Inspection on 10/03/06 for Hft - Gaston And Dolphin Houses

This inspection was carried out on 10th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hft - Gaston And Dolphin Houses 21/10/08

Hft - Gaston And Dolphin Houses 02/10/06

Hft - Gaston And Dolphin Houses 16/08/05

Hft - Gaston And Dolphin Houses 10/03/05

Hft - Gaston And Dolphin Houses 22/11/04

Hft - Gaston And Dolphin Houses 16/03/04

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Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hft - Gaston And Dolphin Houses 7 Waterloo Road Bidford On Avon Warwickshire B50 4JP Lead Inspector Catherine Mundy Unannounced Inspection 10th March 2006 08:20 Hft - Gaston And Dolphin Houses DS0000004244.V286190.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 Hft - Gaston And Dolphin Houses DS0000004244.V286190.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. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hft - Gaston And Dolphin Houses Address 7 Waterloo Road Bidford On Avon Warwickshire B50 4JP 01789 490664 01789 772790 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) www.hft.org.uk Home Farm Trust Ms Sarah Coleman Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: The home is located on rural campus on the outskirts of a village in South Warwickshire. There is another similar home, the parent body’s offices and a large resource centre on the same site, which is used by most service users. The home consists of a single property divided into two living units for five and four service users, respectively. All have varying degrees of learning disabilities and some have a degree of physical disability. The home is near to the village of Bidford-on-Avon, where there are a number of local amenities. Stratford is approximately 9 miles away, Redditch is 12 miles and Evesham is 8 miles away, where there are a variety of facilities available. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second inspection of this home in the 2005/06-inspection year. This inspection focuses on the key standards that were not inspected during the previous inspection and upon the requirements that were made at that time. For a full overview of this service this report should be read alongside the report written following the inspection that took place on 16th August 2005. This inspection took place on 10th March 2006, between 8.20 am and 12.20 pm. The inspection was unannounced, it included a tour of the home, examination of records relating to the residents and the management of the home, discussions with residents, staff and the registered manager and observations of the interactions between the residents, staff and their environment. In addition the home has provided a pre-inspection questionnaire and feedback cards have been received from four residents and one relative. The comments made have been included in the body of this report. What the service does well: The inspection took place over breakfast time, the residents were observed to be supported in a way that reflects their identified needs, breakfast time was calm and relaxed, with the staff spending time chatting with the residents. Observations during the inspection and discussions with the residents indicated that they are comfortable, relaxed and feel safe in the home. The feedback received from the residents is very complimentary of the home. During the inspection the residents were supported in a sensitive way that promotes their dignity and independence and reduces their anxieties, the home had a jovial atmosphere. Care plans examined detail precisely the level of support that each individual resident requires. They are written in a way that allows the staff to quickly and easily identify how the resident’s needs are to be met, enabling the residents to receive care in a consistent way. Observations during the inspection confirmed that the staff follow the care plans. The staff team have worked in the home for a number of years, it is clear that positive relationships between the residents and staff have been formed. The staff have received the necessary training to enable them to fulfil their roles effectively. Feedback from one relative states “My husband and I can not imagine a better place for our daughter to live – she is obviously very happy and completely at home” Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: During the inspection two issues of serious concern were identified. The lounge door in Gaston house did not close properly, this compromises the health and safety of the residents and staff in the event of a fire. The flooring in the dining room of Gaston house and one residents bedroom was not securely fitted, this may cause the residents to trip or fall. The home was immediately required to address these issues. Written confirmation that this has been completed has been provided. The lounge suite in Gaston lounge is broken and the floor seal in Dolphin bathroom requires attention. To maintain the safety of the residents the home must record the date that food items are opened. This requirement was made at the last inspection and remains outstanding. The organisation takes responsibility for completion of quality monitoring of the service provided in the home. With the manager being provided with a report Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 7 detailing the outcomes. The manager should also devise a development plan for the home that addresses the issues raised by the organisation and reflects the views and wishes of the residents 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. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): x EVIDENCE: The standards within this section were not assessed on this occasion. It was noted at the last inspection that the home has an acceptable admissions procedure; compliance with this procedure was not assessed on this occasion, as the home has not admitted a new resident. The home currently has one vacancy. The requirement made at the last inspection to provide each resident with a contract stating terms and conditions of residency in the home has been addressed. Hft - Gaston And Dolphin Houses DS0000004244.V286190.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): 7 The residents are supported to make decisions regarding their every day lives. EVIDENCE: Standards 6 and 9 were not assessed on this occasion as they were met in full at the last inspection of this home. The way in which residents are supported to make decisions differs depending upon the needs and abilities of the residents. Some of the residents are able to make their needs and wishes known verbally, they confirmed that they are consulted in decision making about the issues that affect them. For other residents communicating needs and wishes is reliant upon the positive relationships that have been formed between the staff and residents, staff member’s knowledge of the residents individual methods of communication and their personal preferences. Details of the individual residents means of communication, personal preferences and the level of support required to assist the residents are recorded in detail in the resident’s individual plans of care. Observations of the interactions between the residents and staff, made during this inspection, confirmed that the care provided reflects the guidance detailed in the individuals plan. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 11 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): 16 The resident’s rights are respected; with restrictions imposed where the resident’s safety may be compromised. EVIDENCE: Standards 12, 13, 14 and 15 were not assessed on this occasion as they were met in full at the last inspection of this home. The requirement made at the last inspection to maintain records of the residents diet consumed by the residents has been met. The remainder of standard 17 was not assessed as it was met at the last inspection. The care plans examined, discussions with the residents and observations during the inspection confirmed that the resident’s rights are respected. Care plans detail the resident’s preferences with regard to the care that is provided. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 12 The care plans detail precisely the level of support that is required to assist each resident to attend to their personal care needs, they reflect that the resident’s independence is promoted and maintained. Observations during breakfast time confirmed that the guidance relating to support at meal times is followed by the staff. The residents were observed to move freely around their home. Any restrictions that are in place reflect the residents identified needs and are detailed in the individual residents files. The residents confirmed that they have a key to their bedrooms and are able to keep their belongings securely. During the inspection the residents were able to choose when to spend time alone, some residents chose to watch the television and relax in the lounge whilst others chose to sit to the dining table and chat with the staff. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 13 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): X EVIDENCE: Standards 18 and 19 were not assessed on this occasion as they were met in full at the last inspection of this home. A requirement made in relation to disposal of medications that are no longer prescribed has been met. Training records confirm that the staff who are responsible for the administration of medication have received medications training. The remainder of standard 20 was met at the last inspection and so was not assessed on this occasion. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 the following standard(s): X EVIDENCE: Standard 22 was not assessed on this occasion as it was met in full at the last inspection of this home, other than to note that feedback received from one residents relative is extremely complimentary of the service that is provided, they state that they have not had cause to make a complaint. Examination of training records and discussions with staff confirm that the requirement made for staff to receive training in adult protection has been met. The remainder of this standard was met at the last inspection and so was not assessed on this occasion. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 the following standard(s): 24 Whilst the standard of the environment is generally good further action is required to promote the safety and comfort of the residents and staff. EVIDENCE: Standard 30 was not assessed on this occasion as it was met in full at the last inspection of this home. A tour of the home identified two issues of serious concern and other maintenance issues that require addressing. The lounge door in Gaston house did not shut properly. There is a large gap between the door and the doorframe, this compromises the health and safety of the residents in the event of a fire. An immediate requirement was made for this to be addressed. Since the inspection the home has provided evidence that this has been completed. Floor tiles in one residents bedroom and in the dining room of Gaston house were not securely fitted, this may cause the residents or staff to trip. An immediate requirement was made to make the flooring safe, before the residents returned from their day service. Since the inspection the home has provided evidence that this has been completed. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 16 Discussions during the inspection identified that carpet tiles are not the most suitable flooring for the residents who reside in Gaston house. The tiles in the dining room are marked. The suite in the lounge of Gaston house has broken. The home has made an effort to repair the broken springs. This is not satisfactory as the residents still experience difficulty up from the suite. The bathroom floor in Dolphin house is not properly sealed. With the exception of the issues listed above the environment is comfortable and homely, reflecting the personalities, needs and preferences of the residents. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 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): 32, 34 and 35 The homes recruitment procedures protect the residents from abuse. The residents are supported by a competent and qualified staff team, low staff turn over has enabled positive relationships to be formed and care to be provided in a consistent way. EVIDENCE: The training records and training plan examined and information provided in the pre-inspection questionnaire confirmed that the home has a rolling programme of training which provides mandatory training and training that will enable the staff to meet the residents identified needs. There is evidence that training is regularly reviewed and updated. Examination of the files relating to the two staff members on duty confirmed that the home has acceptable recruitment procedures. The manager confirmed that changes to the staff team are minimal, with no new staff members employed in the past three years. The manager confirmed that should this situation change any new members of staff would be subject to a POVA (Protection of Vulnerable Adults) check prior to commencing employment. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 18 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 and 42 The home reviews aspects of its performance through a programme of self review and consultation with relatives, this would be improved with the completion of an annual development plan, which also reflects the residents views and wishes. Although the home takes some action to promote and maintain the health and safety of the residents and staff, further action is required to ensure that their safety is not compromised. EVIDENCE: The organisation takes responsibility for completion of quality monitoring of the service provided in the home. The manager stated that the organisation send satisfaction questionnaires out to relatives of the residents. This information is collated and a report forwarded to the home. In addition the area manager also completes a quality audit of the service and identifies areas for improvement. The manager stated that she had addressed these. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 19 It was discussed during the inspection that the manager should record the action that she has taken to achieve the improvements identified by the organisation and devise the homes own development plan based upon the views and wishes of the residents. There is evidence that the residents are consulted regarding the care that they receive at house meetings and in regular satisfaction questionnaires, copies of these were available in the residents files. Visits to the home, by a representative of the organisation, are to take place under Regulation 26 of the Care Homes Regulations 2001, every month with a copy of the report made following each visit forwarded to the Commission. Three reports have been received in the six months since the last inspection. Four requirements were made at the last inspection in relation to the health and safety of the premises. The home has taken action to address these by providing heat seals to bedroom doors, as required by the fire officer, completing safety checks of electrical equipment (PAT tests), electrical wiring and gas safety. A requirement to make a record of the date of opening of food items that once opened are to be consumed within a set time period is not met. Please also refer to the ‘environment section’ of this report. The registered manager demonstrated her competency to fulfil her role throughout this and the previous inspection of the home. Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 X 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 X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X 2 X X 2 x Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 21 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 YA5 Regulation 5(1)(b)(c) Requirement Provide a copy of the resident’s contracts of residents to the Commission for Social Care Inspection. Timescale for action 30/04/06 2 YA24 3 4 YA24 YA24 5 YA39 This requirement has been made at previous inspections of the home. 23(2)(a)(b) The provider must ensure that the flooring provided in the dining room of Gaston House and in the identified residents bedroom is appropriate to the needs of the residents. 23(2)(c) The provider must repair or replace the lounge suite in Gaston house. 23(2)(b) The provider must ensure that the flooring in the bathroom in Dolphin house is properly sealed. 24 The manager must develop an annual development plan for the home, which addresses issues raised in the organisations quality monitoring and reflects the views of the residents, their relatives and other stakeholders. 31/03/06 30/04/06 30/04/06 31/05/06 Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 22 6 YA39 26 Reports made following visits to the home under Regulation 26 of the Care Homes Regulations 2001 are to be provided to the Commission each month. This requirement has been made at previous inspections. A record is to be maintained of the date of opening of food items, which are stored in the fridge. This requirement was made at the previous inspection. 30/04/06 7 YA42 13(4) 31/03/06 Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Hft - Gaston And Dolphin Houses DS0000004244.V286190.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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. 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