Inspection on 02/06/05 for The Garden House

This inspection was carried out on 2nd June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Garden House 01/12/08

The Garden House 23/01/07

The Garden House 21/11/05

The Garden House 17/11/04

The Garden House 28/04/04

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 The Garden House Bowden Derra Park Polyphant Launceston PL15 7PU Lead Inspector Philippa Cutting Unannounced 02 June 2005 02:30 p.m. 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. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Garden House Address Bowden Derra Park Polyphant Launceston Cornwall PL15 7PU 01566 86230 01566 86230 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) Bowden Derra Park Limited Mrs Caryn Anne Jory Care Home 12 Category(ies) of Learning disability (12) registration, with number of places The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Service users to include one named individual aged 17 years of age from 21 March 2005 to 24 March 2005 for a period of respite care. Date of last inspection 17/11/2004 Brief Description of the Service: The Garden House is an independently registered home within the Bowden Derra Park complex, which is owned by Bowden Derra Park Limited. It provides care and accommodation in single rooms for adults with learning difficulties, some of who may have associated nursing needs. Service users are essentially a younger age group. The home is situated within large grounds on the edge of a small village approximately seven miles from Launceston. Although it was built before the national minimum standards came into force the home has been designed to provide space for wheelchairs users to be able to move around with relative ease. Service users are encouraged to have an active life style. Full support from carers is provided, plus transport where necessary, to enable this to happen. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out at a time that encompassed the service users returning from their various daytime activities. Paper records were looked at and the premises inspected. The inspector talked with staff and service users or observed those who had communication difficulties. The Garden House tries to treat everyone as an individual and avoids taking people out in large groups, unless this is the service users’ choice. They prefer to go on a one:one basis or with another friend who may be a service user. The premises provide a home to a young group of adults and the entertainments and décor etc. try to reflect this. What the service does well: What has improved since the last inspection? What they could do better: The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 6 The registered manager is part of a management team. They are always open to new ideas and look for these and other opportunities for service users and staff. 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 Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 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 The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 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) These standards were not looked at on this occasion but have always been met on previous inspections. EVIDENCE: There has been no new service users admitted to the home since the last inspection, so these standards were not inspected. There is one vacancy, which the registered manager is considering. She will visit the potential service users to ensure that the home can meet the needs and that the person will fit into the existing group before offering care and accommodation. She commented that she had already declined one person on that basis. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 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) 6,7,8,9,10 Needs and choice are assessed on an individual basis and full care plans implemented to address these. Staff invoke thorough risk management procedures to safeguard service users and involve them in decision making as much as they (the service users) are able. EVIDENCE: Each service user has an individual plan of care and activity which is arranged in consultation with the service user and any important, relevant others. It can be produced in a visual/symbol form if the service user prefers. Each person has a keyworker. There is a regular house meeting which all are encouraged to attend where service users’ views on the home are recorded and actioned. All risks are thoroughly assessed and documented, both on individual activities on a daily basis and as an overall view of a service user’s needs. Very few of the service users are able to manage their own finances so this is undertaken on their behalf. Each person is provided with enough cash for their weekly needs with accessible savings held for them so that they are able to contribute towards holidays and clothes etc. The registered manager said that The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 10 she stressed to carers that service users have limited funds and so they needed to reflect that people were getting value for money when out shopping. Any purchases are recorded with receipts obtained. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 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) 11,12,13,1,4,15,16,17 Service users are provided with as many options as possible to encourage independence, further education and interesting leisure opportunities. They are fully supported to enable them to get the maximum benefit from these. EVIDENCE: All service users are encouraged to become as independent as they are able. Severe limitations due to service users’ functional abilities, remain but for the majority a one:one carer, who has developed a sound knowledge of a person’s preferences and needs, enables the service user to be part of the community and become involved in some very imaginative leisure and activity plans. The staff are aware of the need to arrange activities that are age appropriate but attainable and to this end service users attend college, drama groups, hydrotherapy and a local gym etc. as well as practising independent living skills training at the day centre in the local town. It was noted that a rearrangement of the room spaces provided more dining areas so that people who needed a quiet area to eat, away from the distractions of others, could now be provided with this. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 12 The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 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 Service users can be confident that their health needs will be pursued actively, with their involvement and include specialist input as necessary. EVIDENCE: There are detailed records available, kept discreetly in a folder in each room, recording how each person wishes to be assisted and how that assistance should be given. Staff displayed a good knowledge of people’s needs and abilities. All health needs are addressed with advice being sought regularly for any problems and include physiotherapy, occupational therapy, speech & language therapy, specialist learning disability nurses and chiropody as well as GPs and consultants etc. None of the service users are able to manage their own medication, this is undertaken by the trained nursing staff. There are full written procedures with clear recording. The Garden House has not yet experienced a death but the other registered homes on the campus have dealt with it sensitively and caringly. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 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 standard(s) 22,23 Complaints are few but they are taken seriously and addressed quickly. Protecting service users from abuse or neglect forms part of the regular training that all staff have to undertake. EVIDENCE: The home has polices and procedures that outline its complaints process. These have been made available in a pictorial format as well as the written word. In reality verbal complaints are more likely to come from someone other than a service user; a service user’s behaviour is more likely to indicate if there is a problem. From whatever source, complaints are taken seriously. Training relating to the protection of vulnerable adults has a high priority and the registered manager commented that staff will challenge and seek advice if they feel a colleague has allowed a situation where the service user could be potentially vulnerable to abuse. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 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 standard(s) The home is well maintained and its décor reflects the age and tastes of the service users. Sufficient and suitable equipment is provided to assist both service users and staff. EVIDENCE: The home was seen to be in good order with regular redecoration on going. Service users help choose their colour schemes and are encouraged to personalise their rooms as they wish. Door locks are provided which some service users choose to use. The home has two fully adapted bath/shower rooms with overhead hoists available, plus additional toilets and bathroom. Hoists are fitted in bedrooms as well where indicated. Scales to weigh people who rely on wheelchairs have recently been purchased. The use of CCTV has been discussed and agreed with the Commission for Social Care Inspection. The registered manager keeps this under review. The provision of a sluicing facility is highly desirable. A new room to provide even more communal space has just been completed which enables service users to choose where they wish to sit. There is a The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 16 variety of seating available to help people relax. The re positioning of the television has greatly improved the use of the communal space. Externally the home has created raised flowerbeds suitable for ‘wheelchair gardeners’ to form a sensory garden, as well as new leisure facilities. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21,22,23,24,25,26 The staff are valued. Safeguards are in place to ensure that suitable applicants are employed and a full training programme is provided with rewards available for successful staff. Service users thereby benefit from well supported and trained carers. EVIDENCE: Staff levels are high as the majority of service users have one:one carers with them throughout the day. It was noted that the staff were observant and intervened quickly where necessary to steer a service user away from potential difficulties. A trained nurse is available at all times. Despite the number of people in the home, staff and service users, they were spread through the premises so that it did not feel crowded. Staff details are recorded in individual files that include essential personal information and copies of each person’s training profile. Applicants are invited to the home for an introductory visit to all the areas on the campus and then invited to apply if they wish. New staff are taken on after satisfactory references and Criminal Records Bureau clearance. There is a planned, recorded three-week induction programme and review of progress. A full training programme is arranged and staff are expected to participate with promotion and a financial reward prospect. Training covers basic subjects such as first aid, food hygiene, health & safety etc and then the protection of The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 18 vulnerable adults, LADF (specific to learning disability). Courses are arranged in house and externally. A new staff grading has been introduced so that people with aptitude can progress and have a career structure. Regular supervision and annual appraisals are taking place. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 19 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) 37,38,39,40,41,42,43 The management team is efficient and effective. The policies and procedures safeguard the well being of service users and staff. EVIDENCE: The registered manager of The Garden House is part of a team with two other managers. Whilst they all have their individual responsibilities they work together to plan and formulate new ideas for the management of the homes and the well being of the service users. Records within the home are up to date and meet the statutory requirements. Safe working practices are maintained. There is clear definition of responsibility and accountability amongst the managers. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 4 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 4 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 3 4 3 4 4 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 4 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Garden House Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 3 3 D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 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 Regulation Requirement There are no statutory requirements. Timescale for action 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 30 Good Practice Recommendations The provsion of a sluice should be considered. The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell, Cornwall PL25 4AD 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 The Garden House D52-D04 S38198 The Garden House V226535 UNN 020605 Stage 4.doc Version 1.30 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!