Inspection on 10/05/07 for Gowlands

This inspection was carried out on 10th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Gowlands 14/02/06

Gowlands 25/07/05

Gowlands 28/10/04

Gowlands 10/06/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Gowlands Sutton Bridge Farm Sutton Road Rochford Essex SS4 1HJ Lead Inspector Ms Vicky Dutton Unannounced Inspection 10th May 2007 10:00 Gowlands DS0000018106.V339367.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 Gowlands DS0000018106.V339367.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. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gowlands Address Sutton Bridge Farm Sutton Road Rochford Essex SS4 1HJ 01702 541761 01702 531668 gowlands@hamelintrust.org.uk www.hamelintrust.org.uk Hamelin Trust 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) Ms Cheryl Ann Dibley Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The number of service users to whom personal care is to be offered shall not exceed 9 (nine) younger adults. Personal care to be offered to no more than nine younger adult service users with a learning disability (LD). The age of service users for whom personal care shall be provided shall be sixteen or over. The maximum number of individuals to be accommodated shall not exceed nine (9). 14th February 2006 Date of last inspection Brief Description of the Service: Gowlands is a large detached, three-storey house, which has been extended to provide a good standard of accommodation for guests. The home does not provide any long-term care, but specialises in providing regular respite care for people with learning disabilities who are living with family or carers in the community. The home’s registration enables them to take young people who are aged between sixteen and eighteen, as well as over eighteen. Gowlands is run by Hamelin Trust, a registered charity. People using Gowlands prefer to be called ‘guests’. The home is situated in a semi rural area, and has extensive grounds, all of which are accessible to guests. The grounds include a sensory garden and wheelchair trails. There are car parking facilities to the rear of the home. Internally Gowlands has spacious communal accommodation. Each guest has a single room. Bedrooms are situated on all floors of the home. Upper floors are accessible to guests via a passenger lift. A sensory room and activities room are located on the second floor. Bathrooms and toilets are suitably adapted to meet the needs of guests. Gowlands has its own transport to enable service users to access all the local community facilities. The previous inspection report is made available to guests and their families A Statement of Purpose and Service Users Guide are also available. The nightly charge as quoted in the home’s Pre Inspection Questionnaire is £230.71 to £501.07. The range of fee relates to the level of staffing required by individual guests e.g. one to one. There are no additional charges to guests, although there is an expectation that guests will bring in personal spending money for use during their stay. Gowlands DS0000018106.V339367.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 ‘key’ site visit. The visit took place over a six and a half hour period. At this inspection all the key standards were considered. The home had no previous requirements. Prior to the site visit the home had submitted a pre-inspection questionnaire and provided additional information that assisted with the inspection process. At the site visit a tour of the premises took place, care, staff, medication and other records and documentation were selected and various elements of these assessed. During the site visit time was spent interacting with guests, most of whom had limited verbal abilities. Pictorial surveys were left with the manager for use with those residents who are unable to verbally express their views about the home. Some of the home’s staff were spoken with. Prior to the site visit many surveys were received from families who all made positive comments about the service offered by Gowlands. Further surveys were left at the home, including staff surveys for any who wished to complete these. The views expressed at the site visit and survey responses have been incorporated into this report. The inspector was assisted at the site visit by the registered manager and other members of the staff team. Feedback on findings was given throughout the visit with the opportunity for clarification or discussion. A feedback card on the inspection process was left at the home. The inspector would like to thank the manager, staff team, residents, relatives and visiting professionals for their help throughout the inspection process. What the service does well: Gowlands offers a respite service to guests who have a range of complex needs. Currently the home has approximately 90 guests who use the service on a regular basis. The organisation required to offer this service, with such high satisfaction rates, is extensive. The management and staff at Gowlands achieve this, and achieve it in a way that ensures that guests’ very individual needs are understood and met. Management and staff at the home are always looking for ways to develop and improve the service for the benefit of the guests. Feedback questionnaires are routinely sent to parents/carers to complete after each stay. These showed a high level of satisfaction with the service offered at Gowlands. Feedback on CSCI surveys was also very positive, and many comments such as ‘very pleased with Gowlands’ and ‘Gowlands is a very well run and happy establishment, that always feels a happy and fun place to be’ Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 6 were made. Positive feedback was also received from a visiting professional who made many favourable comments including ‘staff appear very caring and experienced in ensuring that all service users are treated as individuals with their healthcare needs met in every way.’ The home works hard to, as far as possible, provide consistency for guests who use the service. For example, by using the same bedroom and key worker for each stay. One guest spoken with said that they ‘were happy at Gowlands.’ Guests, who were unable to say what they thought, were clearly happy and relaxed at Gowlands. On the day of the site visit, for some regular guests, it was their first night of another stay at the home. They came in from their day care placements full of enthusiasm, clearly very happy to see old friends and staff at the home again. Gowlands provides a comfortable and stimulating environment for guests. A sensory room, activities room and sensory garden are all available to them during their stays at the home. What has improved since the last inspection? What they could do better: Management need to continue to work with families to make sure that guests’ medication is managed in the safest way possible. Staff at the home are generally well trained and able to meet guests’ needs. However some improvements could be made. Update training should be provided in a timely manner so that staffs’ skills are kept up to date. Thought should be given to how medication training to meet the particular needs of the service and staff at Gowlands can best be delivered. