Inspection on 14/02/06 for Gowlands

This inspection was carried out on 14th February 2006.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gowlands 10/05/07

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 14th February 2006 13:00 Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Gowlands Address Sutton Bridge Farm Sutton Road Rochford Essex SS4 1HJ 01702 541761 01702 531668 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) Hamelin Trust Ms Cheryl Ann Dibley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 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 8 (eight) younger adults. Personal care to be offered to no more than 8 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 eight (8). 25th July 2005 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 service users. 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 cares in the community. Gowlands is run by Hamelin Trust who have a website available on www.hamelintrust.org.uk. Gowlands prefers to call its service users 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 recently developed wheelchair trails. There is adequate car parking facilities to the rear of the home. Internally Gowlands has spacious communal accommodation. All bedrooms are for single occupancy and are situated on the ground and first floors. A sensory room and activities room are located on the second floor. Upper floors are accessible to guests via a passenger lift. 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. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of four hours. On the day of inspection seven guests were being accommodated at Gowlands. As it was half term only two guests were attending their regular day care placements, they returned to Gowlands during the afternoon. On the inspectors arrival two guests were at home. Others were out at the cinema with staff and returned in the early afternoon for lunch. A tour of the premises was undertaken. Care, medication, staff and other records were randomly selected and examined. Staff were spoken with and time was spent with the guests, many of who were unable to verbally express their opinion of the service offered at Gowlands. The inspector was assisted throughout the visit by senior and other staff and the registered manager. 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. The home is 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 about the service offered at Gowlands. The home work 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, who has only just started to have stays at Gowlands, was very positive about the experience and the staff at the home. Guests, that were unable to say what they thought, were clearly happy and relaxed at Gowlands. 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. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: 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. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 7 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.V282995.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3, 4, 5. Guests’ needs are always thoroughly assessed before a placement is offered. Development is needed to show the homes involvement in this process. Opportunities to visit the home and experience introductory stays are offered. Staff at the home are trained to meet guests needs. EVIDENCE: The file of a new guest was viewed. This showed that families complete a comprehensive ‘application form’ to seek a place at Gowlands. This information was supported by comprehensive social services assessments, The registered manager confirmed that she would always visit any potential new guest to be sure that the home can meet their needs. The homes part in the assessment and information gathering process is not currently documented, but ways to evidence this are under development. According to individual needs, guests always have a phased approach to beginning their stays at Gowlands. Starting with a brief visit and overnight stays gradually building up to full stays. Evidence of this was seen on a new guests file. Discussion with staff and some training documentation viewed showed that staff are offered appropriate training to meet the individual needs of guests. This included training in communication techniques and in managing challenging behaviour. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 9 Contracts/statements of terms are not currently issued to inform guests and their families about the services offered and fees charged. The registered manager said that work to develop this will be undertaken soon. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Guests care plans reflect their needs and show that the home tries to maintain their established and preferred routines during their stay. Guests are encouraged to make choices and decisions in their daily lives. Risks are assessed. EVIDENCE: All guests staying at Gowlands have an established care plan in place that is regularly reviewed. Those viewed highlighted guests physical, health and social needs. Care plans are reviewed before each stay and new or additional information provided by families/ carers. This enables that all information is up to date and accurate families have just been asked to re-complete ‘application forms’ and verify various activity permissions. 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 are proactive in this area and constantly looking to improve communication strategies. Any individual specialist aids are brought in by guests to assist communication during their stay. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 11 Risks associated with each guest are assessed. In some cases placement is offered on a one to one or two to one basis for all or some of the day to reduce the level of risk, and keep guests and staff safe. Permission is sought from parents for all activities such as horse and aromatherapy Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 14, 17 As far as possible guests continue with established daytime routines during their stay. Other activities and outings are arranged. Routines are flexible and guests nutritional needs and food choices are taken into account. EVIDENCE: Guests are assisted to maintain their normal routines and attend their normal day care facilities and clubs during their stay. On the day of inspection two guests were attending their normal day care placements. Other guests were on their half term break and had enjoyed a trip to the cinema. Gowlands provide a good level of activities for guests both inside and away from the unit. A well equipped sensory room and activities room are available and enjoyed by guests. A sensory garden has been developed and is now well established for guests to enjoy. The home has newly developed paths so that wheelchair users can access more areas of the homes grounds. Transport is available to assist guests in making full use of local community facilities. Guest 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 DS0000018106.V282995.R01.S.doc Version 5.1 Page 13 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 and these are well managed by the home. During the inspection guests were offered choices about what they would like to eat and drink. These choices were respected and upheld by staff. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Gowlands aim to provide a service and maintain routines that help guests to feel comfortable and at home. Guest’s health and welfare is monitored at all times. Medication is managed safely. 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 and nonverbal signals. 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. To ensure guests wellbeing their condition is consistently monitored. Any marks/bruises etc are noted and investigated when appropriate. As Gowlands offers only short term respite placements guest’s families have their own arrangements in place for all healthcare support that may be required. If the need arose these services would be accessed by the unit in consultation with the family or contact person. During their period of stay, Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 15 guests may 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 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. Medication is managed safely at the home. Records demonstrate that all medication brought into the home is clearly documented. There are medication profiles for each service user. The home does have some difficulty in getting medication adequately labelled by the GP/pharmacist. Some medication was labelled to be taken ‘as directed’. The home is trying to work with families to resolve this. As at the previous inspection staff at the home are waiting for update training in the administration of rectal medication to control acute episodes of epilepsy. The registered manager confirmed that they have now found someone to deliver this update training. The home uses a ‘buddy’ system for the administration of medication. To aid this process it is now planned that all grades of staff will complete a medication training workbook to increase their understanding and skills. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 To ensure that guests are cared for safely staff are trained and aware of child and adult protection issues. EVIDENCE: Gowlands are registered to provide a service to guests who are between 16 and 18 years of age. In recognition of this, in addition to adult protection training, staff confirmed that they had completed the NSPCC sponsored programme ‘Full Stop’. Guest’s behaviours are fully assessed and monitored. Staff spoken with confirmed that they had recently received appropriate training in managing challenging behaviour. PRICE training is also currently being undertaken by staff. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Guests stay in a safe and homely environment that is able to meet their needs. EVIDENCE: Gowlands is specifically for guests using a respite care service. The home is a large detached house, which stands in its own extensive 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. In one area of the grounds, the home has created a large sensory garden for the benefit of guests. In another area tracks have been made to assist wheelchairs users to reach the pond area. As at the previous inspection plans are in hand for the replacement of some furnishings. Plans are also in hand to replace the flooring in the dining and other areas of the home. 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. One guest spoken with said that they really liked their room. Each bedroom has a wash hand basin. Toilet and bathrooms are located nearby to each bedroom. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 18 Bathrooms and toilets at Gowlands were bright, well presented and suitable to meet the needs of guests. Bathrooms and toilets were large enough to allow for wheelchair access and staff assistance. Gowlands provide a good range of moving and handling equipment appropriate to meet the needs of guests with an often high level of disability. Track hoists and a mobile hoist are available. Since the previous inspection the home have acquired a new bathing seat aid, which is proving popular with the guests. If guests require individual specialist equipment this is brought in with them for their stay. Guests are assisted throughout the building by the use of appropriate signage, symbols, tactile areas and photographs. Specific needs (such as the use of moon symbols) are used on an individual basis as required. On the day of inspection the home was clean and odour free. The homes laundry area is small, but functional and able to meet guest’s needs. On the day of inspection the homes large washing machine had broken down, but the situation was being managed effectively by staff. The homes kitchen is open plan so that guests can see what is going on. It is also large enough for guests to participate when able. During the inspection one guest enjoyed assisting staff in the kitchen. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34, 35. Guests are protected by safe recruitment practices being maintained. Staff are well trained and able to meet guests’ needs. EVIDENCE: Staff files showed that all relevant checks and processes are carried out before staff start work at the home. Hamelin Trust provides a comprehensive off site seven day induction for all new staff. Ongoing induction then takes place in the home. The booklet used for this was seen to be well completed for one new member of staff. Hamelin Trust have their own training organisation. A recent core skills audit has identified the twelve essential training courses that staff at Gowlands need to complete. A list of each individual staffs current training has been compiled and shortfalls to be worked through identified. The registered manager said that staff are being trained/updated as quickly as possible. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Guest’s stay in a well run home that is focused around meeting their needs in a safe and effective way. EVIDENCE: The registered manager at the home is well trained and very experienced. She is currently investigating what units need to be completed in order to achieve the Registered Managers Award. 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 regular monitoring Hamelin Trust carry out regular monthly visits to the home. Senior staff at Gowlands are 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 is to review all the homes policies and procedures. Some health and safety records were randomly sampled and found to be satisfactory. Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 21 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 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 X 13 3 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Gowlands DS0000018106.V282995.R01.S.doc Version 5.1 Page 22 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. Standard Regulation Requirement Timescale for action 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 YA2 YA5 YA19 Good Practice Recommendations The home should be able to evidence their involvement with assessment and planning process for new admissions. A statement of terms and conditions should be developed for guests/those acting on their behalf. Staff should receive all the training they need to meet guests assessed needs. This refers to the need for training in the administration of rectal preparations to be provided. 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