Inspection on 23/02/07 for Gordena Care Homes

This inspection was carried out on 23rd February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 2 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 18/05/06

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 23rd February 2007 09:30 Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gordena Care Homes Address 16 Overnhill Road Downend South Glos BS16 5DN 01179 569473 01179 569 473 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.V328256.R01.S.doc Version 5.2 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. 18th May 2006 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.V328256.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of the visit was to establish if the home is meeting the National Minimum Standards and the requirements of the Care Standards Act 2000 and to review the quality of the care provision for the individual’s living in the home. This was an unannounced inspection that was conducted in order to look at the six requirements and the four recommendations made at the last announced inspection that took place on 18th May 2006 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, service users care plans, risk assessments and essential lifestyle documents, an examination of health and safety documentation, some areas of the home were viewed and also some discussion took place with service users and staff employed at the home. Further discussion took place with the Registered Provider and Registered Manager in respect of the Commission’s commitment to improving service’s through its ‘inspecting for better lives’ programme and how this would inform the inspection process and also the quality rating completed by the Commission about the service. Throughout the inspection process the staff members spoken with were informative and engaged fully with the inspection. Service users appeared relaxed and ‘at ease’ in their home. The inspector received 9 comment cards from those who live at the home, one from a relative and one from a health professional and the feedback given has been incorporated into the body of the report. What the service does well: Gordena care home is a comfortable, homely environment in which individuals live. The home has a clear, detailed statement of purpose and service users guide in place; these documents provide good information about the services and facilities that are provided at the home. Specialist advice is sought promptly for individuals when a need has been identified, ensuring that individual’s social, emotional and healthcare needs are met. Staff are recruited appropriately and receive core training appropriate to meet service users needs and protect their safety and welfare. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 6 The home is well managed and is run in the best interests of the service users. The manager monitors the quality of care and there are sound systems in place to demonstrate this. What has improved since the last inspection? What they could do better: In order to demonstrate that the home mainaintain clear, up to date records about individuals, which reflect their wishes and choices and also in order to direct staff practice it is recommended that: • • • • • • Monthly inspection reports for reporting to the manager should be completed regularly by staff as instructed. Consideration to be given to the use of language in challenging behaviour records. Records to be reviewed and updated, if required on how staff are to react when behaviour that challenges is displayed. Information to be obtained in respect of individuals wishes in the event of their death. Individuals intimate care practices to be reviewed and updated where required. Individuals risk assessments should be dated and signed DS0000064848.V328256.R01.S.doc Version 5.2 Page 7 Gordena Care Homes Individuals 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, also if all staff completes fully their induction programme. In order to demonstrate that the induction underten is of sufficient content and standard the home has been recommended to obtain a copy of the Skills for Care Induction programme. In order to show that individuals belongings are clearly accounted for it is required that records of valuables deposited by service users must be in place for all; those already in place must be reviewed and better maintained. In order that individual’s relatives are aware of how to raise issues with the home it is recommended that the home provide relatives with a copy of the homes complaints procedure. 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. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 8 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.V328256.R01.S.doc Version 5.2 Page 9 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): 1, 2, 3, 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users individual’s aspirations and needs are assessed prior to admission to the home. Information is available to individuals and the services provided at the home. EVIDENCE: The home is registered with the Commission for Social Care Inspection to accommodate 9 individuals aged 19 –64 years of age. The home has had a minor variation within their registration status in order that they can accommodate two individuals over the age of 65.There are no vacancies at the home. Six men and three females live at the home. The home has a Statement of Purpose that provides prospective service users, their relatives and professionals with information about the home. The Statement of Purpose was found to be fully comprehensive and contained all of the relevant information required as stated in Schedule 1, Regulation 4(1)(c). The Statement of Purpose contained the aims and objectives of the home. The home also has in place a service users guide this provides clear information about the facilities and service provided at the home, this guide has been enhanced by the use of photographs. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 10 There are individuals living at the home who do not use full spoken language as their main method of communication. Information seen in individuals care records clearly showed that staff have established professional caring relationships with individuals and have recorded the complex indicators that individuals use such as body language and behaviour, this demonstrates a commitment from the staff team to ensure that the needs of individuals are met. Information seen in care records showed that when specialist advice had been required in order to fully support individuals this had been sought; examples of external support included care mangers, consultant psychiatrist and the community learning disabilities team. The inspector saw that staff had maintained clear records on the wellbeing of the individual recently admitted to the home, their level of support and how they had settled at the home. The inspector spent some time talking to the most recently admitted service user into the home, they said they liked it at the home, they had made friends and enjoyed their day care activities. Information given by the individual and staff confirmed that the individual had visited the home prior to admission in order to ensure that the placement was appropriate and for the home to demonstrate that they are able to meet the needs of the individual. The manager Judy Parker said that the views of those already living at the home were taken into consideration when determining the suitability of the individual moving into the home. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9, 10. Quality in this outcome area is good, however a number of recommendations have been made and should be acted upon in order to maintain a consistent standard in this area. This judgement has been made using available evidence including a visit to this service. Care planning documentation at the home contains clear, detailed information to enable individual’s personal, emotional needs to be well met, with individuals being supported and encouraged to make decisions that affect their life. Improvements could be made to identified records in order to fully demonstrate that these are reviewed, monitored and updated when required. EVIDENCE: Information seen by the inspector, and confirmed by staff, and information seen recorded within individuals’ care records showed that those living at the home are offered a variety of social activities. Individuals are able to participate or not, this is dependent on the individual’s choice. The care plan documents for four service users were reviewed at this inspection; records reviewed included; essential lifestyle plans, health action plans, and person centred information that includes essential lifestyle information including information in respect of individuals preferred routines, Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 12 ‘things that make me upset/angry’, ‘Important things you need to know to support me’ and ‘What I would like to achieve’. Care plans are well maintained and updated on a regular basis, however there were documents essential for supporting individuals, which had not been reviewed for sometime, and the following good practices recommendations have been made: Monthly inspection reports for reporting to the manager should be completed regularly by staff as instructed and also that records are to be reviewed and updated, on how staff are to react when behaviour that challenges is displayed. It was noted that some of the language and terminology used within these reports were judgemental and subjective. It is recommended that consideration is given to the language within these reports in order that these factual and non judgemental. A requirement was made at the last inspection that care plans to be kept under review at least six monthly and more frequently for residents who are getting older. This requirement was found to have been met, the home have introduced a three monthly record of review in order to ensure that information held better monitored. The inspector further saw that the home had recorded full information about care plan review meetings which had been held with the individual, these recorded significant changes in the service users life or well being, changes in care support needs, and if any risks had been identified. The views of the service users and of significant others had been also reported. Each person has a daily dairy in the home in which staff record the routines, activities and behaviours, these are completed on a consistent basis with each entry being dated and signed by the staff member. Records in place show that staff enable service users to take responsible risks, ensuring that there is good information in place on which to base decisions, within the context of individuals care plan and the homes risk management policies and procedures. The home have risk assessments in place which record the activity, the risk and what the action plan is to include n order to reduce the risk, it was noted that a number of these assessments had not been dated or signed and it is recommended that this is undertaken in order that there is ‘ownership’ and to show when the assessment had been undertaken. A requirement was made at the last inspection that the use of an intercom must be recorded on individuals care plan and risk assessment. During a review of the risk assessments in place it was found that this requirement had been met. The home has a clear confidentiality policy that covers aspects of written and verbal information. It was further noted that the manager was aware of confidentiality when discussing private information about individuals she shut the office door. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. 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. Individuals benefit from accessing the local community and taking part in appropriate activities. Individual’s rights are respected at all times. EVIDENCE: The home have developed essential lifestyle and person centred plans for each service user, these are linked into individuals goals that they wish to achieve and records the steps as to what action will be taken and who will support them. These opportunity plans also linked into individuals care plans and were reviewed at both key worker meetings and day care support review meetings. Nine comment cards were received prior to the inspection from service users who live at the home, all were supported, (due to their communication needs), with the completion of this form by care staff who are employed at the home. All responded that they can do what they want during the day, evening and weekends. All knew who to speak with if they were unhappy. All responded that staff always treats them well and that carers listen and act upon what Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 14 service users said. No concerns or issues were raised in any of these questionnaires or during the inspection. Staff support individuals to participate in the local community in accordance with their assessed needs and individual care plans. Staff ensure that information is given to individuals about local activities and staff support individuals both in and out of the home to participate in activities of their choosing such as visiting places of local interest, and shopping. Prior to the inspection a comment card was received from a relative of an individual that lives at Gordena, they recorded no concerns over the provision of care provided at the home. A recommendation was made at the last inspection that for the home to review the payment of the contract work undertaken by residents to ensure equitable, the inspector spoke with the manager and saw records in respect of this which demonstrated that payment of contract work undertaken was fair and individuals were being paid according to the level of work they had completed. