Inspection on 20/09/05 for Hobbits Holt

This inspection was carried out on 20th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Hobbits Holt 02/05/07

Hobbits Holt 09/03/06

Hobbits Holt 11/03/05

Hobbits Holt 03/06/04

Hobbits Holt 10/03/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Hobbits Holt 156 Ruspidge Road Cinderford Glos GL14 3AP Lead Inspector Ms Tanya Harding Unannounced Inspection 20th September 2005 11:00 Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Hobbits Holt Address 156 Ruspidge Road Cinderford Glos GL14 3AP 01594 823554 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) Park Care Homes (No 2) Ltd Mrs Brenda Barwell Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th March 2005 Brief Description of the Service: Hobbit’s Holt is a detached residential care home situated 1.5 miles from the centre of Cinderford providing local services that are used by the residents. The home provides accommodation for up to six adults with Learning Disabilities who may also present some moderate non-aggressive challenging behaviour. The accommodation consists of the main house and a separate converted garage. On the ground floor in the main house there is a large kitchen/diner, office, laundry, bathroom and three lounge areas (one of which is used as a multi-sensory/music room). On the first floor there are six single bedrooms and a bathroom. The garage has been converted to provide a ground floor resource and activity area with office accommodation above. There are terraced well-maintained gardens, which offer opportunity for leisure and relaxation. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on one day in September and lasted four hours. Upon arrival most of the residents were out for a walk in the near by fields. They later returned for lunch. All but one of the residents were met and three residents were happy to comment on the care they received and showed the inspector their rooms. One person was attending the local adult opportunity centre. The inspection was supported by the Registered manager and one other member of staff. A number of records were examined and a tour of the communal areas and some bedrooms took place. No requirements were made in the last report and no significant changes have taken place in the home since the last visit. The residents appeared contented and busy with their schedules. What the service does well: Hobbits Halt offers a very homely environment and the staff team work hard to maintain areas of the home welcoming and safe for the residents. The manager felt that the staff team has many strengths which contribute to the overall high quality of the service. This includes a strong focus on the individuals who live in the home, building and promoting good relationships between staff as well as the residents and working cohesively to ensure there is good continuity of the support. Residents are encouraged to be as independent as possible and make individual choices on daily basis. The residents have regular opportunities to take part in activities outside the home through formal day care as well as with the support from the staff in the home. Residents’ meetings are held to increase participation in the decision making about events, which take place and increase opportunities for selfadvocacy. The home supports the residents in managing health related needs in a way, which does not disadvantage the individuals in taking part in ordinary activities. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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): Not assessed. EVIDENCE: There have been no new admissions to the home since the last visit. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 and 9 Individuals are supported in a way which is empowering, meaningful and inclusive, although this is not always reflected in care plans. Improvements should be made to recording systems so that care plans and risk assessments can be better evaluated. EVIDENCE: Three care files were examined in detail. These contained information about people’s assessed needs and a number of protocols and guidance which provided additional information for staff. For example one person has a behavioural agreement to help them maintain good relationships with others in the home. There were communication prompts and information about people’s preferred routines. For residents who cannot consent to the approaches used, care plans should reflect this in order to show who has advocated on the person’s behalf. Key-workers are responsible for evaluation of care plans. These evaluations are recorded monthly. Those seen on the day of the visit were very brief for example one care plan was evaluated ‘Continues to require full support’. Evaluation of care plans should demonstrate whether progress is being made Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 10 (if any) and what changes may be necessary to make the care plans more effective in order to achieve the desired outcomes. Some care plans are written so as to suggest that some restrictions are in place for people when they demonstrate certain behaviours. The manager advised that this is not what takes place in practice and that staff would never disadvantage the residents. Care plans which imply that staff would remove the person’s belongings from them or delay giving people their meal should be amended to remove references to possible punitive approaches. Whilst all of the care plans seen on the day of the visit were being reviewed through monthly evaluations, most were compiled some time ago now (some as far back as 2003). Some have comments which can be seen as derogatory, such as ‘she is very lazy if allowed to be’. It is recommended that all care plans, which are over 12 months old, be formally reviewed and re-written, making the necessary changes where necessary. This should be done using person centred approach and with involvement of the residents and their advocates where appropriate. One resident said they were aware of some care plans about them but not all as they could not themselves read. Consideration should be given to how the resident can be supported in this. The office is located centrally, between two communal areas and on the day of the visit was open to staff and residents. People were relaxed coming into the office and this demonstrated that restrictions on access may not be appropriate as would take a lot away from a homely feel. However, there may be issues of confidentially and secure storage of information. The inspector did not discuss this in detail during the visit, but makes a recommendation that these issues be considered. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 and 17 Residents are supported to lead an active life and take part in activities, which they find enjoyable and stimulating. They benefit from flexible routines in the home and their independence and individuality is promoted. EVIDENCE: The residents talked about the variety of activities and occupations they take part in. This included colleges, formal day care, trips out, daily chores, cooking and shopping. On the day of the visit five of the residents have been out for a walk and upon return were supported individually to make a snack lunch of their choice. One person needed more support and this was provided. The residents maintain links with their families and one person went to visit their parent on the day of the inspection. People were observed to have free access to all communal areas of the home including the garden, with supervision where necessary. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 12 Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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): 19 Regular health monitoring and procedures for maintaining personal safety promote physical and psychological wellbeing of the residents. EVIDENCE: There was evidence that people’s health needs are monitored and medical assistance sought when necessary. The necessary charts and records are maintained. The Commission has been kept informed of incidents, which may have had an adverse affect on the residents. A behaviour specialist has been consulted when required about providing advice on approaches to behaviours which challenge. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 The residents feel that their views will be listened and acted upon. EVIDENCE: There is an accessible complaints procedure in place and the residents spoken with during the visit said they would feel comfortable discussing their views and concerns with the staff in the home. The telephone number of the Commission should be added to the policy. There have been no complaints made about the home since the last inspection. Log of complaints and compliments did not have any new entries. The manager said that compliments are received about the care provided in the home and it is good practice to record these, as a validation of the efforts made by the manager and the staff. Several staff have attended a course in Protection of Vulnerable Adults. No physical intervention is used in the home. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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, 25, 26, 28 and 30 Service users live in a homely environment, which promotes their independence. EVIDENCE: The home is well maintained and decorated to a high standard. There are a number of homely touches around, including crafts made by the residents. There are pets in the home and the residents take an active role in looking after them. People’s rooms are well furnished and personalised with colours and possessions chosen by the residents. The laundry room is located away from the kitchen and is accessible to the residents if they wish to launder their own clothes. There is an additional activity space in the converted garage, which provides an area for social events. A large trampoline has been purchased and erected in the garden, with additional safety netting. This is used by the residents under supervision of suitably trained staff. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 16 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 Service users are supported by committed staff who demonstrate interest in providing the right care. Staff have access to training opportunities in order to improve their competence and approach. EVIDENCE: Staff were observed interacting well with the residents and showed good awareness of the individual’s likes, dislikes and habits. A number of staff have been employed in the last 12 months and their files were examined as part of an assessment of recruitment practices. On the whole, the required information was available for staff, including preemployment checks. On one file there was evidence that CRB disclosure was not received until after the staff member was employed in the home. POVA check was obtained for the person as required. The manager advised that this was due to confusion within the personnel department and although the check was done, this was not received by the home until later date. In discussion the manager demonstrated good awareness of the recruitment process and of POVA issues. The training matrix provided during the visit showed that mandatory training is generally being accessed. Three staff are working towards NVQ2 and one staff member has completed NVQ3. A significant number of staff have completed Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 17 their induction training and five staff have completed foundation training. Requirements for specialist training were not discussed on this occasion. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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): The home benefits from a dedicated and committed manager who promotes good care practices and person centred service. Health and safety monitoring is taken seriously in the home to ensure service users live in a safe environment. EVIDENCE: The home has benefited from a good continuation of service provided by the registered manager who has many years of experience in her role. There was an open and relaxed approach to the inspection with the manager showing a commitment to making improvements where these may be necessary. The home is providing support which delivers positive outcomes to the residents. This report identifies minor issues which if implemented should further improve the quality of the service provision. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 19 Health and safety monitoring takes place regularly. This includes checking of fire alarms and emergency lighting at the required intervals. Fire drills take place every three months and outcomes are recorded. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 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 x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X 3 X 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Hobbits Holt Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 x DS0000043073.V251815.R01.S.doc Version 5.0 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 6 Good Practice Recommendations The following recommendations should be implemented in order to improve the quality of care plans: 1. For residents who cannot consent to the approaches used, care plans should reflect this in order to show who has advocated on the person’s behalf. 2. Evaluation of care plans should demonstrate whether progress is being made (if any) and what changes may be necessary. 3. Care plans which refer to restrictive approaches, which are not used, should be amended to remove reference to possible punitive approaches. 4. Care plans which have been written over 12 months ago or contain comments which may be derogatory to the residents should be reviewed and re-written. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 22 6. Consideration should be given to how the residents can be supported to know what is written about them in care plans. Hobbits Holt DS0000043073.V251815.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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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