Inspection on 05/05/05 for Sybden

This inspection was carried out on 5th May 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Sybden 17/04/09

Sybden 21/04/08

Sybden 23/04/07

Sybden 25/01/07

Sybden 02/06/06

Sybden 16/08/05

Sybden 07/01/05

Sybden 28/06/04

Sybden 16/10/01

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 Sybden Pipers Hill Great Gaddesden Hertfordshire HP1 3BY Lead Inspector Hazel Wynn Unannounced 05.05.05 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 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 Stationary 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. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Sybden Address Pipers Hill Great Gaddesden Hertfordshire HP1 3BY 01442 269986 01442 217646 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Turning Point Southern Area Office Application pending Care Home 6 Category(ies) of LD LD Learning Disability - 6 registration, with number of places Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no addiontional conditions of registration. Date of last inspection 07.01.05 Brief Description of the Service: Sybden is a residential home for six service users, who have a learning disability whose needs may require a high level of guidance and support. Prospective Service Users vacancy who are looking for a suitable placement, are supported to make a choice by regular visits, exploring options, and assessment of suitability of the home and that they are compatibale with the current group of service users. Sybden is a single storey country house, situated in the small, rather idyllic, village of Great Gaddesden, which is approximately 5 miles from Hemel Hempstead town centre. The home has been extended and sits amidst extensive gardens. The location is relatively remote and rural. There are a few shops, for basic requirements, services and community resources but these are limited. The home does have its own transport, which provides access to local towns, just a few miles away. There is a bus route close by. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This un-announced inspection took place on the 5th May 2005. A member of the staff team provided professional assistance to the inspector throughout the process; the rest of the team were attending a fire training lecture but the manager joined the inspector during breaks and toward the end of the inspection. Morale amongst the staff team was observed to be good. The inspection resulted in positive findings with one requirements for the manager to be registered (it is noted that the application is in process and date arranged for interview). What the service does well: What has improved since the last inspection? A new manager is in post and staff morale has increased dramatically. Administration has been well organised and the manager is continuing to develop this to increase efficiency and to suit her style of management. The homes keyworkers (the care staff team each have responsibilities for individual Service Users) and this has both developed the staff and encouraged greater ownership of role and enthusiasm for responsibility. The garden has been levelled and developed extensively to provide an even safer recreation area for the Service Users and for staff supporting them in this area of the home. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 6 Team meetings, back to work support sessions, formal supervision sessions and appraisals are regularly held. 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. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,and 5. Prospective Service Users are supported to make (in as far as is possible) an informed choice about where to live. All needs are fully assessed by a competent person in conjunction with the Service User and all significant others. The home will not admit Service Users for who they do not have the capacity to meet needs. EVIDENCE: Prospective Service Users are given a User Friendly Formatted Service User Guide and make frequent visits to the home (including overnight/weekend stays) as part of the assessment and transition process. A plan and progess notes for a prospective Service User was seen. The CSCI has been given a copy of the Service User Guide. We saw full and comprehensive assessments in place on individual files. Contracts are with the Local Authority purchasing the service and Service Users have a copy of the Agreement on their individual files which keyworkers have supported them to work through. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 6,7,8,9 and 10 Care plans contain a full and comprehensive assessment of Service Users personal needs, goals and aspirations and these are kept reviewed. Service Users are supported with an individual approach to make decisions. Service Users influence how the home is run. Risk management is conducted within a risk management framework to promote independence. Information about Service Users is securely stored and confidentiality is protected. EVIDENCE: Care plans that include assessment of needs, risk assessments and personal goals/aspirations were seen and found to be comprehensive and regularly reviewed. We observed Service Users being given choice and making decisions. Service Users views are gathered in a variety of ways and the home is run and changes made in accordance with the Service Users views. This is evidenced in review notes and changes to Care Plans. Risk assessments were seen and these were supportive of risk taking, within risk management guidelines, to promote independence. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 10 Information about Service Users was observed to be securely stored and policies and procedures regarding confidentiality were in place. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 11,12,13,15, and17. Opportunities are provided to promote personal development. Service Users take part in age, peer and culturally appropriate activities including those within their local community and also with family and friends. The home supports Service User to exercise their rights and observe their responsibilities. A wholesome diet is provided and enjoyed. EVIDENCE: Care plans and progress notes provided evidence that personal development is supported and that Service Users enjoy taking part in age, peer and culturally appropriate activities with the support of the care staff team and also with family member and friends. Service Users are well known in the village and use local resources with details in the care plans. Policies and procedures are in place to protect Service User rights and for the recognition of their responsibilities; we observed this in practice during staff and Service User interaction. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 12 The dietician provides regular input at the home and the menus showed a variety of wholesome meals. Alternatives are provided and any alternative meal consumed is recorded. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 18,19,20,21 Personal care needs and health care needs are well supported with an individual approach acceptable/preferred by each Service User. EVIDENCE: The care plans we looked at contained guidance to staff in how to manage personal care needs according to the Service Users preference. Likes and dislikes/preferences were clearly recorded. In reading the progress notes we observed how health care and emotional needs were being met. We also observed the meeting of the emotional needs of two Service Users whilst staff were catering for their needs. Generally a Service User will attend the GP surgery for consultation but if the GP needs to be called out he will visit them in their own room and a member of the homes Care Staff Team will support the Service User. All appointments are recorded and outcomes of appointments are documented, which aids consistency in following up. None of the Service Users in the home are able to self administer their own medication even with support. Staff administer the medication and this was found to be well managed, stored and with no gaps on the Medication Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 14 Administration Record. A record is maintained of all medication returned to pharmacy and a receipt book was observed to be maintained. The home has supported Service User with regard to final wishes, although the Service Users are relatively young. Some Service Users have paid into plans and for those Service Users whose facilities would want to make such arrangements, this was observed to be documented on the Care Plans. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 22 and 23 Service Users views are listened to and acted on. Various tools and methods are used to aid such communication. Service Users are protected from abuse, neglect and self-harm. EVIDENCE: We observed that various methods are used to support Service Users to air their views/express themselves and the home responds appropriately to provide a positive outcome for the Service Users. Behaviour Management Plans are in place to support the Service Users to express themselves in positive ways whilst respecting others. Policies and procedures together with abuse awareness training for the homes care staff team support vulnerable adult protection strategies in place at the home. Finances are well managed and a sample of these were checked by us and found to be transparent and accurate. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 standard(s) 24,25,26, 27,28,29 and 30 The Service Users benefit from living in a clean and comfortable home. The home is well maintained and a safe environment is managed. The service Users also benefit from specialist equipment provided both individually and collectively to aid independence and safety. EVIDENCE: During a tour of the home, we observed it to be clean, homely and inviting. The Service Users own rooms are well personalised and reflect the personalities and interests of the Individual Service users. Adequate bathing facilities and toilets are provided were hygiene and personal needs can be met in privacy and safety. The home has adequate shared space and provides for a larger lounge and a further smaller lounge. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 17 The garden has been extensively tended to and levelled to provide for a safer ‘at home’ leisure facility; where in, fairer weather, Service users can relax or take part in activities in the safe confines of the grounds. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36. The home is adequately staffed and provides training, policies and procedures to ensure Service Users are cared for by a competent team in a safe manner and that their health, welfare and safety are well managed. EVIDENCE: Staff spoken with stated that all new employees receive a staff handbook that contains their job description and a flow chart that shows the roles and responsibilities of others in the organisation. Formal supervision is provided and this also aids clarity of own role and roles of others as well as tracking performance and Service User progress. The Care Plans seen were well maintained and tracking of these had been regularly carried out. There is a training programme in place for all new care staff and the Learning Disability Award Framework is used for this; this is completed during the probationary period and staff are encouraged to follow on with National Vocational Qualifications. Staff training plans were seen to contain all mandatory and additional training needs. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 19 Staff files contained their application form with any gaps explored, at least two professional references, a medical declaration, appropriate forms of ID and CRB/POVA checks. Fire Training for the care staff team was in process during the inspection process and we were able to provide the link to the Fire Service website where the manager will be able to access some guidance and tools for carrying out a thorough Fire Risk Assessment to update the generic/previously completed fire risk assessment. The rotas we observed showed that the home is consistently adequately covered and that rotas were planed ahead. Staff stated that they were very happy working in the home and that the new manager has brought many positive changes which has raised morale. The team is now stable and previously vacant posts are almost fully recruited. Staff appeared happy and joviality together with professionalism was observed both in the interactions of staff with staff and staff with Service Users. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40 41. 42 and 43. Throughout this inspection we were satisfied that the home is well run and that safeguards are in place for the protection of and well being of Service Users and Staff. EVIDENCE: It was observed that records pertaining to the Service Users, health, personal and social care needs were well maintained. Health and Safety records were up to date including: emergency lighting and call point testing in case of fire and other safety checks which included COSHH. A fire equipment servicing engineer had regularly checked fire safety equipment and records of these checks were on the file. A fire safety-training programme was in process when we arrived for this unannounced inspection. Staff training is provided through accredited and recognised resources. Formal supervision and appraisal of staff records were observed to provide evidence that these were regularly provided and staff stated that their formal supervisions were a positive experience. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 21 The organisation carries out a monthly audit of the service, progress of Service Users, and of the records in place, Policies and procedures are in place and Risk Assessments have been carried out in respect of all known risks both regarding the environment and the health, safety and welfare of both Service Users and Staff regarding work and daily living activities. The communication book was well utilised and contained positive communication between the team members. We looked at a sample of Service User financial records and observed these to be transparent and accurate. The manager is not yet registered and a requirement for a registered manager to be in post has been carried forward; although it is noted that an application has been received and a date now arranged for the Commission for Social Care Inspection to interview the manger. Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 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 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sybden Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 1 3 3 3 3 3 3 I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 23 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 YA37 Regulation 8 Requirement A registered manager must be in post. (It is noted that the manager was in the process application for this post, to the Commission for Social Care Inspection). Timescale for action 30.06.05 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 Good Practice Recommendations Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Sybden I52 s19559 Sybden v224199 040505 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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