Inspection on 02/10/06 for Hft - Gaston And Dolphin Houses

This inspection was carried out on 2nd October 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hft - Gaston And Dolphin Houses 21/10/08

Hft - Gaston And Dolphin Houses 10/03/06

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

Similar services:

Polesworth Group Friary Road

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 Mr Martin Brown Unannounced Inspection 2 October 2006 12:45 Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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.V312338.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th March 2006 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 bodys 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 separate living areas for five and four service users, respectively. All have varying degrees of learning disabilities and some have a degree of physical disability. Those who are able to be more independent live in one ‘house’, those with more profound disabilities live in the other. 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. Fees are currently £959.69 in Gaston, and £992.24 in Dolphin. Holidays, hairdressing, and toiletries are extra. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report has been made using evidence that has been accumulated by the Commission for Social Care Inspection. This includes information provided by the home, and a visit to the home. The inspection visit was unannounced and took place on 3rd October 2006, between 12.45 pm and 6pm. All residents, bar one, who was elsewhere that day, were seen over the course of the inspection, as were all staff on duty. The manager was absent, but her deputy was available throughout much of the visit. A tour of the premises was made, relevant documentation was looked at, staff and residents spoken with, and observations of the home in action were made. Staff and residents were welcoming and friendly throughout. What the service does well: What has improved since the last inspection? What they could do better: The home could usefully give more thought to how the needs of some residents are unduly restricting the needs of others. The most obvious example of this being a bathroom/toilet being locked because of the need to keep clinical waste secure from one person. Other, less restrictive alternatives, should be explored. Similarly, alternatives to removing tapheads in some Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 6 rooms, and of locking the kitchen and dining room when staff are not present should be looked at. Whilst the risks posed are appreciated, the home needs to be more aware of the dangers inherent in appearing to solve a problem merely by blanket restrictions, and how addressing the risks posed by one resident can result in unnecessary restrictions on the freedoms of others. One exception to the otherwise good maintenance of the property was the poor state of the work surface in Dolphin kitchen. 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.V312338.R01.S.doc Version 5.2 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 Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 1,2,5 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Prospective residents benefit from clear information about the home and a gradual and assessed introductory process. EVIDENCE: Contracts for three residents were looked at and seen to be written in a clear manner and included costs and what can be expected from the service. These, together with the service user guides, which are well-illustrated with photographs, give a good printed guide as to what a resident can expect the home to be like. Whilst these may not necessarily be understandable by all residents, they form a useful introduction that can be used by residents or their representatives. The home currently has one vacancy; a prospective resident has been identified, and is currently being gradually introduced to the home, having had initial visits and overnight stays at the home. Assessments and daily records were seen, showing how the introductory process was going. Residents spoken to were positive regarding their prospective new housemate. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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 the following standard(s): 6,7,9,10 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents’ needs and goals are reflected in their individual plans, and they are supported in making decisions and in taking risks. Care should be taken to ensure that individual files contain only information about that individual, and not other people’s needs as well. Some approaches to risk taking for particular residents in respect of access to toilets, food and taps would benefit from being reviewed, with a view to being less restrictive, and helping them to learn to use facilities more responsibly. The observation of a resident helping herself, in this instance safely, to a yoghurt, from the fridge without staff being present, in contradiction of an agreed risk assessment, indicates that this risk assessment, or how it is followed, would benefit from being reviewed. EVIDENCE: Information concerning three residents were looked at in depth. Care plans, based around ‘Person-centred plans’ and comprehensive information folders, contain relevant assessments, regularly reviewed. Medical, and social information is clearly presented. One minor exception to the overall good quality of the plans was a section on communication in which three people’s Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 10 communication needs were discussed together. It appeared as if this information had been taken directly from a general information sheet on their communication needs, rather than specifically being written on an individual basis. Staff agreed that having details of one person’s needs in another person’s file constituted a breach of confidentiality, however minor. Where