Inspection on 28/01/09 for Gypsy Corner

This inspection was carried out on 28th January 2009.

CSCI found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Gypsy Corner Badgeworth Lane Badgeworth Cheltenham Gloucester GL51 4UH     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Simon Massey     Date: 3 0 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Gypsy Corner Badgeworth Lane Badgeworth Cheltenham Gloucester GL51 4UH 01242861375 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): gypsy@kentwoodsupport.com Kentwood Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 5 The maximum number of service users who can be accommodated is 5. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning Disability (Code LD) Date of last inspection Brief description of the care home Gypsy Corner is a registered home for adults with Learning Disibilities that has also been equipped to meet the needs of physical disibilities. All the bedrooms have ensuite facilities and also external doors to the garden. The bedrooms are equipped with overhead tracking systems and specialised beds and the ensuite bathrooms contain appropriate bathing facilities. There is also an additional bathroom for communal use that has specialised adaptations in place. All accommodation is arranged on one level, the home being a converted residential bungelow. The home is close to local amenities and is a short drive from the town centre of Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home Cheltenham. The Registered Provider is Kentwood Care, which is owned and run by Lifeways Community care. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on 28th and 30th January 2009. The Inspector met with the acting manager, several care staff and observed staff working with the service users. Records relating to care planning, medication, staff recruitment and training and health and safety were examined. An inspection of the environment was also carried out. A number of questionnaires were distributed and returned from relatives, staff and outside professionals involved with the home. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments are completed on prospective service users who have opportunities to visit and stay prior to moving into the home. The Statement of Purpose needs to better reflect some aspects of the environment. Evidence: The home had been open for six months at the time of this inspection and there were currently two vacancies. Records showed that assessments had been completed prior to admission. Some issues were identified during this inspection about the environment regarding the space available in the home when it is accommodating several wheelchair users. For example the kitchen and laundry areas are inaccessible to wheelchair users. The home is equipped to a high standard to meet the needs of physical disabilities but the space limitations should be better reflected in the Statement of Purpose. The Commission has been informed that some changes are planned for the environment and when these have been implemented the Statement of Purpose and Service User Guide should be reviewed and amended to reflect these changes. Care Homes for Adults (18-65 years) Page 9 of 26 Evidence: Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Detailed care plans ensure that the service users needs are documented and guidance is available to staff. The home takes action to encourage service users to make choices and supports them to take appropriate risks. Evidence: All service users have detailed care plans in place that have been built on assessments. These plans are reviewed regularly and staff spoken with demonstrated a good awareness of the guidance and the individual needs of the service users. The care plans contain details of needs and cover all areas of care and support. There is a daily information file for staff which gives clear guidance on the routines to be followed. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported to pursue their interests and hobbies, and are able to access the local community with support. Evidence: Service users are encouraged to eat healthily but their right to choose their diet is respected by the staff team. The home have tried to develop individual routines for service users which incorporate in-house activities and outings and events in the community. The home has the use of three vehicles, all of which are equipped to transport wheelchair users. The menus show that healthy diets are promoted and that the staff encourage the service users to make choices, with the use of pictures and discussions at service user group meetings. The kitchen was well stocked with fresh and packaged food and all Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: items were necessary were correctly labeled and stored. there was some criticism from relatives about the development of activities during the initial stages of the home being open but evidence was seen that efforts are being made to access appropriate day-time activities for individuals. This includes horse riding, swimming, college courses and trips out into the community. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal and health care needs are met, promoting their dignity and wellbeing. Satisfactory arrangements are in place for the handling of medication, promoting service users wellbeing and, where appropriate, their independence. Evidence: Good records were seen of health appointments and there was evidence that the staff monitor health issues and take the appropriate action. All service users have Health Action Plans in place and thee were up to date. The personal files contain good information about health needs and everyone has had a moving and handling assessment completed. Staff demonstrated they were aware of the individual needs and the importance of respecting privacy and maintaining individuals dignity. Service users are supported to access the specialist services of the local Community Learning Disabilities Team if required. All medication was correctly stored and the administration records were up to date. All staff must complete training before they are assessed as being competent to perform this task. All medication is audited on a regular basis by the management Care Homes for Adults (18-65 years) Page 14 of 26 Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has satisfactory arrangements and procedures in place for the protection of service users. Arrangements and help are in place to enable as far as possible people using the service to raise concerns and complaints. Evidence: There is complaints policy in place and action has been taken by the home to ensure that all relatives and people involved with the service are aware of this and how to access it. Training around communication and the use of various visual aids help the staff to seek the views of the service users, and also encourage people to make decisions about their daily lives. It would be difficult for most of the service users to make a complaint without support or intervention from the staff, but people are further protected by the involvement of the families in the lives of the service users. The acting manager explained how the home are developing a pictorial, or visual version, of the complaints procedure which will further help protect service users with communication difficulties. Systems are in place for the recording of any injuries that may occur, these are documented on charts in the personal files. Staff have received training in Adult Protection issues. There are systems in place for the managing of the service users personal monies and two samples of these records were checked and found to be in order. All expenditure was receipted and double signed. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The lay out of the home places some limitations on the activities of service users and these need to be better reflected in the Statement of Purpose Evidence: The home is a converted bungalow which has been equipped to a high standard to meet the needs of people with learning disabilities who also have physical disabilities. All bedrooms have overhead tracking lifting systems with en-suite facilities. There are also additional bathrooms which have specialized bathing equipment. Generally the home has been fitted and decorated to a high standard. However there are some limitations to the design and layout of the home. The kitchen is very small and is inaccessible to wheelchair users, as is the laundry area which is adjacent to the kitchen. When the home was registered the Commission was informed that the home would be accommodating service users who would be Peg. fed and that the kitchen would therefore only be needed for staff. Peg feeding is when people can only be fed a specialised liquid diet directly into their stomachs through a tube.This has turned out not to be the case, with all of the present service users eating normally, though with staff assistance. It would be preferable for people to have access to the kitchen even if their abilities to participate are limited. The limitations to the kitchen should be clearly stated in the Statement of Purpose and the home should not admit service users. the Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: bathrooms are well equipped but whilst there is frosted glass in place none of the bathrooms have blinds or curtains in place to promote privacy. The lounge and dining area is reasonably large but is also a thoroughfare from one side of the home to the other. When it accommodates several wheelchairs space can be a limited. This problem has been commented on by relatives and staff, particularly in respect of one person who is able to self-propel their wheelchair. There is limited space for this person to maintain this skill without impacting on the other users of the room. Whilst each bedroom has an outside door which accesses the garden area, there is a step down from these doors which is not ideal. The garden area is level but a large part of the drive way has been laid with a gravel which is impractical for pushing wheelchairs. Parts of the pathway to the rear of the house are also very slippery and require cleaning. All areas of the home were clean and hygienic and appeared well maintained. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from motivated staff that have a positive approach to their care and support. Evidence: At the time of this inspection there were three staff on duty, which was sufficient OT meet the needs of the service users. Since the home opened there have been occasional staff shortages which has resulted in some staff having to work to extended shifts and some concerns have been expressed about this by relatives.There is now only one vacancy and the rotas evidenced that the correct staffing levels are maintained and that excessive hours are not being worked. All staff had completed or were undertaking the induction training that is required. Staff interviewed were positive about this training. Staff said they had received the information and support they required during their induction. Some staff also commented that they found the protocols and guidance easy to follow and that generally information was easy to access. There were records of regular supervisions, staff meetings and staff training. Records showed that the correct recruitment procedures were followed and that the required checks had been completed on new staff. Feedback from questionnaires was very positive about the care and support provided Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: and the approach taken by the staff team. Some criticism was made of the ability of the staff to deliver some aspects of the care due to staffing levels but observation of practice and interviews with staff demonstrated to the Inspector that staff had a good understanding of needs and were committed to improving and developing the service and the quality of care and support provided. Several staff commented that they worked well as a team, with good support and communication between individuals. Staff were observed communicating appropriately and professionally with service users. Additional training is being provided in Total Communication. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a home that is well managed and organized and committed to providing quality care and support with systems in place to help to monitor and improve the quality of the service. There is a need for the Provider to appoint and register a permanent manager. Evidence: There is currently an Acting Manager in charge of the home as the registered manager left their position three months after the home opened. The Commission was yet to receive an application for the new manager at the time of this inspection. It was evident from the feedback from questionnaires that there had been some difficulties during this period but relatives and staff were positive about the efforts made by the Acting Manager to address issues around staffing, the environment and some care practice issues. Staff said they were well supported and that they were able to communicate well with the management of the home. The administration of the home was well organized, with all paperwork seen up to date. Systems in place were well organized and information was easy to access. Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: Staff have been receiving regular formal supervision. All health and safety checks had been completed on a regular basis and correctly recorded. The fire safety records were up to date with all checks having been completed. The home has an up to fire risk assessment in place. The Provider has undertaken regulation 26 visits to the home and provided reports and feedback to the acting manager. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 Home must review and update Statement of Purpose Statement of Purpose must reflect the limitations that the environment may place on some service users 04/05/2009 2 37 8 The home must register a manager The home has had an acting manager in place for six months 28/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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