Inspection on 07/08/07 for Gordena Care Homes

This inspection was carried out on 7th August 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gordena Care Homes 23/02/07

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 David Smith Key Unannounced Inspection 7th August 2007 09:45 Gordena Care Homes DS0000064848.V340473.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.V340473.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.V340473.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 F/P 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.V340473.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. 23rd February 2007 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 provides 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. The communal areas of the home are located on the first and top floors. This home would therefore only be suitable for individuals who are reasonably mobile and can use stairs. The kitchen, dining room, one bathroom and the home’s office are 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 and a garden at the rear of the property. Gordena Homes is a family business owned by Mr Parker and Mrs Howick. The registered manager is Mrs. J Parker. The current fees for this service range from £525.00 to £739.00 per week, depending on the support needs for each resident. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit to the home as part of a Key Inspection of this service. I gathered information during my visit through discussions with Residents, the Registered Manager, Deputy Manager and staff members. Interaction and communication between staff and individuals who live in the home was also observed. Care plans and associated records were examined together with accident and incident reports, medication administration, staffing records, Risk Assessments and health and safety records. I was provided with a tour of the home and invited by a number of residents to view their own rooms. The home was provided with their Annual Quality Assurance Assessment (known as AQAA, pronounced as ‘aqua’) and a range of survey forms for residents, relatives, carers, advocates and healthcare professionals, prior to my visit. The AQAA was completed and returned together with eight surveys. Other sources of evidence have been used as part of the Key Inspection process, such as notifications of significant events which have occurred within the home. The people who live at Gordena wish to be known as ‘residents’. This has therefore been acknowledged and replaced the term ‘service user’ in this report. What the service does well: The residents I spoke with said they are very happy living in the home, felt safe living here and are well supported by the staff team. The residents who responded by survey said they choose how to spend their day, are treated well by staff who listen to them and act on what they say. The relatives who responded by survey said the home meets the needs of their son or daughter, helps them keep in touch and supports them to live the life they choose. The home has a clear and detailed Statement of Purpose and Resident’s Guide, which provide very good information about the services and facilities provided by the home. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 6 Specialist advice remains promptly sought for each individual when a need is identified, ensuring that each resident is provided with a safe and consistent service. The home remains well managed and run in the best interests of each person who lives in the home. What has improved since the last inspection? What they could do better: Staffing levels within the home must be reviewed to ensure that the changing needs of residents can be responded to appropriately and that a good quality of service can be maintained. Each member of staff must be supervised regularly to support them to provide a good quality service to each resident. The record of valuables for each resident must be regularly updated and kept as part of each person’s care plan. This would further promote resident’s rights. The home should consider reviewing the induction procedure for new staff to ensure this meets ‘Skills for Care’ standards. This would help to ensure all staff are provided with sufficient information to support each resident. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 7 The home should keep each staff training matrix up to date to ensure that all staff training can be easily tracked and that staff are provided with the knowledge and skills to support each resident. The home should proceed with plans to develop the environment. This would provide an improved environment for each person who lives or works in the home. To ensure the home maintains clear and up to date records, which reflect resident’s views and wishes: • • • • • The home should complete the development of ‘person centred plans’ for each resident. The home should review the frequency of resident’s Monthly Inspection Reports and then ensure these are kept up to date. Complete the review of each resident’s intimate care guidelines. Complete the review of each resident’s challenging behaviour guidelines. Complete the review of individual’s wishes in the event of their death. 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.V340473.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.V340473.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 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents are provided with comprehensive information to enable them to make an informed choice about where to live. Each resident has an individual contract of terms and conditions whilst living in the home. EVIDENCE: The home has a comprehensive Statement of Purpose and Residents Guide. These provide clear, detailed information regarding the ethos of the home and the facilities and services, which are available. These were last updated in July 2007. These documents are written in plain English and contain numerous photographs of the interior of the home, the gardens, the home’s vehicles and local facilities such as supermarkets, the leisure centre, the dental surgery and the church. Each resident has their own copy of both of these documents as part of their care plan. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 10 Each resident I spoke with said they chose to move to Gordena. Those who responded by survey said they were asked if they wished to move to this home and were provided with enough information to help them decide if this was the right place for them to live. There are contracts in place between the home and each Funding Authority, which are kept as part of each individual’s care records. The resident’s guide to the service also describes the terms and conditions in relation to living in the home. Gordena Care Homes DS0000064848.V340473.