Inspection on 22/02/06 for Paddocks Residential Home

This inspection was carried out on 22nd February 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 found no outstanding requirements from the previous inspection report, but made 4 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 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 Jo Govett Unannounced Inspection 22nd February 2006 13:30 Paddocks Residential Home DS0000024470.V284714.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 Paddocks Residential Home DS0000024470.V284714.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. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 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.V284714.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st September 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.V284714.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken on the 22 February 2005. The Registered Manager, Graham Gibbs was available throughout, providing information and discussing issues as they arose. We looked at the progress of previous requirements and reccommendations and completed inspecting the Key Standards. It is therefore recommended that any reader of this report should also see the previous report completed on the 21 September 2005. 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 Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 6 contacting your local CSCI office. Paddocks Residential Home DS0000024470.V284714.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 Paddocks Residential Home DS0000024470.V284714.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): These standards were not inspected on this visit. EVIDENCE: Not Applicable. Paddocks Residential Home DS0000024470.V284714.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): These standards were not inspected on this visit. EVIDENCE: Not Applicable. Paddocks Residential Home DS0000024470.V284714.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): 13, 14, 16, 17. Mealtimes and food are arranged around the needs, likes and dislikes of the residents. This benefits them by ensuring they are able to have choice and make independent decisions. EVIDENCE: The home has a large farm style kitchen where residents can have easy access. Prior visits to the home have shown that when residents return home from work and/or day care, and as part of their routine wash their lunch boxes and help prepare meals. There is a full time cook, although other staff are also trained to prepare and serve food. A menu is available with varied options. The cook said that they often experiment, depending on the seasons and food available from the smallholding, and the residents “change their minds” quite often. On the day of inspection they had made a savoury Yorkshires and pastry pinwheels instead of the fishcakes on the menu. None of the residents said that they minded this change, and the cook had made extra to ensure that residents who were out for the day could taste them on their return home. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 11 Two residents confirmed that they liked the “new” food that the cook had made and said they would like to have it again. One also commented that the pinwheels “wouldn’t last long when the others come home”. Because the home also has day-care status, the amount of people for lunch can vary. One resident said that there is always “something different” if they don’t want the main dish. Residents have a main meal in the evening. They all have a “favourite sheet” and the cook said that they keep up to date and “mix it up” so people have a varied diet. The Registered Manager said that on birthdays residents choose their favourite type of food. This could be a buffet, pub meal or take away for everyone at the home. As with previous inspections residents at the Paddocks continue to be involved in the local community. At this visit residents talked about taking part in a pantomime “Dick Whittington” with a local theatre group. They attend rehearsals every week. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 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): 19, 20. This approach of the home around medication and healthcare is positive for the residents and is careful not to be institutional or bureaucratic. However further training and suitable storage of medication needs to be considered to ensure that staff and residents are protected, and the home can evidence that any identified risks are low. EVIDENCE: Medication is kept in a locked wooden cupboard, which is part of the kitchen units. In discussion with the Registered Manager, the Inspector agreed to confirm whether a more suitable cabinet is required under the Misuse of Drugs (safe custody) Regulations 1973 and make the appropriate requirements and recommendations. Nobody living at the Paddocks self medicates. Medication Administration Records were up to date signed and accurate. A record was also available of non-prescribed medication, including homeopathic remedies. The home has a policy and procedure on the use of these and works closely with health care professionals regarding all of the resident’s medical needs. Information on care plans and assessments confirm this. The Registered Manager confirmed that two residents had epilepsy that is closely monitored. However there has been no formal training in this area. The Registered Manager has been closely involved with residents care (as adoptive brother) for many years and stated Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 13 that they believed their history and work with health care professionals and residents ensured they had the right experience to meet their needs. The home keeps records of seizures and monitors the situation on an ongoing basis. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. Residents can expect their views and opinions to be listened to and the home to ensure that independent advocates are available if needed. EVIDENCE: The home has an abuse policy that refers to the local procedures for the protection of vulnerable adults. Criminal Record Bureau Disclosures are available for inspection on each member of staff. Each resident has an advocate that comes from the local area. Following feedback from previous inspections they now have CRB Disclosures completed. There is a complaints policy and procedure. Staff and residents confirmed that any problems are usually discussed and sorted out individually. Five of the residents are adoptive brothers and sisters of the Registered Manager, who lives on site with their family in a separated flat. One resident said that they would go to the Registered Manager if they were worried about something or talk to their mum and dad. When asked what happens when they are not around they said they talked to “the rest of my family” or people at work. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30. Resident’s benefit from the family orientated approach and are encouraged to be involved in the daily running of the home. However a lack of formal records in some areas, does not evidence all the actions and procedures the home has in place, or has developed to meet resident’s needs. EVIDENCE: The home is a large detached house set in its own extensive grounds that include a village recycling point and the small holding. During the visit the home was having some maintenance work completed including redecorating, replacing a toilet and repairing tiles. The home was clean and tidy, and a resident showed the inspector around all areas. Bedrooms have been decorated individually and in consultation with residents that reflect their interests, for example, posters on the walls and ornaments. One resident spoke about how they had decided to display all their pictures. They said that they liked spending time in their room as it was “their own”. Residents can eat either in the dining room or at a large table in the kitchen. In addition there are several large communal spaces including a music room, games room and living room, with enough space and seating for residents and carers. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 16 A grab rail had been put up in one of the bathrooms to ensure that residents do not hold onto the heated towel rail. The home has hand towels in the bathrooms and toilets that are changed and washed daily. We discussed the cleaning of the kitchen with the cook and Registered Manager. There is no cleaning rota in place, although they stated that the floor and worktops are cleaned at least daily and as required. The whole area is cleaned thoroughly once a week. COSHH materials are stored appropriately, although there is no information around who has access to it or residents capabilities of using some materials. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 17 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): 36. Despite the home having a relatively small staffing group, continued shortfalls in supervision may potentially put residents and staff at potential risk. EVIDENCE: The previous inspection required that the home complete formal supervisions regularly. The home has developed a format for staff supervision, however the Registered Manager confirmed that this has still not been completed on a regular basis. Minutes of staff meetings continue to be available, which evidenced conversations about approaches to certain tasks and residents. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 Residents can expect the home is proportionate about health and safety matters and act when there is a risk. EVIDENCE: As part of looking at the standards around food and provision of meals we looked at the health and safety arrangements in the kitchen area. The home has a food analysis – Food Production Flow Chart and Table which covers: Purchasing, Growing, Storage, Preparation, Cooking, Chilling, freezing, defrosting, reheating, serving cold and serving hot. The environmental health regulators routinely visited the home in June 2005 and no requirements were made. Records of fridge and freezer temperatures are kept and were in the required limits. Food was also seen to be labelled with “use by” and “opened dates”. Some pipe work is exposed in different areas of the home. The registered manager said that where the appearance of exposed pipes “mattered” they are boxed in, but with the maintenance of an “old” house boxing them all in could Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 19 cause problems if there was a leak. They went on to say that the people living at the home had done so for many years and know the house and grounds very well. One resident said that they felt “safe” and did not worry about hurting themselves, as they ”knew” that the family “make sure things are right”. Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 2 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 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X X X X 3 X Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 21 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA19 Regulation Requirement Timescale for action 31/05/06 2 YA20 3 YA36 12, 18, 19 The home must ensure that when residents have specialist needs, for example epilepsy, all staff must be competent and have up to date training. 12, 13 The home must be able to evidence that medication is stored safely and in line with the Usage of Drugs (Safe Custody) Regulations 1973. 18(2) The home must ensure that formal supervision takes place regularly. This is a repeat requirement from the inspection 21/09/05. 12, 13, 23 The home must ensure that any exposed pipe work is not in areas where residents may burn themselves, if the risk is deemed low an appropriate risk assessment must be maintained. 30/06/06 30/04/06 4 YA42 31/05/06 Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 22 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 YA36 Good Practice Recommendations Supervision should take place at least six times a year. This is a repeat recommendation from the inspection 21/09/05. The home should consider introducing a more secure way of storing medication as recommended by the Royal Pharmacuetical Society Guidelines. 2. YA20 Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 23 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. Extracts may not be used or reproduced without the express permission of CSCI Paddocks Residential Home DS0000024470.V284714.R01.S.doc Version 5.1 Page 24 - 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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