Inspection on 16/08/05 for The Old Quarries

This inspection was carried out on 16th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Old Quarries 08/08/06

The Old Quarries 30/01/06

The Old Quarries 26/01/05

The Old Quarries 19/10/04

The Old Quarries 12/02/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 The Old Quarries Rectory Lane Avening Nr Tetbury Glos GL8 8NJ Lead Inspector Paul Chapman Announced 16 August 2005 09:00 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 Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Old Quarries Address Rectory Lane Avening Nr Tetbury Glos GL8 8NJ 01453 832201 01453 832058 Janet.Newbould@hft.Org.uk Home Farm Trust 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) Janet Newbould Care Home 32 Category(ies) of Learning Disability (32) registration, with number Physical Disability (3) of places The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 32 LD includes 3 LD residents who are also under PD Date of last inspection 26/01/05 Brief Description of the Service: The Old Quarries is an old Vicarage House with a number of accommodation facilities within the house or grounds. The home is situated near Tetbury and Nailsworth in Gloucestershire and service users have access to transport that is provided by the Organisation. The service users use the local facilities, supported by staff where appropriate. The site is staffed 24 hours a day, seven days a week. Family and friends are welcome to visit the Old Quarries at any time and service users can meet them in private if they wish to. The service users at the site use a number of Day Services, most service users attend the Day Services that are available on site provided by the Home Farm Trust. Gloucestershire Social Services and local Colleges provide other Day Services. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was completed on a day in August 2005 with the inspector attending the fun day held 3 days after. On the day of the inspection the inspector spent 7 hours at the home. All of the homes across the site were visited; not all of them were inspected thoroughly but will be at the next inspection. All the accommodation seen was of a high standard. The inspector spoke to a number of the service users in different settings about their activities, goals and needs and what they thought it was like to live at the home. In addition to this various documents and records were examined including Person Centred Plans, risk assessments, staff files and records of checks to maintain the health and safety of the service users. What the service does well: What has improved since the last inspection? The environment across the site continues to improve. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 6 The number of service users with Person Centred Plans has increased, and record keeping across the site is more organised. 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. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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 Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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) EVIDENCE: None of these standards were inspected on this occasion. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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 PCP’s are developed with service users involvement making good use of technology to highlight their future goals and current needs that enable staff to plan strategies to meet them. Evidence was seen of these goals and needs being met. Risk assessments are completed by appropriately trained staff that minimise risks to service users. EVIDENCE: During the day of the inspection the inspector met with numerous service users in different settings. This included talking to a group of six service users in their day services, meeting a couple who explained their Person Centred Plans (PCP’s – give service users the opportunity highlight their goals and aspirations for the future) and meeting two other individual’s who explained their PCP’s to the inspector. In addition to this one other PCP was examined. Comments from the service users’ confirmed they were involved in developing their PCP’s and all the people who spent time with the inspector, with their PCP’s were able to explain them and their involvement. Clear evidence was The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 10 seen that the goals identified by the service users were being met with the support of the staff. In addition to PCP’s there are support plans (called a ‘my support plan’), which identified a service user’s strengths and weaknesses, talents, achievements and dreams, etc. These continue to be introduced for all the service users across the site. The format of the PCP’s continues to be developed by the registered manager using video, computers and pictures. Examples of these were available and one service user showed the inspector the CD ROM of his PCP. A good practice recognised by the inspector related to the guidelines for staff to manage a service user’s behaviour. The manager proposed to introduce the guidelines in a staff meeting in the week following this inspection. A number of the service users were able to identify situations where staff had supported them to make decisions about their lives which they felt were appropriate. All of the service users confirmed that they felt they were consulted with, and able to participate in all aspects of life within the home. Whilst visiting the different houses across the site evidence was seen of the service users’ participating in all aspects of day-to-day life with rotas for jobs around the home and service user meeting minutes showing their involvement in decision making. Risk assessments are completed for all service users and those seen were comprehensive. One shortfall was identified in Chandler House and the team leader should complete a “general travel” risk assessment for one service user who can display some behaviour that challenges the staff. All of the records seen were stored securely and managed confidentially by the staff during the inspection. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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, 14, 15, 16, 17 The wide range of leisure activities and opportunities for personal development for the service users mean they lead active and fulfilling lifestyles. EVIDENCE: As mentioned earlier in this report the inspector spoke to a number of the service users. Each of them were asked what activities they are involved in and whether they enjoyed them. The range of activities they stated they were involved in included: College - where they did pottery, dressmaking, embroidery, art and craft, independence, work skills. Day Services – provided on site. Work placements in the local community as well as one person working in the office on site and another delivering the post across site. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 12 Leisure activities – shopping, walking, horse riding, pub, cinema and golf. Holidays – Bournemouth, London, Cornwall, Devon. In addition to these activities service users also attend the local Gateway Club regularly. Service users have friends without learning disabilities and the staff support service users to have appropriate personal relationships. Substantial evidence of this was present in service users files. On the day of the inspection a service user was having a birthday party that the inspector was invited to. The service users parent was present and spoke to the inspector about their sons care at the home. She was really positive about the care he receives and about the homes, and her sons continuing communication/relationship with her. Service users’ PCP’s and Support plans provided evidence of their rights being respected. This was further supported by service users comments when asked if they made a complaint whether they felt they would be listened to, all of the service users stated they felt they would be. Service users spoken with during the day stated that the food was good and they were involved in choosing and preparing it wherever possible. Menus seen by the inspector confirmed that a good range of healthy, fresh meals were available to everybody. Visiting the different homes across the site showed that snacks are available between meals. The inspector visited the home for the fun day on the Thursday after the inspection where he had the opportunity to speak to some other relatives of the service users. Conversations with these relatives supported the comments made by others on the day of the inspection in that they were positive about the care being provided by the home. It was also good to see the substantial input by the service users across the site in running stalls and activities. The inspector wishes to thank the home for inviting him to the event. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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 The home makes good use of other professionals to meet service users’ needs where it is identified that they are unable to. On the whole medication administration is recorded correctly across the site but the shortfalls identified must be addressed to ensure that all of the service users are not put at risk by a medication error. EVIDENCE: All of the service users have Keyworkers. Service user’s files showed that they receive support from other professionals, e.g. occupational therapists, physiotherapists, psychiatrists and others. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 14 Where service users require support with their intimate care, guidelines are available to provide consistent support. On the whole staff support service users with these needs by providing prompts. Where possible service users are supported to maintain their own medication. Examination of the medication administration across the site identified some shortfalls, these included: • • Gaps in recording when a service user had received their medication. The medication sheet key not being used correctly. These areas must be addressed and become a requirement of this report. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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, 23 The complaints and protection from abuse procedure, plus staff training minimises the risks of abuse to service users. EVIDENCE: Before the previous announced inspection the home had introduced a new complaints procedure which made good use of simple language supported by the use of symbols. Since the previous inspection all of the service users have been involved in workshops where staff have explained the new procedure. This was confirmed by the service users. As mentioned previously in this report service users stated that they felt they would be listened to if they had a complaint. The Inspector has examined the policy and procedure regarding service user protection from abuse at a previous inspection. It sets the framework for a robust response to any suspicion or evidence of abuse or neglect. All staff complete abuse awareness training. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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, 28, 29, 30 The accommodation provided across the site meets the current needs of the service users that live there. The organisation continue to fund improvements to the fabric of the accommodation across the site to meet the needs of the service users. EVIDENCE: Across the site the units are decorated to a high standard with all communal areas in the units being personalised by the service users. All of the units provide a safe environment for the service users that live there. The environment across the site continues to improve. The bedrooms seen during the day of the inspection were decorated to a high standard and personalised by the people that lived in them. Service users spoken with stated that they liked their bedrooms. During the inspection the inspector was told about various improvements that are planned for the future across the site. These included: The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 17 • • • Chandler House – The hall, lounge and stairs are to be decorated. New furniture is going to be bought and the floor covering in the hall, lounge and at the bottom of the stairs is to be replaced. Main House – It is planned that the entrance hall will be decorated. Currently the gatehouse is being converted into accommodation which will comprise of a flat for two of the service users, and accommodation for one other in another part of the building. Since the previous inspection Meadow view’s conservatory has been completed and now gives the service users living there considerable more communal space to share. In addition to this there is a sensory garden in front of the main house that has been completed. In the main house one of the rooms has been turned into a sensory room with a ball pool. The units have various adaptations to meet the needs of the service users, for example: grab rails, stair lift and bath seats. All of the units visited during the day were clean and hygienic. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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 Robust recruitment procedures and record keeping ensures that service users are not put at risk of unsuitable staff being employed. The training completed by the staff team ensures that they have the skills to meet the needs of the service users. EVIDENCE: A number of the service users are involved in the recruitment of new staff and it is planned that further training will be provided to enable them to have greater input in the future. Staff files were examined and seen to meet the criteria of the regulations. All staff have job descriptions and contracts and complete a comprehensive induction when they join the organisation. After completion of this further training is available and the inspector examined the training records for 2005. Records showed that courses completed by a substantial number of the staff this year included: Food Hygiene, Fire Safety, Abuse Awareness, infection control, Safe Handling of Medication, Supervisory Development as well as other courses. In addition to this the majority of the staff team have completed, or are completing their NVQ’s. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 19 To address a specific need the staff of Chandler House have completed a 2-day SPACE behaviour training course. Examination of the rota for Chandler House showed that they have extra staff on duty to meet the needs of this service user. One concern was raised by the inspector from examining the rota, not all of the staff working in the home were trained to manage the behaviour. The inspector explained that all staff working in the home should be trained appropriately and this becomes a requirement of this report. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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, 42 The manager’s leadership and approach is a factor in the continuing development and improvement of the service provided at the home. The manager must ensure that fire equipment tests are completed and recorded appropriately to maintain the safety of the service users. EVIDENCE: The registered manager worked at the home for many years before she became the registered manager and has an extensive knowledge of the service user group. The inspector saw clear evidence of her good leadership and management approach which continues to improve the quality of the service provided for the service users. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 21 Each unit across the site has a COSHH file containing data sheets for the chemicals stored/used in the home. The inspector saw evidence at the previous inspection that a Health and Safety audit completed by HFT’s external Health and Safety auditor annually. In addition to this the manager has now developed a Health and Safety Committee on the site that meets regularly to discuss issues and identify health and safety concerns across the site. Hot water outlets are fitted with thermostats and staff monitor the temperatures each month to ensure they are within safe parameters (not to exceed 43°C). The accident/incident books were inspected and showed evidence of thorough recording, auditing and appropriate actions. All fire equipment has been serviced at the appropriate intervals by a qualified engineer. A major shortfall identified at the previous inspection related to the fire equipment monitoring. It was a requirement of the previous inspection that the manager review the following areas to ensure a safe environment is maintained for the service users. • Testing of alarms each week by staff. • Fire drills. • Fire prevention training for staff. • Testing of emergency lighting. Some fire drills have been completed, and staff are receiving fire prevention training but the recording of tests is incomplete and does not meet the criteria of the regulations. This was brought to the attention of the management team on the day of the inspection and becomes a requirement of this report. The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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 x x x x x 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 x 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Old Quarries Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 1 x D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 23 yes 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 9 Regulation 13(4)c Requirement The manager must ensure that a travel risk assessment is completed for the service user in Chandler House The manager must ensure that medication records are recorded correctly across the site. The manager must ensure that staff complete and record the fire equipment tests as required by the regulations Timescale for action 17/10/05 2. 3. 20 42 13(2) 23 c, d, e, v 17/10/05 31/10/05 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 The Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 Page 24 Commission for Social Care Inspection 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester GL3 4AB 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 Old Quarries D51_D03_S16623_TheOldQuarries_V209823_160805_Stage4_A.doc Version 1.40 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. 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