Inspection on 21/09/05 for Paddocks Residential Home

This inspection was carried out on 21st 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Paddocks Residential Home 20/02/07

Paddocks Residential Home 22/02/06

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 Jo Govett Announced Inspection 21st September 2005 1:00 Paddocks Residential Home DS0000024470.V261415.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 Paddocks Residential Home DS0000024470.V261415.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. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 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.V261415.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th March 2005 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, and their adoptive parents visit and go on holiday with all the residents regularly. 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. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken on the 21 September 2005. The Registered Manager, Graham Gibbs was available throughout, providing information and discussing issues as they arose. Mr Gibbs also discussed the homes financial position and current funding issues. We were able to talk with people living in the home as they returned home from work and day centres. They were very enthusiastic about a recent holiday they had all been on and showed us their photographs. 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. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 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 Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 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): 1, 2. Potential residents can expect to be assessed appropriately, and that the information they are given about the home is accurate. EVIDENCE: The home has a Statement of Purpose and Service User Guide, which are all available for the residents. No new residents have been admitted to the home since the last inspection. However the Registered Manager confirmed that the home would undertake it’s own full assessment of an individual before any trial visit and admission. All those who live at the Paddocks have been there for a significant amount of time and consider the other residents and owners to be part of the same family. Other relatives are encouraged to visit and the Registered Manager confirmed that they are welcome at anytime. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 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): 6, 7, 8, 9. People living at The Paddocks can expect to be empowered to make their own informed decisions and take part in the normal everyday routines of a very family orientated home. EVIDENCE: Care plans are well structured and appropriately maintained, all showing evidence of regular review and revision that show resident involvement. People living at The Paddocks are encouraged to be active in their everyday lives through work, training and or attending day centres. Care plans reflect the thoughts and opinions of individuals. They also include questions about what the person wants, for example, “would you like an advocate”, and “would you like lockable storage in your bedroom”. Risk assessments are also very individual. For example; “Seizures – in the bath, travelling, in the community, near the stairs etc.”. There are no specific instructions about people’s routines, although there is plenty of information about residents’ personalities, likes, dislikes and choices. They are more like a “life plan” that sets out general aims and objectives. The Manager added that the home does try to change routines sometimes to vary Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 9 things and see if improvements can be made saying that “change is not to be scared of”. Minutes are available of staff meetings were changing needs and issues are discussed and information given. Because the care staff team is small, the home feels that it is easy to ensure everyone has the same approach. Examples of recent actions and approaches to situations were discussed with the inspector. This information was also kept in the minutes of meetings that are kept in the staff room. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16 Residents benefit from the family orientated approach of the home and are encouraged to be responsible, independent and develop skills. EVIDENCE: Everyone had just returned from a holiday. We were able to look at photographs they had taken. They were all interested in the pictures and talked about the different day trips they had been on and the place they had stayed. Residents are encouraged to fill their time productively to develop new skills. The Manager said that the “family” have a wide variety of interests and they try to ensure their experiences are fulfilling. They also confirmed that some people are benefiting from learning from the more able residents. Examples of work and placements include; charity shop, hairdressers, café, grooming parlour, day services for the elderly, Upper Waveney Valley Project, Onward Enterprise and the small holding at the home. Every weeknight residents attend a variety of clubs, including country and western dancing in the local community. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 11 During the visit residents returned home from work or placements they washed their own lunch boxes, made snacks and chatted with each other. One resident chose to sit alone in the lounge after their day out. The home is large enough that most people tend to come together in the kitchen and dining room. They also are able to spend time alone in their own rooms. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19. Residents can expect the home to ensure that their health and welfare is maintained. EVIDENCE: Care plans and reviews evidence that each person living at The Paddocks is given choices around the amount of assistance they want with all aspects of daily life. Each resident has said that they would like (and now have) a befriender/advocate who is also involved in the decision making process. Those spoken with said that they chose when they went to bed and although sometimes they had to get up to go to work they “didn’t mind” that they were woken by staff if they weren’t up in time. The Registered Manager confirmed that they consult with medical professionals on a regular basis and this is recorded in resident daybooks. They also said that they are currently very interested in the recent recognition that people with Downsyndrome can develop secondary problems such as Alzheimer’s. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 13 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): These standards were not inspected at this visit. EVIDENCE: Not applicable. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 14 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): These standards were not inspected at this visit. EVIDENCE: Not Applicable Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35, 36 The home benefits from a management team that live on site and who are qualified and responsible. However some shortfalls in training and supervision may potentially put residents and staff at potential risk. EVIDENCE: Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 16 A previous requirement that the home provide the CSCI with a training plan that takes into account the needs of the resident has been completed. Currently the home has five care support workers, a cook, and two domestic members of staff. The Registered Manager and Deputy make up two of the five care workers. The Assistant Manager deals with administration duties and organises the small holding produce. One carer has NVQ qualifications (Registered Manager) and another is in process of working towards NVQ3. This falls short of the targets set by the Sector Skills Council for 50 of carers with NVQ2 or above by 2005. A training record sheet evidenced the progress of care staff and logged Induction training, foundation, LDAF & NVQ. The Registered Manager is a qualified NVQ assessor, however they said they could only support one person at a time to complete the qualification taking 12 – 18 months. All staff had been booked onto a First Aid course and they had also attended a course on the administration of medication. A new member of staff has previously been a trainer in Food Hygiene, Health and Safety, COSHH and Moving and Handling. The home hopes that these skills could be utilised in the future to update staff. Staff files examined included a training programme (including induction). Some elements were missing from staff files including ID, a recent photograph, gap in work history. The home asks that potential carers visit the home for a preinterview. The manager said that this ensured that applicants understand the approach the home has and gives them an opportunity to meet the family/residents. Part of the selection process involves the residents being asked two questions about the prospective staff they meet: 1. Would you like (carers name) to work here? 2. Can you tell me why? The Registered and Assistant Manager conduct interviews. Records are kept of the questions and answers given. The new cook also came in to cook a “test meal” to see how they felt and what the residents thought of their cooking. A previous requirement for the home to ensure that befrienders/advocates are checked thoroughly, in line with normal recruitment proceesures, including a Criminal Records Bureau Disclosure, has been actioned and there is now a procedure in place. The home has developed a format for staff supervision, however this has not been completed on a regular basis. Minutes of staff meetings were available, which evidenced conversations about approaches to certain tasks and residents. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 42, 43 The Paddocks ensures that the residents feel part of a large family and that they have an important role to play in the running of the home. EVIDENCE: The Registered Manager has NVQ4 and is also an assessor. They provide the CSCI with an update of all policies and procedures at each visit and highlight the ones that are being developed. This also provides details of where information is kept including certificates and maintenance checks. An Environmental Health Officer recently visited the home and made no requirements or recommendations. Certificates were available for electrical wiring (for the extension) and plumbing. Electrical wiring checks are due to be completed on the whole home and will be checked at the next inspection. Policies and procedures on health and safety are in place alongside individual risk assessments for those living at the home. Checks and monitoring for hot water, fridge and freezer temperatures were also seen. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 18 Because the management are very “hands on” and live on site, they feel that they continually monitor the home and the events inside it. However they still undertake self-audits and ask befrienders/advocates, and relatives their opinions. This information can be seen as part of individual residents reviews. Evidence detailed in this report shows that residents are encouraged to take an active role in the running of the home. They said that the home is a place where their (step) brothers and sisters live with them and their ”other relatives can come too”. The Registered Manager discussed the home’s current viability and running costs. They are currently waiting for decisions regarding individual funding from local authorities. They provided us with accounts information which did not highlight any immediate concerns. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 19 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 3 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 4 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Paddocks Residential Home Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 X DS0000024470.V261415.R01.S.doc Version 5.0 Page 20 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 YA34 Regulation 19 Schedule 2 (1) Requirement The home must ensure that it can evidence that workers have proof of identity, including a recent photograph and all the elements required by Schedule 2 of the Care Homes Regulations 2001. The home must ensure that formal supervision takes place regularly Timescale for action 31/01/06 2 YA36 18(2) 31/01/06 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 4 5 Refer to Standard YA34 YA36 YA32 YA32 YA34 Good Practice Recommendations The home should develop a policy and procedure around their plans for the renewal of CRB Disclosures. Supervision should take place at least six times a year. The home should ensure that when the management are off duty or away from the home that a suitably qualified person in left in charge. The home should look into alternate ways of meeting and maintaining the sector skills training targets. The home should explore the reasons why an applicant has DS0000024470.V261415.R01.S.doc Version 5.0 Page 21 Paddocks Residential Home left a care position, if they do not provide a referee from that employer. Paddocks Residential Home DS0000024470.V261415.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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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