Inspection on 21/12/06 for Peel and Sumachs House

This inspection was carried out on 21st December 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Peel and Sumachs House 07/03/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Peel and Sumachs House 26 - 27 Old Weston Road Flax Bourton North Somerset BS48 1UL Lead Inspector Paul Grey Unannounced Inspection 21st December 2006 09:30 Peel and Sumachs House DS0000065503.V321149.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 Peel and Sumachs House DS0000065503.V321149.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. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Peel and Sumachs House Address 26 - 27 Old Weston Road Flax Bourton North Somerset BS48 1UL 0117 9077200 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) www.brandontrust.org The Brandon Trust Mrs Tina Curtis Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The registration is short term until 31 December 2007 and will cease to have effect after that date. The registration is for service users who are transferred from NHS retained provision and no new service users should be admitted to the service. The service may accommodate and provide personal care for up to five service users who have a learning disability aged 18 - 64 years. 07/03/06 Date of last inspection Brief Description of the Service: Peel and Sumachs are an interim service for people with learning disabilities. Both homes provide supportive environments for people with moderate to more extensive levels of need. The homes are divided into flats to enabling service users a greater degree of independence whilst being able to access support from the staff team. At the time of writing Peel and Sumachs have a designated manager who will undertake the Fit Person Interview with the commission. The temporary registration expires on the 31st of December 2007. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted in the absence of the manager over a period of one-day. During the inspection, the Inspector spoke with one service user, all staff members on duty, and reviewed documentation on both premises. A tour of both premises was conducted followed by an observation of care being delivered. At the time of inspection there were only 3 service users on the premises, one of whom chose to speak to the Inspector. During the inspection process the inspector saw care being delivered and talked to staff about this process prior to reviewing care files. The inspector found a well resourced service providing a good standard of care to its service user group. The inspector was not able to fully access some management and quality assurance documents as the manager was off duty. The inspector was unable to access some information. The inspector made one requirement regarding the gate into Sumachs. What the service does well: What has improved since the last inspection? What they could do better: The premises are generally well maintained. There appear to be consistent problems with the gate into the Sumachs garden. This appears to have been made from an internal door that expands when wet. At the time of inspection the new handle was pulling out of the gate as it had expanded was sticking in the frame. Staff were also having to push the gate with their feet on entry as it was very hard to open. The presents a health and safety hazard and must be replaced. Peel and Sumachs House DS0000065503.V321149.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. Peel and Sumachs House DS0000065503.V321149.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 Peel and Sumachs House DS0000065503.V321149.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 No admissions are made to the home until a full needs assessment has been undertaken. Service users are assessed by a skilled and experienced member of staff. The assessment involves the individual, and their family or representative, where appropriate. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector reviewed 4 care files. 2 for service users at Peel House and 2 service users at Sumachs House. The Inspector met one service user from each house, spoke with staff on duty and reviewed the assessment of needs. The service uses the Brandon Trusts person centered planning documents. This included a comprehensive assessment of service users’ individual needs. This assessment was in depth and reviewed the full range of service users’ needs covering aspects as diverse as sexuality, communication skills to social contact and health issues. Given the complex and diverse needs of the service user group there were restrictions on service users choice. Service users may be restricted from leaving the grounds on a risk-assessed basis. The Inspector Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 9 reviewed this and found that it was in the interests of health and safety and clearly care planned. The Inspector was able to observe staff working with service users. This observation supported staff statement and the home’s documentation to demonstrate the home can meet service users’ needs. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 10 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, 10 Quality in this outcome area is good Care plans are developed following person centred planning principles. Each resident has a plan that has been agreed with him or her. Each care plan includes a comprehensive risk assessment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Plans of care were detailed and highly individual. The service used Brandon Trust’s ‘Person Centered Planning’ documents called ‘Planning for Life’. The documents set out how the service would meet service user’s specialist needs and explored issues from the perspective of the person being cared for. Included in the plans were detailed protocols for staff in the event of acts of aggressive behavior by a particular service user. The protocols explored a range of probable causes of behavior, strategies for calming the person Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 11 involved and where necessary, appropriate physical interventions. This was also appropriately risk assessed. Where possible the staff team had drawn