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20, 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individuals are supported in their preferred manner and individual’s physical, emotional and healthcare needs are well met, some review of intimate care practice records is recommended. Medication is managed in line with legal requirements. The aging, illness and wishes in the event of death are handled with respect, however some improvements are needed to ensure that individuals wishes have been obtained in the event of their death. EVIDENCE: Systems of medication administration, storage and recording were reviewed at this inspection. The inspector has seen at previous inspections that the home has clear policies and procedures in place to direct staff and provide instruction. Medication is stored in a locked cabinet with an additional facility for the storage of controlled medication. A monitored dosage system of medication administration is in place at the home and this appears to work well It was recommended at the last inspection that the use of PRN medication to be recorded on individual’s behavioural strategies, this had been completed with information in place to ensure that a consistent approach is undertaken by staff. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 16 It was evident at this inspection that the staff spoken with are sensitive to the emotional, physical and health needs of those living at the home and through observation and discussion demonstrated an understanding of the wishes of individuals living at the home. All individuals had in place intimate care practices and these guide staff to the specific wishes and preferences as to how individuals should be supported, it was noted that the records of three individuals had not been updated for sometime. In order that information held about individuals is correct it is recommended that these are to be reviewed and updated where required. The ageing process and general healthcare of individuals is handled well and with respect. It was noted that the home had supported individuals at the home to discuss what arrangements they would want in the event of their death and that some individuals had pre paid funeral plans in place, however not all individuals had their wishes recorded and therefore it is recommended that the home seek the wishes and choices of individuals in the event of their death. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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. Individual’s can be confident that their complaints would be listened to and taken seriously and staff demonstrated a clear understanding in this area, which has been underpinned by the home having clear policies and procedures in place. Improvements could be made in providing information to relatives about how to raise issues. The home has inventories of individual’s items of value in place, however these are in need of review in order to ensure there are accurate. EVIDENCE: The home has in place procedures for responding to suspicion or evidence of abuse or neglect to ensure the safety and protection of individuals, this includes a protection of vulnerable adults policy and a protection of vulnerable adults policy that has been developed by South Gloucestershire’s Community Care department. It was noted that care plans files contained a copy of the proceedure for making a complaint with evidence to show that this had been discussed with individuals. It was also seen that a copy of how individuals can complain was on display in individuals rooms. Comment cards received from service users recorded that individuals knew who to speak with if they had any concerns and this was confirmed when talking to clients during the day. No issues of concern were raised during the inspection visit. From discussion with staff it was evident that staff were fully aware of their role and responsibilities in respect of protecting individuals living at the home Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 18 and have acted appropriately when they have been concerned over the behaviours of individuals in order to ensure their rights and wishes are protected. On the comment card received from a relative of an individual who lives at the home did not how to make a complaint, it is recommended that the home look of ways of ensuring that relatives are aware of how to raise issues and concerns. A review of files found that two individuals did not have a record in place of their valuables; three other individuals’ inventories had not been updated or reviewed since 2005. In order to fully show what valuables have it is required that inventories are in place for all individuals and are updated when required. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 19 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, 28, 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The relationships between staff and those living at the home are good, and this creates a warm, supportive, safe environment, which promotes a good quality of life for the individuals living at Courtview. Furthermore individuals live in a homely, comfortable and safe, clean and a well-maintained environment. EVIDENCE: Gordena Care Home is registered as a care home for those with a learning disability and is able to accommodate nine individuals. Gordena 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. There have been no changes in the services and facilities provided at the home since the previous inspection. The location and layout of the home is suitable for its intended purpose. There is no lift for access to the upper floors and Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 20 therefore those who live at the home are required to be fairly mobile and be able to manage stairs. 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. The home has purchased a new industrial type washing machine and tumble dryer since the last inspection. Since the last inspection three bedrooms have been redecorated with new flooring and vanity units. The entrance hall has also been redecorated and also has had new flooring. A hand test of the water temperature found the temperature was not excessive and was at a safe level, the temperature in the home was warm and comfortable. At the time of the inspection all areas seen were clean, tidy and odour free. All of those living at the home have access to their personal and communal space. There is a large enclosed garden to the rear of the house that is well established with tress and scrubs, this area has been enhanced since the last inspection due to new fencing being erected and security lights being fitted. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 21 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, 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff must fully complete their induction programme and staff members should have an individuals training record. EVIDENCE: Each individual has a key worker to support them with the manager being involved with the overall monitoring of individual care. It was clear that staff have developed relationships with individual’s and have worked together with them and others in order to identify the needs of a resident and then support the person in achieving their goals and future aspirations. There was information in individual care plans that provided information to guide staff to the appropriate level of support that individuals require. A recommendation was made at the previous inspection a checklist to be developed of the recruitment and selection documentation for new staff. The inspector saw that these were in place in the front of each individuals staff file. The recruitment, selection, induction and training records for three staff