CARE HOME ADULTS 18-65
HWCGS Segal Gardens 436 Fleet Lane Parr St Helens Merseyside WA9 2NH Lead Inspector
Mrs Joanne Revie Unannounced Inspection 23rd January 2006 10:00 HWCGS DS0000022458.V279978.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 HWCGS DS0000022458.V279978.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. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service HWCGS Address 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) Segal Gardens 436 Fleet Lane Parr St Helens Merseyside WA9 2NH 01744 28828 01744 25941 Www.segalgardens.com/hwcgscare@ukonline.co .uk HWCGS Ms Gillian Louise Gilmore Care Home 4 Category(ies) of Learning disability (4), Mental disorder, registration, with number excluding learning disability or dementia (4) of places HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Service users to include up to 4 MD and up to 4 LD Date of last inspection Brief Description of the Service: Segal Gardens is owned by the company HWCGS. This company was formed by a group of experienced carers all of whom work within the service in one form or another. The home provides care and support to four young people up to the age of twenty-five years old that have various mental health problems and/or learning disabilities/difficulties. Segal Gardens accepts referrals from all parts of the U.K. It is unique as it has two Managers who have achieved registered mental nurse status and who oversee the day-to-day running of the establishment. The home is situated in the Parr area of St. Helens. It is a detached bungalow with a separate detached extension. The extension is used for a variety of hobbies; horticulture, crafts, computer studies, ASDAN classroom and a quiet lounge for visitors and for care reviews. The service aims to support Service Users with all aspects of personal development .The aim is that they will return to their home town once they are 25 years old, equipped with the skills to live a more independent and fulfilling lifestyle HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The visit was unannounced and focused on the remaining core standards, which were not assessed during, the last visit. The reader should therefore refer to both this report and the report dated October 05 to gain a full overview of the service. What the service does well:
The managers regularly travel throughout the UK to meet young people. The service should be commended for the amount of time it spends ensuring that Segal Gardens is the right place for a young person to live. Time is spent getting to know them and sending birthday cards, photos of events etc encourages friendships between the home and the young person. As well as encouraging trust this time allows the managers the opportunity to really get to know the young persons needs. This means that the chance of a young person finding out that Segal Gardens is not for them or staff discovering that they cant meet a young persons needs is greatly reduced. The ethos of the home promotes independence and this extends to supporting the young people to take control of their lives. Examples of this are community meetings where the young people are encouraged to think about any ideas they have prior to the meeting taking place and then supported by staff to express these ideas. All of this has a positive impact on self-esteem. The home eats together at mealtimes (including staff) and staff wear everyday clothes rather than uniform which helps to break down boundaries and further encourages the young people to feel in charge of their life. There is a strong emphasis on individuality within the home. The young people are encouraged to plan their forthcoming week with staff support. Activities are chosen and recorded on a weekly planner, which gives structure. Although some group activies take place many activities are individual with the young person receiving one to one staff support. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 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. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 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 HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 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): 2 Service users receive a very comprehensive assessment, which allows time for relationships to develop with Key staff of the home. EVIDENCE: A care plan was viewed for the most recent young person admitted to the home and this was discussed with the manager. The documentation showed that the young person was first introduced to the home six months before the admission took place. Both managers frequently travelled to see the young person. Records of seven separate visits were viewed. Copies of documentation were viewed which had been produced in Makaton. Copies of questions that the young person had been encouraged to write about the forthcoming admission were also viewed. During this period birthday cards, photos of staff and the home were also sent to the young person. A copy of a document entitled “getting to know you” was also viewed. This gave details of what the assessment process would involve. The young person was given a copy of this. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 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): EVIDENCE: No standards were assessed from this section on this occasion HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 10 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 young people are encouraged and supported to take control of their lives. EVIDENCE: Two care plans and copies of community minutes were viewed as well as a tour of the environment and a discussion with the manager. All the young people are provided with keys to their bedrooms. All receive their post unopened but are supported by staff when needed. Care plans showed that all the young people are known by their first name. Minutes of the community meetings show that the young people are consulted on all aspects of life at Segal Gardens and that they are encouraged prior to the meeting to identify any ideas they may like to raise. Minutes are produced in makaton and plain English. The care plans contained copies of the young persons weekly planner. Each person is encouraged and supported to choose appropriate activities and to plan their forthcoming week with staff support. Staff were observed eating with the young people and wearing everyday clothes. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 11 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): 18,20 The young people receive guidance and encouragement but not direct assistance with personal care. Medications are managed safely but staff do not always record omissions.. EVIDENCE: A care plan was viewed and a discussion was held with the manager. The service does not provide personal care. However staff oversee the young persons hygiene habits and will encourage and prompt to ensure these are maintained. These prompts were recorded and viewed in a care plan. The medication administration records and storage systems for medication were viewed. Staff are provided with lots of information about each medication that they administer. Training records showed that staff that administer medication have had training to do so. Medication administration records for one young person had missing signatures, which meant that it could not be determined whether medication had been given as prescribed. HWCGS DS0000022458.V279978.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): EVIDENCE: No standards were assessed from this section on this occasion. HWCGS DS0000022458.V279978.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): EVIDENCE: No standards were assessed from this section on this occasion. HWCGS DS0000022458.V279978.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): 32,35 Fifty percent of the homes staff will hold care qualifications if the three NVQ candidates obtain their awards. The home offers sufficient training to ensure staff have the skills to meet the needs of the residents. EVIDENCE: Staff files and training records were viewed and a discussion was held with the manager. Fifteen staff are employed in total, which includes ancillary and bank staff. Two staff have achieved NVQ three and one member of staff has achieved NVQ two. A further three staff are undertaking training towards these awards. The manager explained difficulties that the home had had in finding a reliable provider of NVQ training. Each staff file has an individual training record. The manager confirmed that a separate dedicated budget exists for training purposes. Records showed that staff have attended training on managing challenging behaviour. A list of staff names on the wall showed that staff are undertaking training on child protection. Training records showed that all staff employed have achieved First Aid and food hygiene training. Records showed that all staff that administer medication have had training on how to do so. The manager stated that a company has been sourced who can deliver training on breakaway techniques and that the service is considering applying for long distance learning training on Autism. HWCGS DS0000022458.V279978.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): EVIDENCE: No standards were assessed from this section on this occasion. HWCGS DS0000022458.V279978.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 4 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 X 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 3 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 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X X X X X X X X HWCGS DS0000022458.V279978.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. 1 Standard YA20 Regulation 13.-(2) Requirement The manager must ensure that staff sign for all administrations omissions of medication on the Medication Administration Records. Timescale for action 31/03/06 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. 2. 3. Refer to Standard YA32 YA35 YA35 Good Practice Recommendations The managers should ensure that the three NVQ candidates complete their training and achieve their award. The managers should pursue the intention to offer break away techniques training to staff The managers should pursue their intention to offer training on Autism to staff. HWCGS DS0000022458.V279978.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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