Inspection on 09/03/06 for Hobbits Holt

This inspection was carried out on 9th March 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 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 20/09/05

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 9th March 2006 1.15 Hobbits Holt DS0000043073.V286174.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 Hobbits Holt DS0000043073.V286174.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. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Hobbits Holt Address 156 Ruspidge Road Cinderford Glos GL14 3AP 01594 823554 01594 824975 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), Learning disability over registration, with number 65 years of age (1) of places Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 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 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 wellmaintained gardens, which offer opportunity for leisure and relaxation. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on a Thursday afternoon and lasted two and a half hours. The registered manager supported the inspection. All but one of the service users were seen and greeted and discussions were held with some staff. A number of records were examined including medication administration records. Following this inspection, the home has sought advice and received written guidance from the pharmacy inspector about safe handling of medication when service users stay with their relatives. This report should be read in conjunction with the last inspection report to gain a more comprehensive picture of the service provided. What the service does well: 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.V286174.R01.S.doc Version 5.1 Page 6 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.V286174.R01.S.doc Version 5.1 Page 7 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 for some time. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 8 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): Not assessed. EVIDENCE: Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 9 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): Not assessed. EVIDENCE: On arrival to the home all of the service users were out on activities. Some had returned for lunch and one person went out again in the afternoon. Staff spoken with had a good awareness of people’s favourite activities and interests. The service user talked about how the home supports their friendships. People’s friends are invited to visit for meals and the service users from the home are supported to make visits to see their friends. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 10 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 and 20 Service users are supported with personal care in ways which respect individual preferences. Good systems are in place to support people with taking their prescribed medication and resolution of the supply problem should further safeguard people from possible medication errors. EVIDENCE: The majority of the service users require a degree of support with personal care. Staff confirmed that there is guidance in care plans about how this should be provided in line with the individual’s needs and preferences. Medication administration systems were examined and were found to be mainly satisfactory. MAR charts were examined for February 2006 and these were accurately completed. There is a list of homely remedies dated January 2006 and signed by the GP. Protocols for ‘as required’ medication were seen. The home has been experiencing problems in obtaining correct number of tablets for two service users and have been doing ‘catch up’ by removing the last tablet in the blister pack to compensate for the shortage every month. The manager advised that this has been a problem since Christmas and the concern is that there is an increased risk of confusion and potential for error. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 11 This needs to be resolved as soon as possible with the supplying pharmacy / GP practice. Meanwhile the manager has agreed to provide a written statement describing the problem so that this can be monitored and referred to in case of future audits. This will be included on the medication file. The home has sought advice from the pharmacy inspector about supporting service users with continuing to take their medication when they are visiting relatives. For one person this may present opportunities for self-administration within a risk assessment framework. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 12 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): 23 Staff have a good understanding of protection issues and use their knowledge of the service users’ needs to safeguard people from abuse and harm. EVIDENCE: Staff spoken with were clear about their roles and responsibilities to safeguard the vulnerable service users. Staff felt that people would be supported to voice their concerns and where a service user could not communicate their upset / anxiety verbally, staff would be vigilant and monitor through observation whether people were happy or not. Staff confirmed that they would report any poor practices to the manager and gave examples of what they understood would constitute poor practice, such as speaking to the service users inappropriately and not carrying out set care plans. Staff advised that they have received training in protection of vulnerable adults and in prevention of abuse. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 13 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): Not assessed. EVIDENCE: The home is well maintained and decorated with many homely touches. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 14 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 Service users are supported by staff who know them well and provide support to meet their needs, although on occasion this may not be delivered in the most consistent way. EVIDENCE: The home has a stable staff team and no new staff have been employed since the last inspection. Discussions took place with two staff, the registered manager and deputy. Observations on staff approach were made during the lunchtime meal. Staff spoken with confirmed their understanding of the individual needs, aspirations and preferences of the service users. Staff advised that individual care plans and risk assessments were discussed at staff meetings and staff would be informed of any changes to these. One service user requires close supervision during meal times and this is generally provided by staff sitting by the service user. It was observed that this specific support was not given to the person, although staff were in close vicinity and did respond quickly to prevent a possible incident. Caution should be exercised by staff to ensure where there are identified and agreed strategies, the right support should be given. Interactions between staff and service users on the whole were positive. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 15 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): 39 There are good systems in place for obtaining feedback about the quality of the service from the service users and their families which promotes involvement in the process and is used to measure service users’ satisfaction with the home. EVIDENCE: The home obtains feedback from the service users through the use of questionnaires and during regular service users’ meetings. Samples of the feedback were seen. Wherever possible these are completed by the service users independently. Questionnaire completed by one service user was examined and contained very positive comments about the support they receive. Feedback has also been sought from carers and relatives and again there were a number of very positive comments about service users being happy and settled in the home. The area manager carries out unannounced visits in line with Regulation 26 and resulting reports are forwarded to the Commission. Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 16 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 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X X X 3 X X X X Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 17 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 YA20 Good Practice Recommendations Medication supply problem should be resolved as soon as possible as described in the text. A written statement as to what this problem is and how it has been managed should be provided for reference on the medication file. Agreed support strategies should be followed by staff to promote consistency of approach. 2. YA32 Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 18 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. Extracts may not be used or reproduced without the express permission of CSCI Hobbits Holt DS0000043073.V286174.R01.S.doc Version 5.1 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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