Inspection on 20/02/07 for Paddocks Residential Home

This inspection was carried out on 20th February 2007.

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

Paddocks Residential Home 22/02/06

Paddocks Residential Home 21/09/05

Paddocks Residential Home 18/03/05

Paddocks Residential Home 08/09/04

Paddocks Residential Home 15/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Paddocks Residential Home Church Road Weybread Diss Norfolk IP21 5TR Lead Inspector Jane Offord Unannounced Inspection 20th February 2007 11:15 Paddocks Residential Home DS0000024470.V323505.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 Paddocks Residential Home DS0000024470.V323505.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. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paddocks Residential Home Address Church Road Weybread Diss Norfolk IP21 5TR 01379 852415 01379 852415 graham@gibbs63.fsnet.co.uk 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) Mr Graham Robert Gibbs Mr Graham Robert Gibbs Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd February 2006 Brief Description of the Service: The Paddocks is a large detached house, sitting within its own extensive grounds in the village of Weybread, near Diss. In addition to residential care the home also provides day care/work experience. The location is rural and as a result the service users need to travel to visit shops or other public facilities. The home is currently registered for eight adults with a learning disability. This was increased from six in 2001 to enable five young adults, who were adopted and previously cared for by the proprietors parents, to be cared for at the Paddocks. Therefore the owners and residents consider themselves to be a family, as the Registered Manager is their brother. The grounds are increasingly being cultivated and worked by residents and those attending day care placements. This provides fruit and vegetables for the home with excess produce being sold locally. All produce is organically cultivated and where possible recycled materials are used for outbuildings and gardening management. The home also acts as a recycling point for the village. Fees for accommodation are £328.00 per week. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection looking at the core standards for care of young adults took place between 11.15 and 15.00 on a weekday. The manager was present and assisted with the inspection process. This report has been compiled using information available and evidence found during the inspection. During the day a resident’s care plan was seen and the file of a newly appointed member of staff, a number of policies and maintenance records, the medication records and the residents’ personal finance details were all seen. The manager gave a conducted tour of the home and a number of staff and residents were spoken with. Some residents were out working on the smallholding but returned to lunch together. The meal was a cheerful period with laughter and chatter. Residents seemed relaxed and comfortable in the home. What the service does well: What has improved since the last inspection? What they could do better: An individual programme for each resident to develop their self-help skills should be implemented and included in the care planning process. Training in dementia care and understanding should be accessed for all staff and consideration given to the implications for staffing and the premises now three residents have early signs of dementia. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Paddocks Residential Home DS0000024470.V323505.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 Paddocks Residential Home DS0000024470.V323505.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. People who use this service can expect to have an assessment of need before being admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The present residents have been together in the home a number of years and consider the owners and themselves as a family unit. There is information available for residents about the service offered and the manager said they would undertake an assessment of need prior to accepting any new resident should there be a vacancy in the future. Paddocks Residential Home DS0000024470.V323505.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9. Quality in this outcome area is good. People who use this service can expect to have a care plan in place and be supported to take risks but cannot be assured that the care plan will address all their learning and development needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The file and care plan of one resident was seen. To aid the understanding for the resident there were picture symbols for skills such as numeracy, literacy, mobility, communication, health, domestic abilities and inter-personal skills. There was clear evidence that the resident had had input into the care plan with details of their likes and dislikes. The plan had been reviewed with the resident and their family and an advocate in March 2005. In discussion with the manager they said they would usually have an annual review. However last year due to bereavement in the family some things had not been achieved but dates were already set for reviews this year. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 10 There were individual risk assessments in place for activities such as ‘using tools outside’, ‘making hot drinks’, ‘using ladders’ and ‘going into the community’. There was information on the level of skill that the resident already had in the areas of the care plan but no evidence of interventions to help the resident build on that and develop improved skills. One member of staff said one of the residents had an interest in learning more cooking skills but that was not reflected in the care plan. Paddocks Residential Home DS0000024470.V323505.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. People who use this service can expect to be encouraged to maintain contact with their family, play their part in the community and receive a well-balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each resident has an individual Monday to Friday programme of occupations. These include working in a supermarket, a hairdresser, a charity shop, a conservation project, day services for older people and the smallholding at the home. Two residents have a day a week at home to clean and tidy their rooms, as they have no interest in the work in the smallholding. When the residents working in the smallholding on the day of inspection came in for lunch one of them said they had been clearing the strawberry patch ready to plant new plants for this year. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 12 Residents regularly attend services in the Church of England or Baptist church depending on their preferences. Several members of the congregations act as befrienders or advocates for the residents. The village is putting on a pantomime in the next few weeks and several of the residents have parts in it. Daily records seen say, ‘XXXX went to church this morning and then panto practice’. The manager said that a number of the residents’ family members have asked them to obtain tickets for the pantomime so they can attend. Residents have a choice of evening clubs to attend including Karate, a Gateway club and line dancing. Lunch for the residents at home and the staff on the day of inspection was bread with a variety of spreads, fresh fruit and cakes made by the residents. There was a choice of hot or cold drinks. The meal was taken in the large kitchen/diner at the refectory table. The home employs a full time cook who was preparing fish pie with fresh greens from the garden for supper. The food stores were well stocked with a vegetable store used for surplus produce from the smallholding. Paddocks Residential Home DS0000024470.V323505.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. People who use this service can expect to have their health care needs met and be protected by medication administration practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents have varying levels of ability and it was clear from documentation that support is given according to the choice and need of each individual. Although they have busy weekdays, the weekends are free for residents to choose their pastimes. They can choose when to get up and go to bed and whether to spend time with others or alone. The individual rooms show evidence of different interests and pursuits. There were records of consultations with health professionals and hospital appointments. The manager said three of the residents had been seen by doctors because they were showing early signs of early onset dementia. The staff were monitoring their behaviour and mental status. Another resident who has epilepsy has had medication reviews to control the condition. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 14 Medication is stored in a locked cupboard in the kitchen. None of the residents self-medicates. The medication administration records (MAR sheets) were inspected and showed that the signature boxes were correctly completed. Homely remedies such as paracetamol or cough linctus were recorded separately. One resident uses homeopathic remedies and there was an agreement for them to do that from their GP and they too were recorded separately each time they were administered. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Quality in this outcome area is good. People who use this service can expect to have their concerns taken seriously and be protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure but the manager said they had not had a formal complaint for a long time. In keeping with the family orientated philosophy any concerns are discussed, often at mealtimes, by everyone. One resident spoken with said they could always approach the manager or they had a social worker they could talk to if they wished. The home has an abuse policy cross-referenced to the guidelines issued by the vulnerable adult protection committee of Suffolk. The policy has been moved from the office into the staff office for easy access by staff. The home has a whistle blowing policy to protect staff who exercise their duty of care. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30. Quality in this outcome area is good. People who use this service can expect to live in a comfortable, spacious environment that is clean and attractive. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Paddocks is a large country house set in its own extensive grounds. It was recently extended to give more space to the flat on the first floor that is the accommodation of the owner and their family. The extension also enlarged the dining room and gave an area inside the back door for the residents to change their boots and overalls as they came in from the smallholding. A tour of the home was undertaken with the owner and everywhere was clean and tidy. The communal rooms downstairs consist of an attractive lounge, a music room equipped with drums, an electric organ and a karaoke machine and a games room with a pool table and second television. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 17 There is a formal dining room and a large kitchen with a breakfast area for informal meals. The windows throughout the home are large and offer views over the gardens and surrounding countryside. A patio is being constructed outside the dining room and games room that will have a checkerboard effect included so the residents can play giant draughts. The residents’ bedrooms were seen and were all differently decorated. The manager said the residents are consulted about the colours they would like in their rooms. Individual residents had collections of items they had an interest in such as dolphins, teddy bears or pop star posters. The manager said one room had been redecorated since the last inspection but they had plans to do more this year. The decorator is a local person and the home hires their services for a couple of months each year and prepares a list of work for them to complete. This year’s list includes two further residents’ rooms, the games room, the upstairs corridor and repainting a number of doors. The laundry, which is part of the new extension, was seen and was clean and tidy. Residents are responsible for bringing their own clothes to the laundry but the staff do the washing. Some residents do some of their own ironing. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Quality in this outcome area is good. People who use this service can expect to be supported by adequate correctly recruited and trained staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The file of a newly recruited member of staff was seen and contained evidence that their identity had been checked and a criminal records bureau (CRB) check had been received before they commenced in post. The residents were involved in the interview process and there was a copy of a contract detailing terms and conditions. Documentation showed that the induction had included fire awareness and procedures, food handling, control of substances hazardous to health (COSHH) regulations, infection control and risk assessments. The duty rotas showed that in the mornings and evenings there are two care staff on duty. There are two part time domestic staff and a full time cook employed and a day care assistant who works on the smallholding with the residents. One carer sleeps in over night and the manager is on call. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 19 There was evidence that mandatory training is updated and staff spoken with confirmed this. The manager has had additional training about managing epilepsy that has been shared with the staff team. The manager said they were trying to access training on dementia in people with learning disabilities as three of the residents are showing some signs of early onset dementia. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. People who use this service can expect that it is run by a competent manager, that their views will be sought and that policies and practice will protect their welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has a number of years experience in care work and has owned and managed the Paddocks for the last sixteen years. They hold an NVQ level 4 in management and a Higher Diploma in Management of Care Services. They are also an NVQ assessor. Staff and residents spoken with said the manager was approachable and generated a family style philosophy in the home. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 21 There is an annual questionnaire for the residents to give their views of the service they receive. The most recent one was completed in December 2006 and the residents were helped, when needed, by their advocate or befriender to fill the forms. The responses to questions such as ‘Are you happy at the Paddocks?’ and ‘Is there anything you don’t like at the Paddocks?’ were all very positive. To the question ‘What do you like best at the Paddocks?’ there were a number of answers. One resident said, ‘Being all together’ and another said, ‘The office in my bedroom’. The manager said they do not hold formal residents’ meetings as things are discussed, as they would be in any family, as they occur and often during meal times. Staff meetings are held regularly, the most recent was in January 2007 and the minutes were available. They showed discussion took place about a job vacancy, planning for the summer holiday, how the arrangements had gone over the Christmas period and staff annual leave. Some maintenance records were seen and showed that a fire officer had inspected the home in May 2006 and the boiler had been serviced in April 2006. Fire equipment is checked six monthly and was done in February 2007 and electrical appliances were checked in December 2006. The temperatures of refrigerators and freezers were recorded and showed they were functioning within safe limits for food storage. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 22 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 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 2 3 X 3 X 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 Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? None. 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. 2. Refer to Standard YA6 YA35 Good Practice Recommendations The registered person should ensure that residents’ care plans include interventions to help each resident develop self-help skills building on their present abilities. The registered person should access training for the staff team about dementia awareness in people with learning disabilities. Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Paddocks Residential Home DS0000024470.V323505.R01.S.doc Version 5.2 Page 25 - 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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