were reviewed in depth and a further three staff files were also sampled. A requirement was made at the last inspection that criminal record bureau Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 22 checks must be in place for all staff before they commence work. All staff had in place a completed application form, verification of identity documents, a CRB check, a protection of vulnerable adults check and two good references and contracts of employment. The induction records of the most recently appointed staff members were viewed and it was found that the induction checklist had not been fully completed and was a format that the home had developed, this induction checklist was comprehensive however it is recommended that the home obtain a copy of the ‘skills for care’ induction standards in order that it is in line with government recommendations. It is also recommended that each staff member have an individual training record of courses attended in place in order that a clear audit is in place of training that has been completed is recorded. As records of induction were incomplete it is required that staff must complete a full and comprehensive induction in order that they are given the appropriate information in order to fully understand their duties, role and responsibilities. At this inspection six staff training files were reviewed, information contained within these showed that staff have undertaken training in areas such as: protection of vulnerable adults, manual handling, dementia awareness, person centred planning and the management of behaviour that challenges. It was further noted that the home had arranged for training to be given for staff by a clinical psychologist that is supporting an individual at the home in order that staff can gain a better understanding of their behaviours. This training also provided guidance on how to support the individual appropriately. Information seen within staff files showed that staff receive regular, formal recorded supervision with the manager, areas of discussion include progress in achieving a National Vocational Qualification, training and personal development and discussion about individuals service users support. Also in place were individual staff assessment sheets, this reviews area of staff performance such communication skills, understanding the aims and objectives of the home and general attitudes to service users and other members of the staff team. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the service users. The home is well managed ensuring that individual’s interests and rights are promoted and protected by a knowledgeable and committed staff team. EVIDENCE: The registered providers are Sarah Howich and Simon Parker. Sarah Howich is very much a ‘hands on’ provider and is fully engaged with the day-to-day running of the home. Mrs Judy Parker is the registered manager. Both Mrs Parker and Mrs Howich both have worked within the care field for a number of years within the learning disabilities field and have a great deal of experience in this area. The inspector saw evidence that the home ensures as far as is reasonably practicable the health, safety and welfare of the service users and staff. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 24 There are clear equal opportunities policies within the home and all staff are given copies of these. Staff meetings are held regularly and there are also other strategies for enabling staff, service users and other stakeholders to voice concerns and to affect the way in which service is delivered. These included staff supervision; individuals review meetings, quality assurance, and an open and approachable management approach. The inspector saw that the home has in place a comprehensive fire risk assessment; this document covered areas of identified risk within the homes A requirement was made at the last inspection that weekly and monthly fire checks must be recorded. The fire logbook was reviewed at this inspection and it was found that all checks had been well recorded. This record also evidenced that fire drills and ongoing staff instruction and induction into fire safety had been undertaken by staff. The home have in place a fire risk assessment this covers all areas of the building. A requirement was made that health care records must be maintained; these were reviewed at this inspection, the home have met this requirement and have in place individualised ‘Health Action Plans’ these show how each person wishes to be supported in aspects of their healthcare such as how they are to be supported with their medication, attendance to appointments and ongoing primary and specialist healthcare. Staff meetings are held regularly at the home in order to ensure effective communication and continuity of the services being provided, the last meeting held at the home took place in February and areas of discussion included: contracts of employment, training, uniform and staff roles. The meeting was well attended. Accidents and incidents were well recorded with information to show that situations had been dealt with appropriately. The home maintains clear records in respect of challenging behaviour reports that have occurred and where required incidents had been reported to the Commission. It was noted that some of the terminology used within these reports was inappropriate and it is recommended that consideration is given to how these reports are worded in order that they are respectful and non judgemental. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 25 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 3 3 3 X 3 X Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 26 No 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. 2. Standard YA35 YA23 Regulation 18(1) c 17(2) Requirement Timescale for action 23/02/07 All new staff must fully complete the induction programme. Records of valuables deposited 23/02/07 by service users must be in place for all; those already in place must be reviewed and better maintained. 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. Refer to Standard YA22 YA35 YA6 YA6 YA6 YA21 Good Practice Recommendations Relatives to be given information on how to raise concerns. For each staff member to have an individual training record of courses attended. Monthly inspection reports for reporting to the manager should be completed regularly by staff as instructed. Consideration to be given to the use of language in challenging behaviour records. Records to be reviewed and updated, if required on how staff are to react when behaviour that challenges is displayed. Information to be obtained in respect of individuals wishes DS0000064848.V328256.R01.S.doc Version 5.2 Page 27 Gordena Care Homes 7. 8. 9. YA35 YA9 YA18 in the event of their death. The home is advised to obtain a copy of the Skills for Care Induction Standards. Individuals risk assessments should be dated and signed. Individuals intimate care practices to be reviewed and updated where required. Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Gordena Care Homes DS0000064848.V328256.R01.S.doc Version 5.2 Page 29 - 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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