up plans of care with the involvement of the service. Plans of care are written in plain and simple English and regularly reviewed by the team. Staff were able to give examples of how service users were supported with day-to-day decisions. The Inspector noted evidence that service users were supported to have an involvement in the planning of their own care. The Inspector also noted that the home had been adapted to meet the service users’ needs and preferences. One service user particularly likes to wander in and out of the home and into a particular area of the garden. Staff at the home had arranged the rooms in the building in such a manner that this service user could enter and exit the building at his discretion without disturbing the other service user. Documents and confidential information were stored securely on the premises. Service users’ records appeared accurate, and were stored in accordance with the data protection act. Staff were aware that the contents of service user files were confidential. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 12 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): 13, 15, 16 and 17 Quality in this outcome area is good The service has a strong commitment to enabling residents to develop their skills, including social, emotional, communication, and independent living skills. Residents are involved in meaningful daytime activities of their own choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff at the home support service users to access the local community facilities. Activities include supported visits to local events, the cinema, a leisure centre and a pub. Because of the complex needs and levels of disability experienced by the service user group, extensive staff support is provided to enable service users to access community activities. The inspector found evidence from the care Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 13 files of service users visiting local facilities, shopping trips, and having supported outings. The daily routine at the home is flexible and designed to meet the needs of the service user group. One service user told the inspector that she was able sleep in if she was tired and could to go to bed when she wanted. During the tour of the premises, the Inspector was able to review the home’s menu. Both homes had a four weekly rotating menu that was adjusted seasonally. During the inspection, the Inspector observed staff preparing food and offering a choice to service users. A service user spoken with told the Inspector that if she did not like what was on offer she could have something else. Service users are offered 3 meals a day and a range of drinks and snacks as they require. Any particular dietary needs can be addressed by the service. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 14 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 Specialist health, nursing and dietary requirements are clearly recorded in each resident’s plan. It is recognised that the delivery of personal care is highly individual and must be flexible, consistent and reliable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the tour of premises the Inspector was able to watch staff interacting with service users. One service user was agitated and required support. The staff team treated the service user with dignity and respect, taking time to find out what was the likely cause of the person’s agitation. Due to the service user’s limited verbal ability the staff team required some skill understanding the individual’s needs. The service user’s case file had a range of words and utterances the service user used along with explanations for the meaning and probable causes of aggitation. This was good practice. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 15 Staff were able to outline service user’s preferences and give examples of successful staff intervention based on knowledge of these preferences. This was clearly documented in the service user’s care file. Additional specialist support will be obtained for a service user when needed. The Inspector found evidence of support from external professionals including, speech therapists and psychologists. All service users have a designated key worker. Staff were able to show the Inspector how healthcare needs had been assessed and where they were documented in the care files. The Inspector found evidence of medical assessment and treatment of conditions identified by the staff team. Service users would be supported to access national health service facilities by staff team. Service users at are unable to store and administer their own medication. The Inspector found risk assessments and care planning appropriate to reviewing the service users’ ability to administer their own medication. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 16 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 The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. Training of staff in the area of adult protection is regularly arranged by the Home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service has clear complaints, policies and procedures. A service user told the Inspector that if she was unhappy she could speak to staff. The service user trusted staff and felt that they would help her if she wanted to complain. The service user was aware of her right to complain although did not understand the role of CSCI. At the time of writing there were no complaints at either Peel or Sumachs. Both Peel and Sumachs had appropriate policies and training to protect service users from abuse. The Brandon trust specialist provides training for the staff team. The Inspector saw evidence of a comprehensive revolving program of training. This included training for staff to detect and understand abuse. The Inspector reviewed 6 staff files. In files sampled, all staff had received training relating to abuse of service users. Staff were able to outline their role in the event of evidence of suspicion of abuse or neglect. The Brandon trust have also provided positive response training for the staff team. This training covered how to manage, prevent and avoid physical and verbal aggression by service users. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 17 Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 18 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 The home provides a physical environment that is appropriate to the specific needs of the residents who live there. The lay out and design of the home allows for small clusters of residents to live together in a non-institutional environment This judgement has been made using available evidence including a visit to this service. EVIDENCE: Peel and Sumachs provide temporary accommodation to the service user group. The Brandon trust had gone to some lengths to refurbish the 2 properties to provide satisfactory temporary accommodation. Both Peel and Sumachs were suitable for their stated purpose. Both premises were safe, comfortable, bright and pleasant inside. The entry gate to Sumachs appears to be made from an internal door. During inspection staff informed the inspector that the gate kept swelling and sticking Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 19 in the frame. A large handle had been attached to the door but this had come away exposing screws and other hazards. The inspector identified the gate as a health and safety hazard. As such the inspector requires an appropriate gate be used to replace it. Both houses were free from offensive odours and had good light, heating and ventilation. A service user told the Inspector that they liked their house, and they liked their room. Furnishings and fittings at the home are of good quality but have to comply with strict health and safety assessments due to the needs of the service user group using the premises. The Inspector discussed the nature of the fixtures and fittings with the staff. Staff statement evidence, the Inspectors observation and review of the service user’s risk assessments indicated that the Brandon trust has appropriately furnished both houses. Both premises have planned routine maintenance and are in good order. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 20 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 Staff undertake external qualifications beyond the basic requirements. The Manager encourages and enables this and recognise the benefits of a skilled, trained workforce. Accurate job descriptions and specifications clearly define the roles and responsibilities of staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspection was conducted in the absence of the manager. As a consequence, the Inspector was unable to access certain documents relating to aspects of key standards 32 and 34. The Inspector reviewed records of staff training courses made available by the Brandon trust. There were a wide range of courses available to employees. During inspection, staff treated the service user group with respect and dignity. Training records indicate that staff have access to a range of courses that would develop skills and the abilities of staff to provide specialist care to the service user group. Staff were aware of cultural and religious issues that Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 21 may arise with service users of the different ethnic background. In excess of 50 of the care staff at the home had achieved NVQ two or higher. The Inspector was unable to access staff records to review the home’s recruitment procedures. Staff on duty confirmed that they had been requested to supply to references, undergo a criminal records bureau check and for more recent staff, a check against the protection of vulnerable adults list. Staff had received statement of terms and conditions and held a contract. In the absence of the manager, the Inspector was unable to find a training and development plan for the home. The Inspector noted evidence that staff had undergone a comprehensive induction package. Staff said they did receive paid leave for training although were unable to comment on how many days staff members took. Staff working at the home had received LDAF, (learning disability award framework), accredited training. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 22 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): 38,42 Quality in this outcome area is good The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. Staff are positive in their approach to translate policy into practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector spoke with staff, service users and reviewed documentation. Feedback from staff and service users indicates that the team and those that live on the premises feel the home has a sense of direction and leadership. Staff statement and documentary evidence indicate that the Brandon trust is an equal opportunities employer. Employees at Peel and Sumachs are recruited according to this policy. Reviewing available staff documentation, the Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 23 Inspector noted that there were strategies and policies that would enable staff members to voice any concerns they regarding the care provided. Staff have received training in moving a manual handling, fire safety and first aid. Staff have also received positive response training to manage acts of violence or aggression. The Brandon trust provide regular mandatory training for staff at the home. Staff were able to outlined their role in the event of the fire alarm sounding or a fire being discovered. Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 24 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 2 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 3 3 x 3 3 LIFESTYLES Standard No Score 11 x 12 x 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 x 3 x x x 3 x Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 25 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 YA24 Regulation 23 23 23 23 2 2 2 4 b c o c3 Requirement The inspector requires that the existing entry/exit gate to Sumachs is replaced with an appropriate external gate. Timescale for action 30/03/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Peel and Sumachs House DS0000065503.V321149.R01.S.doc Version 5.2 Page 27 - 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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