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 7 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. Gowlands DS0000018106.V339367.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 Gowlands DS0000018106.V339367.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): 2, 3, 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests using Gowlands can be sure that the service will assess and meet their needs. EVIDENCE: Guests’ individual files showed that families complete a comprehensive ‘application form’ to seek a place at Gowlands. This information is supported by education/social services assessments. It was confirmed by the manager that staff from the home visit the potential guest at home/school/day care to assess their needs and the suitability of offering a placement. At the moment the home uses a blank care plan format to record this process. One seen had been well completed. The manager said that the current system is to be improved on. According to individual needs, guests always have a phased approach to beginning their stays at Gowlands. A family member confirmed that their relative had visited the home for ‘tea visits’ and that two overnight stays had so far been attempted. Discussion with staff, and training documentation viewed showed that staff are generally offered appropriate training to meet the individual needs of guests. However many guests using the service have limited verbal communication Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 10 skills. From training information provided many staff at the home have yet to complete training in ‘Inclusive Communication’ that might help them to work more effectively with individual guests. A new guest, whose first stay was planned two days after the site visit, has been diagnosed with diabetes. Staff had received training in this area, and it was seen that their care plan was prepared ready with copious information and instruction about the management of their condition. Gowlands DS0000018106.V339367.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests can expect to receive good support and care during their stay at Gowlands. They will be supported to make individual choices. EVIDENCE: Families felt that their relatives received good care at Gowlands ‘they are looked after very well,’ and ‘my relative receives excellent care at Gowlands’ were two of the many positive comments received. All guests staying at Gowlands have an established care plan in place that is regularly reviewed. Those viewed highlighted guests’ care, health, behavioural and social needs and provided a good basis for care to be delivered. Since the previous inspection work to improve care planning at the home has taken place, and further improvements are planned. Care plans viewed showed a much greater level of detail and provided good information for staff. Many guests using Gowlands have complex needs and care plans reflected this. Care Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 12 plans are reviewed before each stay and new or additional information provided by families/carers incorporated into the plan. Staff explained that the home has an effective key worker system in place that helps to support consistent care for guests during their stays. The manager said that this system was now being extended to include night staff working at the home. As far as possible guests are encouraged to make choices. Different communication aids such as symbols and photographs are available to assist this process. The home is proactive in this area and constantly looking to improve communication strategies. Since the previous inspection, information boards have been changed to incorporate photographs (rather than purely symbols) of guests’ day care placements etc. The home feels that this has improved guests’ comprehension. As seen in one bedroom any individual specialist aids are brought in by guests to assist communication during their stay. Risks associated with each guest are assessed. In some cases placement is offered on a one to one or two to one staffing basis for all or some of the day to reduce the level of risk, and keep guests and staff safe. In one case a generic risk assessment in place had not been reviewed in a timely manner and did not incorporate an assessment for bed rails that were in place. This could a pose a potential risk. The manager undertook to address this. Permission is sought from parents for all activities such as horse riding and aromatherapy. Gowlands DS0000018106.V339367.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 excellent. This judgement has been made using available evidence including a visit to this service. Guests at Gowlands will have the opportunity to take part in suitable activities, and will be supported to carry on with their preferred routines. EVIDENCE: Guests are generally assisted to maintain their normal routines and attend their regular day care facilities and clubs during their stay. Where this is not possible due to distance guests undertake alternative activities/outings during their stay. On the day of the site visit all guests were attending school or a day care facility. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 14 Families confirmed that guests using Gowlands enjoyed the lifestyle provided at the home. Comments such as ‘it certainly ticks all my relative’s boxes,’ and ‘really enjoys their stay and is always looking forward to the next visit.’ Were frequent. Gowlands provides a good level of activities for guests both inside and away from the home. A well equipped sensory room and an activities room are available and enjoyed by guests. The home’s lounge areas also provide plenty of equipment and opportunities for activity. During the site visit some guests enjoyed a game of pool. A sensory garden has been developed and is now well established for guests to enjoy. The home has developed paths so that wheelchair users can access more areas of the home’s grounds. Transport is available to assist guests in making full use of local community facilities. Guests’ preferences in relation to activities were recorded in care plans. Guests can bring in their choice of belongings and any equipment to pursue individual hobbies or interests during their stay. Gowlands offers a respite service; therefore families are often away during guests’ stays. Relatives are however encouraged to have whatever input they wish. One said ‘you can ring up anytime you want to hear how they are doing’. Another said that they generally visit when their relative stays at Gowlands and are always made very welcome. Care plans reflect how guests are to be supported in a way that encourages maximum independence whilst being cared for safely. Menus are planned and shopping done on a weekly basis. Symbol and picture cards assist guests to make choices. Many guests have individual dietary needs such as diabetes or food allergies and these are well managed by the home through the use of individual dietary information cards. During the site visit guests were offered choices about what they would like to eat and drink. Gowlands DS0000018106.V339367.