Inspection on 21/11/05 for The Garden House

This inspection was carried out on 21st November 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 02/06/05

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 Cornwall PL15 7PU Lead Inspector Philippa Cutting Unannounced Inspection 21st November 2005 02:30 The Garden House DS0000038198.V254167.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 The Garden House DS0000038198.V254167.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. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 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 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) 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 DS0000038198.V254167.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd June 2005 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 DS0000038198.V254167.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place in the afternoon. Most of the service users were in the home for at least part of the visit, some returning from their various day time activities at the end of the afternoon. The inspection included a review of care records, discussion with staff, service users and observation. Some recently completed building works and the way the extra space was being used was seen. What the service does well: What has improved since the last inspection? What they could do better: The use of the ‘old‘ office space must be considered carefully as, if the doors are shut, it has no ventilation. The reports compiled under Regulation 26 need to be fuller and more informative. Some alternative formats will be sent for reference. Please contact the provider for advice of actions taken in response to this The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Garden House DS0000038198.V254167.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 The Garden House DS0000038198.V254167.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): EVIDENCE: As there has been a stable group of service users these standards were not inspected. The Garden House DS0000038198.V254167.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): 6,7,8,9,10 Choice and individuality is at the heart of the care provided for service users. They are actively encouraged to participate in as many aspects of the home as they wish or are able. Risks are regular assessed and action to minimise them taken. EVIDENCE: Each service users has an individual plan that sets out his or her needs in detail and the care needed to meet these. The service users and/or family or other relevant people are included in preparing plans. Some are produced in alternative formats if this is easier for the service user to understand. It is important to ensure that service users’ functional needs and abilities are fully included as well as their developmental and social goals, as this can form an important reference point subsequently when progress is being assessed. Risk is assessed and documented. There is an aide memoire regarding risk assessment for each service user every time they leave the campus that accompanying carers must complete. The home holds regular minuted meetings which everyone is encouraged to attend. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 10 Currently all service users need help managing their money so this is held for them, with a receipt obtained for any expenditure. Spending is not controlled by staff but people are encouraged to save for holidays and treats etc. The Garden House DS0000038198.V254167.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): 11,12,13,14,15,16,17 A flexible lifestyle that provides service users with opportunities is at the heart of the care provided. Service users are encouraged to be responsible and responsive in their daily lives. Staff have to balance the needs of people who may be more vocal with those of a quieter nature. EVIDENCE: Service users’ care plans and their comments showed that people are involved in a wide variety of activities both locally and in college. Activities include hydrotherapy, gym workouts, drama and independence skills. Work experience opportunities have been arranged where this was indicated. The majority of service users have one:one care. It was noted that there was a friendly repartee and banter between carers and service users when in the home although the carers attended to their prescribed responsibilities for that day. Service users asked who would be on duty as they were obviously aware of people’s particular strengths and interests. Families are welcomed to visit and service users can go home for weekends and breaks if they wish. Everyone is offered a holiday of their choosing. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 12 Service users now have the opportunities to eat in various places rather as a large group. This is more satisfactory as people have choice as to where and with whom they might wish to sit and those who need a quiet area away from distractions, are catered for. Meals are prepared in the central kitchens and delivered to The Garden House for serving. The Garden House has scope to prepare simple snacks and drinks etc. Diets or special nutritional needs are met. The Garden House DS0000038198.V254167.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): 18,19,20,21 Service users’ health care needs are properly met within the home with specialist help being sought where this is indicated. EVIDENCE: All service users are registered with local GPs. There is a trained nurse on duty at all times in the home, whose expertise is sought as necessary. Care staff, seniors in particular, have developed a good knowledge and understanding of the service users’ needs. Help and support is provided for any service users who have to attend an outpatient appointment or hospital stay. Some services are provided on a domiciliary basis e.g. chiropody, physiotherapy, speech & talking therapy, epilepsy nurse specialist etc Medication is currently administered by the trained nursing staff as none of the current service users are able to undertake this for themselves. There are written procedures and clear medication administration record sheets. