Inspection on 20/02/06 for Red Gables

This inspection was carried out on 20th 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Red Gables 04/12/06

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 Red Gables 1 Pinnocks Croft Berrow Burnham-on-sea Somerset TA8 2NF Lead Inspector Sally Murphy Unannounced Inspection 1:15 20 February 2006 th Red Gables DS0000061625.V263247.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 Red Gables DS0000061625.V263247.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. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Red Gables Address 1 Pinnocks Croft Berrow Burnham-on-sea Somerset TA8 2NF 01278 786607 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) Voyage Ltd Mr Mark John Coxwell Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users may be admitted to the home that have a concurrent physical disability. The home may admit service users aged 16 and 17 years. Date of last inspection 30th June 2005 Brief Description of the Service: Red Gables is a large detached property on the outskirts of Berrow. Service user accomodation is provided over two floors. All bedrooms have en suite bathroom facilities. The is a range of communal space available to service users, including an activities room and training kitchen. The home has been decorated and furnished to a a high standard, and appropriate adaptations have been provided to meet service users needs. Red Gables is registered with the Commission for Social Care Inspection to provide accomodation for up to ten service users. The home is able to admit service users aged 16-65 years who have a learning disability. Service users who also have a concurrent physical disability may be admitted to some ground floor rooms. Tina Thomas has been appointed as the Manager, and has applied to CSCI to become the Registered Manager for the home. The Registered Provider is Voyage Ltd. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and carried out by two Inspectors over one day. This was the second inspection for the service. On the day of the inspection there were six service users residing at the home. During the course of the inspection service users, staff members and the Manager were spoken with, care practice was also observed, records examined and a tour of the premises was made. What the service does well: What has improved since the last inspection? What they could do better: On the day of the inspection, an Immediate requirement was issued in relation to fire safety and safeguarding service users. The Registered Provider has responded promptly and provided written confirmation that each of the areas raised have been addressed. In order to reduce the risk of cross infection, appropriate hand washing facilities consisting of liquid soap and paper towels must be available for staff in all areas where they provide assistance with personal care. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 6 Staff must ensure that damaged furniture is repaired quickly, and heavy items such as wardrobes are secured to ensure that they do not pose a risk to service users. 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. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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): 1, 2, 3 & 4. Service users and their families are provided with appropriate information to make a decision regarding admission to the home. An assessment is completed to ensure that the home will be able to meet the service users identified needs. EVIDENCE: The home has a Statement of Purpose and Service User Guide that provide details of the services and facilities offered at Red Gables. These documents also set out how the home aims to meet the needs of service users aged 16-17 years. Pre-admission assessments were seen within service user files. Prospective service users and their families are encouraged to visit the home. Service users are supported in spending short periods at the home before moving in on a permanent basis. Two new service users have moved into Red Gables since the last inspection. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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): 6, 7, 8 & 9. The home ensures that an assessment of need and individual plan is developed for each service user. Service users are supported in making decisions and exercising choice over their lives. EVIDENCE: Care plans are maintained for each service user. The Manager is currently in the process of reviewing service user plans and has completed the care plan for one service user in the new format. Two care plans were examined during this inspection. Those care plans seen were detailed and provided information regarding service users needs, daily routines and preferences. Care plans had been regularly reviewed and updated as required. Service users are encouraged to exercise choice, wherever possible. Staff have a good understanding of service users’ needs and are respond to choices that are expressed through verbal and non-verbal communication. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 10 Risk assessments had been completed for each service user. Care plans included details of strategies to be used to manage challenging behaviour, where necessary. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15 & 16. Service users are provided with a range of activities that are appropriate to their individual needs, and are supported in accessing the local community. On the day of the inspection, one service user was attending college. Not all of the standards were assessed on this occasion. This report should be read in conjunction with the last inspection report. EVIDENCE: The high level of staffing at the home provides service users with the opportunity to participate in a range of activities. These include: music & relaxation, trampoline, creative play, ‘atmospherics’, hydrotherapy, physiotherapy, horse riding, music therapy and swimming. On the day of the inspection service users were participating in an exercise and movement session. There is also a training kitchen where cookery such as bread making had been offered as an activity. There is a sensory room provided in the Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 12 home. A music therapist visits the home each week. The home has use of two minibuses to access local facilities. Staffs support service users in maintaining contact with friends and family members. Visitors are welcomed at the home. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Service users are provided with support and assistance to meet their personal care needs. The home supports service users in accessing healthcare services. All medications are stored securely. Staff are provided with appropriate training to meet service users health and personal care needs. EVIDENCE: All service user rooms are single occupancy and have en suite facilities. Care plans provide details of the level and type of assistance each service user requires to meet their personal care needs. Staff at the home work closely with the GP, dietician, and District nursing service to meet service users healthcare needs. Two physiotherapists visit the home each week, and the chiropodist visits on a six weekly basis. Staff ensure that those service users who are not able to stand unassisted, are weighed on a regular basis at another home owned by Voyage Ltd. The Manager had ensured that staff receive training in relation to service users’ specific health and personal care needs. The manager has also requested new staff training such as diabetes awareness. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 14 All medications were stored securely. Medication Administration Records were examined. A record had been maintained in relation to all medications entering and leaving the home. Medication Records include a photograph of the service user. An opening date had been recorded for all liquid preparations. The home must ensure that Medication Administration Records include clear guidance for the use of ‘as required medication’ and external creams. Some good systems were evidenced such as the use of drug incident reports, and asthma management guidelines. It is recommended that the home record the reason when medications are returned to the pharmacy. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. The home has appropriate policies and procedures in place to safeguard vulnerable adults, and those service users aged 16-17 years. EVIDENCE: The home has a complaints procedure that provides details of external agencies that may also be contacted including CSCI. A copy of this policy is displayed in the entrance to the home. The home has received one complaint since the last inspection, and has taken appropriate actions to address the issues raised. The home has appropriate policies relating to the Protection of Vulnerable Adults. The home operates a robust recruitment procedure and ensures that a POVA First check is received prior to any staff member commencing employment in the home. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 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. The home had been decorated and furnished to a good standard. Appropriate adaptations have been provided to meet individual service user’s needs. There was a range of communal areas available. The home was found to have a high standard of cleanliness. EVIDENCE: The Registered Manager had ensured that appropriate adaptations are installed prior to any service user moving to the home. All service user rooms have en suite facilities. Bedrooms have been decorated to reflect individuals’ tastes and preferences. Staff must ensure that heavy items such as wardrobes are secured to ensure that they do not pose a risk of injury to service users. Doors have keypads fitted to ensure privacy, and alarms that may be activated during the night to alert staff that an individual may require assistance. Communal areas comprise of a lounge, dining room, activities room, conservatory, well-equipped sensory room and training kitchen. There are also further seating areas within the home. Two drawers within the cabinet in the dining room were damaged, and must be repaired to ensure that they do not Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 17 pose a risk to service users. The garden is secure and accessible to service users. The home receives regular support from a handy man in order to ensure furnishings & décor are maintained. For the protection of service users, the kitchen and laundry are accessed via a keypad. The washing machine has a sluice facility. In order to reduce the risk of cross infection, hand washing facilities consisting of liquid soap and paper towels must be available in all areas of the home where staff provide assistance with personal care. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 & 36. Staff levels are appropriate to meet service user needs. Staff are provided with relevant training to undertake their role. The home operates a robust recruitment procedure. Staff are provided with regular supervision. EVIDENCE: Duty rotas are maintained. At present there are generally five staff on duty during the day and three waking staff at night. Two of the present service users require 1:1 assistance. Since the last inspection, three additional staff have joined the team at Red Gables. The Manager has recently completed an analysis of staff training needs, to ensure that all staff are provided with appropriate training to undertake their role. Newly employed staff complete a thorough Induction programme and undertake LDAF training. Staff are provided with regular opportunities to receive training, and have attended courses on health and safety, food hygiene, First Aid, rectal administration, manual handling, Protection of Vulnerable Adults, autism and epilepsy. Five of the twenty staff employed have obtained the NVQ level 2 qualification in care. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 19 Two staff recruitment files were examined. Each was found to contain the documentation required within Schedule 1 of the Care Home Regulations 2001. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41 & 42. The home is well managed, and staff are provided with appropriate support to undertake their role. Staff endeavour to promote the rights and best interests of service users. Records relating to health and safety have been appropriately maintained. EVIDENCE: Tina Thomas has been appointed as the Manager, and has applied to CSCI to become the Registered Manager for the home. Ms Thomas has many years experience of providing care to a service users who have a learning disability. Staff at the home seek service users’ views on an individual basis, taking account of behaviours, verbal and non-verbal communication. Staff spoken Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 21 with confirmed that the Manager was approachable and that they would be able to raise any concerns. On the day of the inspection an Immediate requirement was issued in relation to the Inspectors and staff being unable to open the fire exit on the first floor. The Inspectors were also concerned that service users may be able to leave the building without staff supervision, and that staff and service users may be at risk from the fire door to the laundry not being kept shut. The Registered Provider has responded promptly to the issues raised within the Immediate requirement and provided written confirmation that each of these areas has been fully addressed. The home operates a comprehensive system of health and safety audits. Fire safety records were examined. Fire equipment had been serviced and tested as required. The electrical hardwiring certificate, portable appliances and landlord gas safety certificates have been appropriately maintained. Hoists and assisted baths have been tested under LOLER Regulations. Accidents have been recorded and an analysis completed on a monthly basis. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 4 3 3 3 2 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 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Red Gables Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 X DS0000061625.V263247.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? No 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 (2b) Requirement Two drawers within the cabinet in the dining room are damaged, and must be repaired to ensure that they do not pose a risk to service users. Staff must ensure that heavy items such as wardrobes are secured to ensure that they do not pose a risk of injury to service users. In order to reduce the risk of cross infection, hand washing facilities consisting of liquid soap and paper towels must be available in all areas of the home where staff provide assistance with personal care. Appropriate actions must be taken to ensure that staff and service users may leave the building through the first floor fire exit. The laundry door must be kept closed or an appropriate closure device fitted. Timescale for action 14/04/06 2. YA24 13 (4c) 14/04/06 3. YA30 13 (3) 31/03/06 4. YA42 23 (4a & b) 20/02/06 Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 24 5. YA42 13 (4a) Due to the high level of support required by service users at this home, appropriate actions must be taken to ensure that staff are alerted should service users attempt to leave the home without appropriate supervision. 20/02/06 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. Refer to Standard YA20 Good Practice Recommendations It is recommended that the home record the reason, when medications are returned to the pharmacy. Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Red Gables DS0000061625.V263247.R01.S.doc Version 5.0 Page 26 - 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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