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests can expect to receive excellent personal and healthcare support based on their individual needs whilst staying at Gowlands. However further work with families, and staff training is needed so that people can be assured that medication is always managed safely at the home. EVIDENCE: Gowlands operates an established key worker system. Whenever possible, the home endeavours to provide the same key worker to each guest throughout their varied periods of stay. Whenever possible, according to ability, and with the use of appropriate communication aids, guests are encouraged to make their own choices in as many daily activities as possible. Observations during this inspection showed that staff are very aware of guests’ needs. Care plans identified guests’ preferred routines such as rising and retiring times. Gowlands has a range of aids and equipment to meet the general needs of guests. Where guests require more specialist and individual equipment to met their assessed needs this is brought with them for their stay. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 16 Care planning, other recorded information and a staff hand over attended showed that guests’ health is carefully monitored by staff at the home. One guest had recently lost weight. Care planning and records showed that this was being monitored and managed well during their stay. A visiting professional said that the home was proactive and ‘often asks our advice to improve individuals healthcare.’ As Gowlands offers only short term respite placements guests’ families have their own arrangements in place for all the healthcare support and specialist care that may be required. If the need arose these services would be accessed by the unit in consultation with the family or contact person. A relative confirmed that ‘they always keep me informed of any problems or concerns during my relatives stay.’ During their period of stay, guests retain the services of their respective GP where the location allows. If this is not possible, the home is registered with a local group practice and there are arrangements for any guest to be seen as a ‘temporary resident,’ should the situation arise. As part of the pre admission assessment process, records showed that an appropriate medical history is noted, and information is sought from the guests’ GP’s. Again any changes in guests’ needs are discussed and recorded prior to each stay. This was confirmed by a relative who said ‘they make a note of any changes on their care plan.’ Medication is generally managed well at the home, but there are areas of risk. Records demonstrate that all medication brought into the home is clearly documented. There are medication profiles for each guest. The home does have some difficulty in ensuring that medication is brought into the home in suitably labelled containers. Some parents retain the same bottles for respite care and decant the appropriate medication into these prior to each stay. This meant that pharmacy labels for the medication of one guest dated from 2000 and 2002, another guest from 2005. This clearly presents an element of risk on several levels. (The medication may be incorrect, not the same medication/dose as on the label, or out of date.) The home is trying to work with families to resolve this. The manager said that staff at the home have a good awareness of the medication taken by guests and would spot any anomalies. A buddy system is used as a further safeguard. It was reported that staff at the home have/are undertaking medication workbooks that are internally verified. Training records identified two types of medication training: medication workbooks and medication distance learning. All four senior staff have completed the workbook training, and some update training. The manager said that updates were supposed to take place on an annual basis, and recognised that there were some shortfalls in this. The most recent update training dates for the four senior staff were 10/04, 02/06, 03/06 and 12/06. No staff at Gowlands have completed the distance learning course. Due to the nature of the service the home does not have a supplying pharmacist to offer support, training and advice. Following the site visit the manager has been in contact with a Community Services Pharmacist, who will be carrying out a visit to the home to assess their procedures and offer support and advice. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 17 Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Guests and their families can to raise any concerns, and have access to a clear complaints procedure. Guests will be protected from abuse during their stay at Gowlands. EVIDENCE: Gowlands has a clear complaints process in place. It was noted that bedrooms and the lobby area contained laminated sheets, which used symbols and pictures to explain to guests ‘what to do if you are sad, angry or worried about something when you come to Gowlands.’ Surveys received from relatives showed that they were aware of the home’s complaints process, but had not had the need to use this as, ‘Staff are always helpful, you can talk to them and they will sort out any queries or problems.’ No complaints about the service have been received by Gowlands or CSCI since the previous inspection. Records showed that staff have attended training in adult protection. As the home is registered to provide a service to guests who are between 16 and 18 years of age some staff have also completed the NSPCC sponsored programme ‘Full Stop’. This deals with child protection issues. Guests’ behaviours are fully assessed and monitored. Staff have received training in managing challenging behaviour. Gowlands DS0000018106.V339367.