuals views, these had been recorded with one resident having in place a pre paid funeral plan. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 18 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): 22, 23 The quality outcomes in this area are good; residents are listened to and their views are acted upon. The home has appropriate measures in place in order to adequately protect residents from abuse. EVIDENCE: The home has clear and robust adult protection protocols, policies and procedures in place. These include a staff ‘whistle blowing’ document and South Gloucestershire Social Services Protection of Vulnerable Adults Policy. There are staff working at the home who have either achieved or are undertaking an National Vocational Qualification in Care, (promoting Independence) and this has a core unit that incorporates adult protection and staff responsibility should they have any suspicions or concerns. The manager said that staff have undertaken training in this area, however evidence of this was not in place. The home has been requested to send this to the inspector in order to verify this has been completed. During the inspection Judy Parker was able to demonstrate a sound understanding of the diverse needs of individuals who live at the home and gave clear examples of the home’s intervention in order to ensure the safety and protection of those living at the home from potential dangers. The complaints logbook held at the home was viewed. Clear information was in place to demonstrate that issues are dealt with effectively to the satisfaction of those involved. The Commission for Social Care inspection has not received any complaints. No areas of concern were observed or raised during the inspection. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 19 A requirement was made at the last inspection that the Policy on complaints must be reviewed to ensure it reflects the home’s structure and includes timescales and the contact details for the CSCI. Copies must be given to residents and their representatives. This document was reviewed at this inspection and was found to contain all of the required information in order that individuals can be assured that complaints would be responded to appropriately. A copy of how residents are able to raise concerns or complaints are held in individuals rooms Resident’s finances are well audited at the home, the home has clear information to show that the registered manager is acting as an appointee, supporting residents with their finances. A requirement was made at the last inspection that the home reviews their policy on restraint and protection in order to ensure compliance to legislation and guidance, (No Secrets and the Department of Health’s Guidelines on restraint for people with learning disabilities). The policy is in place and is clear. The duty manager said that restraint is not used at the home as the person this technique was used for no longer lives at the home. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 20 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): 24, 25, 28, 30 The quality outcomes in this area is good, residents live in a homely environment that is clean and well maintained. EVIDENCE: Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 21 Gordena care home is located within a residential area of Downend. The home is in keeping with surrounding houses and close to local amenities and shops. Gordena was found to be well furnished and with soft furnishings such as pictures, plants and photographs making for a homely environment. The home was found to be clean and tidy. The home is arranged over three storeys and lounge and dining areas are accessible by stairs therefore the residents who live at the home have to be fairly ambulant in order to access these facilities. The current registered providers are considering the reorganisation of facilities and the current layout of the home and options are being explored in order to improve the accommodation for those living at the home. The home has sought guidance from the Commission’s registration officer and changes in this area will be monitored by the Commission at future inspections. The inspector was invited into resident’s rooms and residents said that they liked their room and that they had chosen items for their room and had been consulted about how they had wished their room to be set out. Rooms were personalised and reflected individual’s age, personal interests and taste. There are two residents who share a room and a screen is provided in order to provide some degree of privacy. Both the front and rear gardens are accessible to residents. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 22 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): 32, 34, 35, 36. Quality outcomes in this are poor with the residents being potentially at risk due to the poor recruitment and selection of staff, with poor record keeping in this area. It must also be noted that residents enjoy warm and friendly relationships with staff that are trained, well supported and motivated. EVIDENCE: At this inspection the recruitment and selection documents for four staff members were reviewed, of these there was not full recruitment and selection information held at the home. It is required that the home must ensure that Criminal Record Bureau checks are in place for all staff before they commence work, this is to protect residents. It is further required that the home must ensure that records of recruitment and full employment documentation are in place. It is also recommended that the home develop a checklist of the recruitment and selection process for newly appointed staff in order to ensure that these correspond with the home’s polices and procedures in respect of this area and to demonstrate that the National Minimum Standards have been met. A requirement was made at the last inspection that the home must ensure that staff have completed an induction within six weeks of employment, Mrs Parker confirmed that induction is undertaken. A