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 No complaints have been received since the last inspection. EVIDENCE: Service users have opportunities to raise concerns at any time. Where there are communication problems, concerns or anxieties are more likely to be demonstrated through behaviour. The protection of vulnerable adults from abuse (PoVA) is taken seriously with regular training and updates. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,26,27,28,29,30 The home is presented as a young person’s environment with service users’ taste and age being reflected in the décor. Service users can choose where they prefer to spend their time when at home and this is respected by the staff. There is sufficient and suitable equipment to meet the needs of service users. EVIDENCE: The home is decorated in a bright and cheerful style that suits the age group of the people living there, with a choice of communal areas. Considerable talk and laughter was observed in the main lounge with staff playing games or helping service users with activities. Others had chosen to sit in a quieter area, some with staff, others being observed discreetly. The majority of service users are independently mobile so there is frequent damage in doorways from wheelchairs when the users turn corners too tightly; this is constantly being repaired & redecorated. A selection of seating is provided in various areas and it was seen that people had chosen to curl up and sleep on sofas. Storage has been a problem as a number of service users have additional equipment to aid physiotherapy exercises. The additional space, recently built, has helped with this. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 16 All service users have their own individual rooms. They have been decorated and personalised to each person’s taste. They contain pictures of families, popstars/sports men & women and ornaments etc. Many have their own music systems, videos & televisions as well as coloured lights with the result that people choose to spend time there as well as in the communal parts of the home. Staff were aware of who preferred their privacy and respected this. Ceiling track hoists are fitted to assist both service users and staff. There are two fully adapted ‘wet floor’ bathrooms with walk-in showers & toilets with hoists etc. as well as additional toilets. The bathrooms are more appropriate for the needs of the current service user group (as opposed to en suite facilities), the majority of whom need help with bathing and toileting. The home has CCTV, which may be used within strict agreed guidelines. Laundry is taken to the central laundry and returned ready to be put away. Externally there is a paved area around the home with level ground leading to lawn. Staff have created raised flowerbeds with scented plants and an exercise/ play area for service users to use. Despite the number of people, staff and equipment in the home the inspector’s concerns that it would be overcrowded has not materialised during the times she has visited. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36 Staff & service users were seen to interact well with one another. Staff indicated that they felt supported and all commented that they enjoyed their work which they found challenging and rewarding. EVIDENCE: The staff team are organised so that whilst service users have a key worker to whom they can refer, other carers are familiar with peoples’ needs so that there is flexibility within the working day. Staffing levels are high, as most people need one:one care throughout the day and in some cases at night. The staff team was generally settled at the time of this inspection. New staff are given the opportunity to work indifferent areas of the Bowden Derra complex initially so they can decide where they feel most suited. Training for staff receives high priority and this was discussed with the registered manager. The records for this and recruitment were not inspected on this occasion as these are held centrally in the administration office in the main house. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41, Management is effective and puts the interests of service users first whilst ensuring that they are safeguarded. The staff team is valued and supported by management. EVIDENCE: Management is inclusive and proactive. The registered manager is experienced in the field of care for younger people and has brought a number of ideas and good practices to the home. She consults regularly with two other managers within Bowden Derra to plan how to deliver the services that all the service users need, whilst retaining her individual responsibility for The Garden House. Statutory records are maintained adequately and correctly. The inspector felt that the reports by the responsible individual were not very informative or else did not reflect the extent of visits made under this regulation. A sample of alternative formats will be forwarded for consideration. Where an issue is identified it would be helpful if the report indicated whose responsibility it was to take an agreed action. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 19 The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 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 Score 4 4 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 4 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 4 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Garden House Score 4 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 X 3 X X DS0000038198.V254167.R01.S.doc Version 5.0 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. Standard Regulation Requirement 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 YA41 Good Practice Recommendations Regulation 26 should be fuller. The Garden House DS0000038198.V254167.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office 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. 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