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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Gowlands is a safe and pleasant place for guests to stay. EVIDENCE: Gowlands is specifically for guests using a respite care service. The home is a large detached house, which stands in its own extensive and wheelchair accessible grounds. Gowlands provides spacious accommodation for service users, which is safe and generally well maintained. A passenger lift provides access to upper floors. All parts of the home are wheelchair accessible. Since the previous inspection a number of improvements have been made to benefit guests who use the service. New sofas and chairs have been provided in one lounge area. The flooring has been replaced in some areas including the dining area and one lounge. Furnishings, flooring and décor in other areas needs some attention/replacement to further improve the environment. It was reported that a general hand is now being recruited to work throughout Hamlin Trust and help with maintenance and decorating tasks. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 20 All the bedrooms at Gowlands are single and spacious. Guests are encouraged to bring in personal items to enable them to individualise the bedroom they occupy. Whenever possible, guests occupy the same bedroom that they have used on previous stays. Many have a favourite room. Each bedroom has a wash hand basin. Toilet and bathrooms are located nearby to each bedroom. On the day of the site visit the home was clean and odour free. The home’s laundry area is small, but functional and able to meet guests’ needs. On the day of inspection the home’s large washing machine had broken down, but the situation was being managed effectively by staff. The home’s kitchen is open plan so that guests can see what is going on. It is also large enough for guests to participate when able. Gowlands DS0000018106.V339367.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be assured that staff at Gowlands are safely recruited and given suitable training to help them to meet the needs of guests staying there. EVIDENCE: Relatives provided positive feedback about the staff at Gowlands. One said ‘the staffs’ care and interest in our relative and the whole family has always exceeded our expectations. It is an exceptional place.’ During the site visit guests were happy and relaxed with staff. Staff at Gowlands receive a good level of training to assist them in caring for guests. Thirty two care staff work at the home. Ten of these staff currently hold a National Vocational Qualification (NVQ) at level two or above. A further two staff are currently working towards this qualification. The files of two recently recruited staff showed that guests are protected by good recruitment procedures being in place. The files viewed detailed that Criminal Records Bureau checks had been undertaken, references obtained and other processes carried out before staff start work at the home. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 22 Hamelin Trust is still working towards better organising training information so that staff training undertaken, and training and development needs are clearly identified on individual profiles. Hamelin Trust has their own training organisation. This ensures that new staff are trained and ready to work with guests by providing a comprehensive induction programme. A seven day off site induction training is provided. The seven training days are interspersed with time working with experienced staff at Gowlands. The booklet used to record the six week induction programme was seen to be well completed for one new member of staff. Gowlands DS0000018106.V339367.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, 39, 44 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guests will stay in a well run home that is focused on meeting their needs in a safe and effective way. EVIDENCE: The registered manager at the Gowlands is well trained and very experienced. Due to their prior leaning and training the manager only needs to complete two units to gain the Registered Managers Award. A training provider is being sought so that this can be achieved. The home are proactive in monitoring and improving the service they offer to guests. After each stay families are asked to complete a questionnaire on the service provided, and to assess if the guest enjoyed their stay. The questionnaire responses viewed showed a high level of satisfaction with the service offered by Gowlands. As part of quality monitoring Hamelin Trust carry Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 24 out regular monthly visits to the home, (as required by regulation.) Other internal audit processes are in place such as medication audits. The home has however yet to tie all these elements together to form an overall quality assurance strategy that provides an annual development plan for the home. At the previous inspection of the home it was reported that senior staff at Gowlands were joining together with other Hamelin Trust staff and undertaking a development programme for first line managers produced by Social Care Institute for Excellence. Part of this programme was to review all the home’s policies and procedures. This work has not progressed as expected and most of the home’s policies and procedures have not been reviewed since 2004. The pre-inspection questionnaire completed by management at the home identified that systems and equipment are serviced and maintained. A fire risk assessment was in place and fire records satisfactory. The manager acknowledged, and training records available, showed that there were some gaps in staffs’ training and update training in some core areas such as moving and handling. Further training is planned. Gowlands DS0000018106.V339367.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 X 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 4 X 3 X X 3 X Gowlands DS0000018106.V339367.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. Standard YA20 Regulation 13(2) Requirement Staff administering medication must receive a good level of training, so that this aspect of guests’ care is managed safely. Timescale for action 01/08/07 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 YA4 Good Practice Recommendations Management of the home should continue to provide opportunities for staff to undertake appropriate training that will give them the skills to meet guests’ needs. This includes training in inclusive communication. Work on upgrading and improving the environment for guests should continue. Management at the home should continue to develop quality assurance strategies that link into an annual development plan for the home. The homes policies and procedures should be regularly reviewed and updated. 2. 3. YA24 YA39 Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 27 4. YA42 Staff should be given training and update training in core areas such as moving and handling so that guests are cared for safely. Gowlands DS0000018106.V339367.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG 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. 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