requirement was made at the last inspection that staff must undertake training in the protection of vulnerable adults and supporting individuals who exhibit behaviour which challenges. A review at this inspection showed that staff have undertaken training to support Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 23 residents when they exhibit behaviour that challenges and certificates were in place to evidence this. The duty manager said that staff had undertaken training in respect of the protection of vulnerable adults; there was no evidence to show this. The manager has been requested to forward evidence of this to the inspector in order to verify this. At the last inspection it was recommended that each staff member had in place records of courses attended, including copies of certificates. The inspector saw certificates in place, however the home has not yet developed individual training records, the recommendation that this is completed remains as this will provide a clear overview of training undertaken and future development needs. A requirement was made at the last inspection that the home must review staffing to ensure that residents have opportunities to go out in the evenings as detailed in the statement of purpose. From discussion with residents, the duty manager and a care manager visiting a resident at the home (who was reviewing the care plan for a resident they had placed at the home) it was clear that this had not been achieved. Mrs Parker felt that due to a new staff member being solely employed to improve the social and educational opportunities for residents and when all of the residents have been consulted this would be an area of improvement. This requirement remains and will be reviewed at the next inspection. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 24 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): 37, 38, 40, 42, 43. The quality outcome in this area is poor due to inconsistent record keeping however the home is well managed and resident’s benefit from the ethos of the home and staff work within the home’s aims and objectives. EVIDENCE: Gordena is a well run home. The manager is experienced in working with people with a learning disability. Staff said that the manager was enthusiastic and that the residents were central to decisions made within the home. The staff on duty were complimentary about the high levels of support and clear leadership provided by the manager and stated that all staff are involved in making decisions about the management of the home and care issues and worked closely with the manager. At the inspection the temperature of the water in a bathroom was tested, this was found to exceed 60 degrees centigrade. An immediate requirement was made that the home must ensure the safe temperature of the water in order to eliminate the risk of scalding and the home were given until 25th May to Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 25 comply. The inspector revisited the home on June 2nd and water temperatures were found to be safe and the requirement had been met. Inventories were in place to demonstrate a clear audit of individuals personal possessions, this was a recommendation from the last inspection and the home have demonstrated a commitment to meet the National Minimum standards by ensuring compliance in this area. Polices and procedures in place at the home were reviewed at this inspection these reflected the structure of the home and the care needs of residents as outlined within the National Minimum Standards. Those in place included: equal opportunities, training, health and safety, complaints and processes for admissions into the home. A recommendation made at the previous inspection that the home review these documents had been met, all of the policies and procedures had been reviewed recently. Data sheets in respect of COSSH (control of substances hazardous to health) were in place. The fire safety logbook was reviewed as part of the inspection process and full records were not available to demonstrate that all of the appropriate checks have been undertaken on a consistent basis. The home is required to ensure that the weekly and monthly checks in respect of fire safety are clearly recorded. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 26 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 1 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 2 13 X 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 X 3 1 1 3 Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 27 Yes. Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 (2) (b) Requirement Care plans to be kept under review at least six monthly and more frequently for residents who are getting older. Weekly and monthly fire checks must be recorded. Criminal record bureau checks must be in place for all staff before they commence work. Records of staff recruitment must be in place for all staff members. The use of an intercom must be recorded on individuals care plan and risk assessment. Health care records must be maintained. Timescale for action 18/07/06 2. 3. 4. 5. 6. YA42 YA34 YA41 YA9 YA41 17(2) 7, 9, 19 Schedule 2. 7, 9, 19 Schedule 2. 12 (4) a 17 (1) a 18/06/06 18/05/06 18/06/06 18/06/06 18/06/06 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 YA12 Good Practice Recommendations To review the payment of the contract work undertaken by DS0000064848.V294153.R01.S.doc Version 5.1 Page 28 Gordena Care Homes residents to ensure equitable. 2. 3. 4. YA35 YA20 YA41 For each staff member to have an individual training record of courses attended. Use of PRN medication to be recorded on individual’s behavioural strategies. A checklist to be developed of the recruitment and selection documentation for new staff. Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 29 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gordena Care Homes DS0000064848.V294153.R01.S.doc Version 5.1 Page 30 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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