one person has physical mobility support, these were detailed, along with how they are met. Person centred plans were seen to be part of the process whereby people were supported to make choices, with wishes for the following year, such as having a large print bible, or attending more discos, being recorded, and staff being able to discuss how these were being met, in this instance, with a large print bible being ordered, and more outings to clubs and concerts being arranged. Information concerning individual risks and how they are managed were included in care plans, mainly in the form of guidelines, and included behaviour guidelines, signed to denote agreement, by the residents concerned in the examples looked at. One bathroom was locked. Staff advised that this was because of the clinical waste bin being in there, which one resident was inclined to rummage through. Staff agreed that this was a restriction for everyone, and that locking, or resiting the waste bin might be a better solution. One dining room and kitchen was locked when staff were not present. Staff advised that this was because one resident would help herself to potentially dangerous items, such as food that required cooking. This person was seen to return from an outing, enter the other kitchen alone and help herself to a yoghurt. Taps in two residents’ rooms are removed when not in supervised use, and locked away. Staff advised that this is because the people concerned tended to play with water and there had been floods in the past. One wash basin had been fitted with slow release, push button taps. A discussion ensued with staff regarding finding less restrictive alternatives to the removal of taps. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 12,13,15,16,17 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents benefit from a variety of activities and contacts that help enhance their quality of life and social and living skills, and enjoy a healthy diet. EVIDENCE: Each resident has a plan of activities for the week, and where residents were able to discuss this, they did so positively, and said that they enjoyed the variety of things that they did. Activities are tailored to individual needs and wishes. One person had had individual swimming tuition in the morning, as he wanted to learn to swim; in the afternoon, those at home that day all happily went to a swimming session. Dancing and music were favourite activities for some residents, and these were catered for by regulars discos and clubs, as well as by individual music in rooms. There were plenty of photographs of residents enjoying holidays abroad, which they enjoyed showing me, with support from staff. Although the setting of the home is rural and quite secluded, being at the very edge of the village, residents told me that they regularly walk into the village, Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 12 principally to use the local bank. The home has transport that is used to get about to Stratford and the wider community. Family contact is supported with regular visits to and from families. Individual care plans detail family links, as well as having photos and brief positive details of friends. Residents are encouraged to take responsibility in helping tidying and cleaning their own and communal spaces, and took pride in showing off their rooms. People’s needs and abilities vary greatly within the home, and during this visit, residents were seen to be respectful and tolerant of each other, and staff were seen to be respectful throughout. Lunch was taken in one dining room with the residents, and part of the evening meal was observed in the other. Both meals were relaxed, easy-going, and with people tolerant and respectful of others’ frailties. All residents ate heartily, and staff advised that no-one was on a special diet. The kitchen was well-stocked, and menus show a good variety of nutritious meals being offered. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents have their health and personal support needs met appropriately, with the help of outside professional advice and support where necessary. EVIDENCE: Health and support needs were seen to be well covered in individual care plans, with details of all medical appointments clearly recorded. There are also health action plan folders, a health authority initiative. A local Speech and Language Therapist provides specialist support, and local community health facilities are used. Specialist outside support and advice for one person with physical support needs continues to be available, and this person was seen to manage tasks very well and confidently. Medication records on one unit were looked at. These were all accurate, with clear guidelines, including clear descriptions of individual medications, and their purpose, and consent by individuals to medication. Most medication is in the form of ‘blister’ packs, where it is not, it is clearly and accurately stock controlled. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 22,23 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents are able to be confident that their views are listened to. The atmosphere within the home indicated a respectful, positive and open service that promoted residents’ well –being and protected against abuse. EVIDENCE: There have been no complaints received regarding this service. Residents who were spoken to were very complimentary of the service, as were previous letters that have been written by relatives. The complaints procedure was seen to be available. Notes of residents’ meetings were seen, and showed that this is a useful arena for residents to bring up and resolve issues that are bothering them, with staff support as necessary. The observed interactions between staff and residents were of a respectful and positive manner throughout. One male staff on duty confirmed that, in line with policy, he only helped assist male residents in matters of personal care. All adult abuse and whistle blowing procedures and practices have been recorded as satisfactory following the previous year’s inspection and there were no grounds to believe this to be anything other than satisfactory still. Similarly, there had been no concerns regarding the management of residents’ finances. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 24,27,30 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents are able to enjoy a spacious, airy, comfortable and safe environment, in which they obviously felt at home. The locking of the dining room and kitchen, and a bathroom in Dolphin at times may restrict residents freedoms at times, but this did not appear to unduly concern people who had, perhaps, got used to this. EVIDENCE: The environment was clean, homely and well maintained during this unannounced inspection. Residents were happy to show me around, and were especially proud of their bedrooms, which reflected individual wishes and personalities. Flooring in various rooms has been improved following previous requirements. The gardens are pleasant and accessible and staff advised that they are wellused in good weather. There were no unpleasant smells or odours. Access is currently restricted in one bathroom, as discussed earlier in the report. The procedure for dealing with clinical waste was explained by staff, and was satisfactory, other than it Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 16 resulting in limiting access to one bathroom. Staff agreed that alternative siting or security for the clinical waste may be advisable. The one noted exception to the good quality maintenance of the environment was the poor state of the work surface in the kitchen in Dolphin house. The staff advised that this had been reported as needing repair/replacement. There was a damp patch on the lounge wall in Dolphin. Staff advised that this was where recent heavy rain had found a weakness in attached conservatory, and was about to be attended to by the relevant professionals. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 32,34,35 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. Residents benefit from a consistent and well-trained staff team with whom they are familiar with, and who are familiar with them. EVIDENCE: All staff spoken to had worked at the home for many years, some as many as seventeen. All staff spoken to had a good knowledge of the residents and their needs and wishes. The rota is arranged so that there are always at least two staff on duty in each side of the house at peak times. If needed, relief staff are occasionally used. These are Home Farm Trust staff from nearby homes or the resource centre who are familiar with the residents. Staff files were not looked at on this occasion, as, in the absence of the manager, they were not able to be accessed. Recruitment procedures were judged to be satisfactory at the last inspection, and there was no reason to suppose them to be any different now. A staff training matrix showed that staff received that suitable training in mandatory and specialist areas take place. Staff consensus was that training was much improved in quantity and quality as opposed to the case a few years ago. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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): 37,39,42 Quality in this outcome area is good. The judgement has been made using available evidence including a visit to this service. The home continues to be well-run, to take the views of residents into account, and works to safeguard the health, safety and well-being of residents. EVIDENCE: The manager was absent during this inspection, but observation and scrutiny of records showed the home to be well run. Records of monthly house meetings were looked at. These were recorded in type and symbols, and showed useful and relevant items of concern being discussed, including holidays, the vacant room and a prospective resident, issues with other residents, and managing in the hot weather. Letters and comments were seen from relatives of residents that were supportive and appreciative of the home and the care and support it provides. Residents comments and actions all indicated a high degree of satisfaction with the service. Staff were able to explain the fire procedure satisfactorily, and evidence regular fire drills and fire safety checks. Pre-inspection information provided showed sufficient safety checks taking place in the home. Hazardous Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 19 substances were seen to be kept safely. A rubbish bin in one kitchen was sited in a position that meant it had to be leaned over to open the freezer. Staff agreed that this would be better in a different position. Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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 3 2 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 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 YA24 Regulation 23(2)(b) Requirement The work surface in Dolphin kitchen must be replaced. Timescale for action 10/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA9 Good Practice Recommendations It is recommended that the service reviews its management of risk in respect of access to the kitchen, and to taps, and to the upstairs bathroom that is currently locked. The service should ensure that confidentiality is maintained in recordings by making sure that individual records only discuss the needs of the individual concerned. The bin in Gaston kitchen would be better sited away from the freezer. 2 3 YA10 YA30 Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 22 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. Extracts may not be used or reproduced without the express permission of CSCI Hft - Gaston And Dolphin Houses DS0000004244.V312338.R01.S.doc Version 5.2 Page 23 - 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. 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