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, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensures that the service provided to each individual takes into account their personal preferences, supported by both written information in care plans and risk assessments which are subject to ongoing review. EVIDENCE: Three care plans were examined in detail and these provided comprehensive information on the areas of support each person required. Each care plan had been written in an individual way and covered key areas of support people required. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 12 These include information relating to health, personal and social care and money management. The care plans also described more complex needs, such as how to respond and support an individual if they become distressed. Interactions between staff and people who live in the home were observed at various times during my visit. These demonstrated the staff had a very good knowledge of the support needs of each resident and how to communicate effectively. Discussion with the Manager, her Deputy and staff members also confirmed this. Regular formal review meetings are held, which include residents, their families, staff members, Social Workers and Keyworkers. Each resident is supported to prepare for, plan and attend their review meeting. These meetings are clearly recorded and the outcomes used to update individual care plans. The home operates a keyworking system whereby each resident has a named member of staff who plays a key role in co-ordinating the services they receive. Between each formal review Keyworkers ensure that residents’ changing needs are monitored through regular review of their care plan. To suppor this process, the home has developed a three monthly review process which is recorded in each person’s plan. The home also uses a ‘monthly inspection report’ for each person, to assist with the review process. I did find that these are not being used consistently by staff as there were several months where these were not completed in the care plans I examined. I did discuss this issue with the Manager who agreed the home should review the frequency of these reports and how to ensure they are then kept up to date. Some areas of care planning are currently being reviewed, such as intimate care guidelines and plans relating to responding to behaviour which can be perceived as challenging the service being provided by the home. The Manager did show me hand written copies of these updated plans, but these need to be typed up and then placed in each person’s care plan. This must be completed as soon as possible. The home has recently introduced person centred plans, which will eventually replace the existing care plans and other related files. I did examine one which has been partially completed and this format appears easier for residents to understand and also contains many photographs of residents, their family and friends and various places which they have visited or which are important to them. The residents and their families are being involved in the development of these plans and although they will take some time to complete, they will be an improvement on the current care planning style used in the home. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 13 Each resident I spoke with told me they were always asked about their home and the service they received. Those who responded by survey said they did make decisions about what they would like to do each day and felt that they generally do the things they choose. Each resident has several person centred Risk Assessments to help them take risks as part of their lifestyle. Each assessment I examined has been regularly updated and is kept as part of each person’s care plan. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels within the home currently fail to adequately support residents to access leisure and educational facilities both within the home and wider community however, these are being reviewed. A healthy and balanced diet for each individual is promoted. EVIDENCE: Each resident has their own timetable of activities. These show access to local community facilities such as local colleges, shops, cinema, pubs and other activities such as swimming or ten pin bowling. Each resident I spoke with said they did go out and were mostly able to choose what they would like to do. One person told me they “love going out” and were part of ‘People First’ (a social and advocacy group for people who have Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 15 Learning Difficulties) and attends meeting and social events with them. They are also current planning a holiday abroad to meet members of their family. Another person told me they had been out independently on the bus that morning, are looking forward to travelling on the bus to visit their family and also starting a college course in September. The residents who responded by survey said they are generally able to do the things they want to during the day, although not always. Residents also said they often could not do the things they wished during the evenings or weekends. Staff spoken with explained that they work hard to ensure each person is provided with opportunities to do things which they enjoy. The Manager, her Deputy and staff members I spoke with did feel they could offer more opportunities and better respond to some residents’ changing needs if the number of staff on duty each day was increased. It is apparent that staffing levels are currently being reviewed with some resident’s Funding Authorities and the issue of appropriate staffing levels is discussed in further detail later in this report. It is evident that many residents had made significant progress since moving into the home. Some were attending more varied services or longer sessions. Others access the community independently, attend college courses and make use of public transport. On the day of my visit some residents spent part of the day doing ‘contract work’ of packing greeting cards. One individual I spoke with like this work as they were paid for it, knew the money went into their Bank Account and they could spend this how they wished. Individuals are supported with maintaining friendships, personal relationships and contact with their families. Some staff have known the residents’ relatives for a long time and promote ongoing communication with them. The relatives who responded by survey said the home helps their son or daughter keep in touch with them, meets their needs and supports them to live the life they choose. Each resident has access to a kitchen where they can prepare their own drinks and snacks. Meals are usually cooked by staff, although residents are encouraged to help in the preparation and I did see individuals making use of the kitchen and helping to prepare meals during my visit. Weekly menus are planed in consultation with residents and these show a wide range of food, which provide both a healthy and balanced diet. Each person’s likes, dislikes and allergies in relation to food are known and clearly recorded. I did note that the home had a food hygiene inspection completed on 04/05/07, by South Gloucestershire Council. Following this inspection Gordena was awarded a ‘Maximum 5 Stars Rating’. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 16 The cooking and dining facilities are currently located on the top floor of the home. This is not ideal and the proposed improvements to the environment, including the cooking and dining area, are discussed in more detail later in this report. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 17 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 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported in their preferred manner and their personal and healthcare support needs are well met. The policies and procedures relating to administration of medication promote their welfare and safety. The ageing, illness and death of any resident is handled with respect and in the way the resident would wish. EVIDENCE: The care documentation in place for residents provided clear guidance for staff on how they should support those living at the home with their personal care, although some plans are currently undergoing review. The care plans I examined showed that individuals were registered with a local GP, dentist and optician. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 18 Other specialist services are accessed when an identified need arises. These are provided by the local Community Learning Disability Team (known as ‘CLDT’). Care records show the home is regularly supported by the Consultant Psychiatrist, Psychologist, Speech and Language Therapists, Occupational Therapists and other relevant health care professionals. Contact with each professional is recorded and forms part of each persons care plan. The home has developed a ‘Health Action Plan’ for each resident. Each individual’s plan contains information which each person considers to be important about them, explains who supports them with their health care and how this is monitored. All of the staff I spoke with did have a good knowledge of residents’ healthcare needs. Any changes, which may cause staff concern, are noted and acted upon. It remains evident that the management and staff are sensitive to the personal, healthcare and emotional needs of those living at the home. The home uses the Boots Monitored Dosage System of medicine administration and this system is well managed. The medication administration file contains the home’s medication policy, guidance on using the Boots system, a recent photograph of each resident and details of medication which as given ‘as and when needed’ (known as ‘PRN’). Each resident’s medication record was correctly completed, signed by staff with no gaps evident in the records. A senior member of the staff team or the Manager dispenses medication. These staff members are provided with formal training in relation to medicine administration and the records I examined showed that they complete ‘Boots MDS Training’. The home also uses a Risk Assessment to help determine staff competence in this area. The ageing process and changing healthcare needs of individuals are handled well and with respect. The home has continued to support residents (and their families) to discuss what arrangements they would want in the event of their death, including supporting individuals to arrange pre-paid funeral plans if they wish to have one. This process now needs to be completed for only one resident. One family member who responded by survey said their relative has been “very poorly, the home have moved things around for them to stay on one level. I can’t thank them enough”. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 19 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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to communicate their views and they can be confident that they will be listened to and their views acted on if necessary. Clear policies and procedures are in place in order to protect individuals from the likelihood of abuse, neglect and self-harm. EVIDENCE: The home has policies and procedures in relation to concerns and complaints, whistle blowing (where staff can raise concerns regarding poor practice or possible abuse in a confidential way), equal opportunities, diversity and antioppressive practice. Each resident has their own copy of the home’s complaints procedure as part of their care plan. Many of the resident’s rooms I was invited to view also contained further copies of this document. There have been no concerns or complaints raised with the home since the last inspection. The CSCI has not received any concerns or complaints direct about Gordena. Each resident I spoke with said they were happy living in the home, felt safe and knew who to speak to if they were unhappy. One person said “if I was unhappy I would tell the staff. I feel safe here, if I didn’t I wouldn’t live here”. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 20 Each resident who responded by survey said they know who to speak to if they are unhappy about any issue and how to make a complaint. The relatives who completed a survey said they know how to complain, but added they have never needed to. There are policies and procedures in place relating to the issue of protection of vulnerable adults from abuse. Training records indicate that staff have attended training in the protection of vulnerable adults. Some of the people who live in the home can display behaviours which may be perceived as challenging the service being provided. These are varied and include self-harm, verbal and physical aggression and property damage. The home has policies in relation to dealing with violence and aggression and physical intervention and restraint. Staff are provided with training in relation to why people can present challenging behaviour and how they should respond to support them. Each care plan contains details of how staff are to respond appropriately to known behaviours. These are mainly distraction techniques or verbal redirection. There are no residents who require staff to physically intervene to ensure individual’s welfare and safety. Some of these plans are currently being updated, or awaiting typing and return to care plan files. This must be completed as soon as possible. There had been an increase in aggressive behaviour from one individual, which staff had identified and acted upon appropriately. The home had ensured that relevant healthcare professionals were notified and provided the resident and the home with suitable support. One member of staff who had supported this resident during a recent incident told me they were pleased that their training “had worked in practice”. Each staff member is subject to an Enhanced Criminal Record Bureau Disclosure, prior to working in the home. The home maintains clear records of all accidents and incidents. It also notifies the CSCI of any significant event which occurs within the home. Most residents now have a record of their valuables, or an inventory, as part of their care plan. The home must ensure these are in place for each individual and they are then kept up to date. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 21 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, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Gordena provides a homely, comfortable and safe environment for residents to live in. EVIDENCE: Gordena is a large semi-detached Victorian property that is situated in a wellestablished 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. The communal areas of the home are located on the first and top floors. This home is only suitable for individuals who are reasonably mobile and can use stairs. The kitchen, dining room, one bathroom and the home’s office are situated on the top floor. The middle floor has one lounge, a further three bedrooms and a bathroom. The laundry, shower room, conservatory and five further bedrooms are situated on the ground floor. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 22 I did view all of the communal areas of the home, along with five of the resident’s rooms. All areas of the home were clean and tidy and furnishings and fittings are of a good quality. The house is tastefully decorated and most areas appear light and ‘airy’. Some of the resident’s room have been redecorated and had new flooring laid since the last inspection. Each person has many personal items, pictures and photographs which help to ‘personalise’ their rooms. Residents told me they chose the colour schemes and had were happy with their rooms. One person said “I have everything I want”. Each resident who responded by survey said the home is ‘always’ fresh and clean. Some residents have chosen to have Sky TV in their own rooms and this is also available in the main lounge. The Manager and the Deputy told me they hope to make some important changes, which will improve the environment for both residents and the staff team. It is hoped the kitchen and dining areas can be moved from the top floor to the ground floor, with new bedrooms being created on the top floor. Some of the toilets, showering and bathing facilities would benefit from redecoration, although it appears sensible to carry out all of the works at the same time to limit the disruption within the home. It would appear these plans would improve the home and provide a much more sensible layout, in particular moving the kitchen and dining area from the top floor. It is hoped these alterations can be completed by the summer of 2008, although there are funding issues the home still need to resolve before this work can start. There is a well-tended garden at the rear of the property. On the day of my visit it was a warm, sunny day. Some residents spent time relaxing in the garden with staff members. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 23 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): 31, 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy promotes both individual’s rights and their safety. Each person that lives in the home is supported by a cohesive and effective staff team that is committed to providing a good service. The clarity of staff roles and responsibilities along with staff training and supervision are designed to provide a consistent approach to the support of staff and residents. EVIDENCE: There remains a well-established staff team with varying abilities who are skilled and experienced to meet the needs of those living in the home. Staff spoken with were able to demonstrate a clear understanding of their role and responsibilities within the team and their own personal role and accountability. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 24 Staff members I spoke with said that the staff team continues to be very open, honest and supportive. Each commented on how nice it is to work in the home. They felt well supported by the managers and were able to discuss issues in an open and honest way. Staff were observed interacting extremely well with each resident and those spoken with demonstrated a good understanding of the support needs of each person in the home. The residents I spoke with said they liked the staff and felt well cared for. One person told me “I love living here, the staff are brilliant” and another person said “all the staff are lovely here”. The residents who responded by survey said there are ‘always’ treated well by staff who listen to them and act on what they say. The relatives who completed a survey said the staff have the right skills and experience to look after each individual properly and meet their needs. One relative commented “all the staff, manager and owners of Gordena have been polite and most welcoming when I visit”. The Manager told me the staff have recently had to adapt to meet the changing needs of residents. The home now has one staff member providing waking night cover and another member of staff sleeps-in. This is to ensure that two residents who now require support during the night have easy access to staff. There are usually two staff members on duty on both an early and late shifts, although the Manager and the Deputy are able to provide additional staff support themselves on certain days. Both the Manager, the Deputy and other staff told me that due to some residents changing needs or due to the progress they have made, this level of staffing is no longer sufficient. Some residents now require 1:1 support from staff at certain times, while others would have more opportunities or choices if staffing levels were increased. These comments are certainly supported by the survey information from residents, who said they could not always do what they want, especially during the evenings or weekends. The home is already in discussion with some resident’s Funding Authorities to ensure increased staffing levels are agreed and the fees increased accordingly. This will then allow the home to recruit additional staff members. The progress made in this area will be focused upon during the next inspection process. The home operates a robust recruitment process and the records I examined included application forms, job descriptions, two satisfactory references, copies of the home’s Statement of Purpose and Complaints Procedure, documents confirming proof of identity and Enhanced Criminal Record Bureau Disclosures. Staff training records are kept as part of their personnel files. These