Inspection on 25/07/05 for Gowlands

This inspection was carried out on 25th July 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gowlands 10/05/07

Gowlands 14/02/06

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)

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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 Vicky Dutton Unannounced 25th July 2005 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 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 Stationary 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 I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 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 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 LD Learning Disability (8) registration, with number of places Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users to whom personal care is to be offered shall not exceed 8 younger adults. 2. Personal care to be offered to no more than 8 younger adult service users with a learning disability. 3. The age of service users for whom personal care shall be provided shall be sixteen or over. 4. The maximum number of individuals to be accommodated shall not exceed eight. Date of last inspection 28/10/04 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 living within the community. Gowlands prefers to call its service users “guests”. The home is situated in a semi rural area, which has extensive grounds, all of which are accessible to guests. The grounds include a recently developed sensory garden. 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 service users via a passenger lift. Bathrooms and toilets are suitably adapted to meet the needs of service users. Gowlands has its own transport to enable service users to access all the local community facilities. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a period of five and a half hours. On the day of inspection eight guests were being accommodated at Gowlands. Most guests were attending established day care placements and returned home during the afternoon. On the inspectors arrival two guests were at home. One was able to speak with the inspector briefly before being collected to go home. The other guest went out for lunch with staff. Apart from the guest spoken with briefly all other guests staying at Gowlands on the day of inspection were unable to verbally express their opinion about their stay at the home. A tour of the premises was undertaken. Care, medication and other records were randomly selected and examined. The inspector was assisted throughout the visit by the registered manager and other staff. What the service does well: Gowlands offers a respite service to guests who have a range of complex needs. Currently the home has 85 to 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 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 regularly stays at Gowlands, was very positive about the experience, and always happy to return. Other guests, although 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 I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 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 I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 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 standard(s) 2, 3, 5. Guests’ needs are always thoroughly assessed before a placement is offered. Development is needed to show the homes involvement in this process. Staff at the home are trained to meet guests needs. EVIDENCE: Files of guests sampled 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 said that she would always visit any potential new guest to be sure that the home can meet their needs. To improve continuity the proposed key worker also takes part in this visit. The homes part in the assessment and information gathering process is not currently documented. 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. Contracts/statements of terms are not currently issued to inform guests and their families about the services offered and fees charged. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 9 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 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 and social needs. Care plans are reviewed before each stay and new or additional information provided by families/carers. This enables staff to be kept up to date with guests’ current needs. As far as possible guests are encouraged to make choices. Different communication aids such as symbols and photographs are available to assist this process. 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 basis for all or some of the day to reduce the level of risk, and keep guests and staff safe. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12, 13, 14, 15, 16, 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. 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. Transport is available to assist guests in making full use of local community facilities. During the inspection one guest told the inspector about a trip to Clacton that had taken place over the weekend. 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 I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 11 The home works closely with families to provide consistent care during their stays. Within individual risk assessments and needs guests have unrestricted access to the home and grounds. 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. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 12 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 standard(s) 18, 19, 20 Gowlands aim to provide a service and maintain routines that help guests to feel comfortable and at home. Guests 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. 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. The home tries to meet guests individual needs and preferences about the gender of staff offering care. 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 Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 13 consultation with the family or contact person. During their period of stay, 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. Again any changes in guests needs are discussed and recorded prior to each stay. Medication is managed safely at the home. Guests current medication regimes are confirmed with family/carer before each stay, and a form sent into the unit. Guests bring in their own medication with them on each period of respite stay. Records demonstrate that all medication brought into the home is clearly documented. There are medication profiles for each service user. At the end of the respite period, any remaining medication is returned to the family/carer and this procedure is clearly recorded. Staff confirmed that they had undertaken medication training. At the moment staff at the home are waiting for update training in the administration of rectal medication to control acute episodes of epilepsy. This means that sometimes additional hospital visits are needed, or families to be contacted for assistance. Records sampled were found to be satisfactory. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 14 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 standard(s) 22, 23 The home has a complaints procedure in place. To ensure that guests are cared for safely staff are trained and aware of child and adult protection issues. EVIDENCE: The home has an established complaints procedure in place. No complaints have been recorded by the home or received by the CSCI. 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, all staff at Gowlands are currently completing the NSPCC sponsored programme ‘Full Stop’. Guests behaviours are fully assessed and monitored. Staff spoken with confirmed that they had received appropriate training in managing challenging behaviour. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 15 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 standard(s) 24, 25, 27, 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. Plans are in hand for the replacement of some furnishings. To improve the environment further flooring in various rooms around the building would benefit from replacement as some carpets are stained. 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. Each bedroom has a wash hand basin. Toilet and bathrooms are located nearby to each bedroom. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 16 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. 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 guests needs. Protective clothing and other equipment was noted to be available. For the safety and dignity of guests the storage of these items needs to be monitored. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33. Staffing levels are planned around each group of guests individual needs. Guests are supported by well trained staff. EVIDENCE: Hamelin Trust provide a comprehensive seven day induction for all staff. The registered manager said that this course runs every month so that established staff can update core skills as necessary. Staff spoken with confirmed that training had been undertaken in a range of appropriate areas, enabling them to meet the needs of guests staying at Gowlands. The registered manager said that four staff have achieved NVQ at level three, and that a further nine staff are currently completing this. An NVQ assessor visited the home during the inspection. The homes rotas showed that staffing is flexible at Gowlands, and that they are constantly adjusted to meet the individual needs (and purchased service) of the guests accommodated at any one time. The home does not seem to have set established hours, so this makes it difficult to assess the level of staff vacancies at the home. The home do use a number of bank staff on a regular basis. The registered manager reported that currently 30 to 37 hours of agency staff are used each week. The agency worker present during the inspection confirmed that they regularly worked at Gowlands and knew the guests and routines. Housekeeping hours are provided. The home has still Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 18 been unable to recruit a cook. Additional care staffing hours are allocated to compensate for this and ensure that this task does not take staff away from caring duties. Regular staff meetings are held to assist communication. It was reported that no new staff had been recruited since the previous inspection. Records were not therefore viewed on this occasion. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39, 42 Guests 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. Copies of reports from these visits have not been sent into CSCI as required by regulation. Some health and safety records were randomly sampled and found to be satisfactory. Although relevant professionals have stated that the system is fully safe the home are still seeking a full electrical compliance certificate. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 x 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Gowlands Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 39 Regulation 26 Requirement Copies of reports undertaken under regulation 26 of The Care Homes Regulations should be sent into CSCI. Timescale for action 01/10/05 2. 42 23 Equipment at the care home must be maintained in good working order. This refers to the need for a current and satisfactory electrical certificate to be available. A copy of this to be sent into the commission when available. Previous requirement date of 01/12/04 not met. 01/09/05 3. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard 2 5 19/20 24 30 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. Stained carpets around the home should be replaced if they cannot be cleaned to a satisfactory level. Appropriate storage for gloves and other items should be maintained. Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex, SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Gowlands I56-I06 S18106 Gowlands V240780 250705 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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