include an individual training matrix and copies of training certificates the staff member Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 25 receives when they have completed each course or session. I did note that the training matrixes are not being regularly updated, as staff had completed training courses which were not noted on these records. Each new member of staff is provided with a formal induction to prepare them for working in the home. Records of this process are kept to show that staff complete their induction, however, as the home has now obtained a copy of the ‘Skills for Care’ Induction Standards the induction process should be reviewed to ensure each of these standards are being met. Staff are provided with a number of training opportunities. The records I examined showed that staff have completed training in Protection of Vulnerable Adults, First Aid, Core Values (in supporting residents), Dementia, Fire Safety, Health and Safety, Infection Control, Supporting People Who Self Harm, Manual Handling, Challenging Behaviour, Principles of Person Centred Planning, and Food Hygiene. Most staff who work in the home have either completed or are actively working towards a National Vocational Qualification (known as an ‘NVQ’). This means that 90 of the staff team will hold this qualification shortly and this is commended. Each member of staff has a supervision contract, which confirms they should be provided with formal supervision every six to eight weeks. However, the records I examined did show that meetings have become infrequent, as there are often gaps of three or four months between supervision meetings. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 26 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, 41 and 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 well run and residents benefit from the ethos, leadership and management approach of the home. Residents’ views are central to the monitoring and review of the service provided by the home. The home’s policies, procedures and record keeping promote residents’ rights and best interests. The health, safety and welfare of residents is promoted and protected. EVIDENCE: Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 27 The Registered Manager, Mrs.Parker, has a number of years experience in social care and has known many of the people who live at Gordena for some time. She has attained NVQ Level 2, 3 and 4 and completed the Registered Managers Award. Mrs. Howick, who is both the joint owner of the home and the Deputy Manager, ably assists her in running the home. Both Mrs. Parker and Mrs. Howick undertake periodic training to maintain their knowledge and update skills and levels of competence. Mrs. Parker and Mrs. Howick were working in the home on the day of my visit and supported the inspection process fully. The management approach remains open and positive, with a clear sense of direction and leadership. The ethos of the service is person centred with the views of residents central to this process. Staff spoken with said their views are always listened to, and that they are well supported by the managers. Through discussion with the Managers, staff members and a number of residents it was evident there continues to be an inclusive atmosphere within the home. The residents remain the focus of the service and the Managers are keen to develop the person centred approaches. The involvement of residents in both the day-to-day running of the home and in proposed developments or improvements of the service remains high. There are regular house meetings, although individuals told me they are able to speak with the Managers or other staff at any time about their service. Gordena has comprehensive policies and procedures in place, which are designed to ensure it complies with the law and remains aware of good practice guidelines. Full details of each policy were provided on the AQAA completed for the CSCI as part of this Key Inspection process. Most of the records I required to complete the inspection are stored in the home’s office, situated on the top floor of the house. Each one was easy to locate and follow its contents. If any records were currently being updated, these were also shown to me by the Manager. There are recording systems in place to support Health and Safety within the home, which are being used consistently. Records examined included fire drills, fire alarm system checks, fire fighting equipment checks, hazardous products which are used in the home, risk assessments, the safety of gas appliances and portable electrical appliance testing. All of these records were in order and checks were up to date. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 28 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 X 3 X 4 X 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 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 2 12 2 13 3 14 3 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 3 3 X Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO 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 YA23 Regulation 17(2) Requirement Records of valuables deposited by residents must be regularly updated and kept as part of each person’s care plan. Timescale for action 07/08/07 2. YA33 18(1)(a) The home must review staffing levels to ensure residents’ changing needs are appropriately supported. 07/11/07 Each member of staff must be supervised on a regular basis. 07/08/07 3. YA36 18(2) 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. Refer to Standard YA6 YA6 YA18 Good Practice Recommendations The home should complete the development of ‘person centred plans’ for each resident. The frequency of the current ‘Monthly Inspection Reports’ for residents should be reviewed and then be kept up to date. The home should complete the review of each resident’s DS0000064848.V340473.R01.S.doc Version 5.2 Page 30 Gordena Care Homes 4. 5. 6. 7. 8. YA21 YA23 YA24 YA35 YA35 intimate care guidelines. The home should complete the review of individual’s wishes in the event of their death. The home should complete the review of each resident’s challenging behaviour guidelines. The home should proceed with plans to develop the environment. The home should consider reviewing the induction process for new staff to ensure this is in line with the ‘Sills for Care’ Induction Standards. The home should update each staff-training matrix every time staff complete a training course or session. Gordena Care Homes DS0000064848.V340473.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Southwest and Regional Office 4th Floor Colston 33 33 Colston Avenue Bristol BS1 4UA 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.V340473.R01.S.doc Version 5.2 Page 32 - 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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