Inspection on 30/01/06 for The Old Quarries

This inspection was carried out on 30th January 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Old Quarries 08/08/06

The Old Quarries 16/08/05

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 Mr Paul Chapman Unannounced Inspection 30th January 2006 01:00 The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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 Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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 Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Old Quarries Address Rectory Lane Avening Nr Tetbury Glos GL8 8NJ 01453 832201 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) www.hft.org.uk Home Farm Trust Mrs Janet June Newbould Care Home 32 Category(ies) of Learning disability (32), Physical disability (3) registration, with number of places The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 32 LD includes 3 LD residents who are also under PD Date of last inspection 16th August 2005 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 DS0000016623.V284424.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was completed on an afternoon in January 2006 and was completed over a period of 4.5 hours. The inspector met with two staff and one service user whilst at the home. In addition to this a tour of the communal areas of two of the units was completed and service users, medication and other health and safety records were assessed. The main aim of this inspection was to assess the homes’ progress towards meeting the requirements of the previous inspection report and examination of two key standards not assessed on the last occasion. It is recommended that for a more comprehensive overview of the service provided at the home, that this report is read in conjunction with the report for the announced inspection completed on 16/08/05. What the service does well: What has improved since the last inspection? What they could do better: Testing of the emergency lighting in the main house and the recording of the evacuations must be improved to meet the regulation. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 6 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 DS0000016623.V284424.R01.S.doc Version 5.1 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 Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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): 2, 5 Comprehensive assessments are completed before prospective service users are admitted to the home. This minimises the risk of someone being admitted to the home whose needs cannot be met. EVIDENCE: The inspector examined the assessment process for a service user admitted to the home after the previous inspection. The person’s file contained an assessment completed by a previous placement and another completed by a social worker employed by HFT. Both assessments were comprehensive and enabled the home to make an informed decision as to whether they would be able to meet the person’s needs. Whilst examining the new service user’s file the inspector found the contract between the home and the service user was incomplete. This must be addressed by the manager and this information was feedback to them during the inspection. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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, 9 The support plans sampled by the inspector were person centred and showed involvement by the service users in their development. EVIDENCE: A service user’s file examined by the inspector showed that staff were meeting their changing needs (i.e. dementia). Plans have been implemented to ensure that the person’s days are structured with set routines to ensure a consistent approach by staff and to minimise the risk of unnecessary confusion. As part of these plans the staff have developed pictures and symbols to support the person to remember specific important details in their day-to-day life. Another file examined by the inspector was for a person admitted to the Gallery flat since the previous inspection. A support plan had been completed by staff with the service user. This identified their goals and aspirations and was a person centred approach. The inspector will wish to re-examine this person’s plan at the next inspection to identify the progress made towards meeting the goals. The inspector noted two issues: The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 10 • • The plan identified that staff should monitor the person’s weight regularly but the inspector was unable to find any records to show that this was done. Staff had not recorded the person’s inventory of personal possessions. The inspector brought both of these issues to the attention of the manager on the day of this inspection. A requirement of the previous inspection was for the home to complete a risk for one service user while they were travelling. This has now been completed. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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): EVIDENCE: All of the above standards were inspected at the previous inspection and no shortfalls were identified. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 12 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): 19, 20, 21 The medication administration examined in the two units was managed correctly and minimises the risk of medication errors that may have a detrimental effect to the service users. Staff support service users appropriately to be empowered when making decisions about their lives. Staff have made good use of other professionals to meet a service users changing health needs. EVIDENCE: Examination of a service user’s personal file showed that staff have made good use of other professionals to meet his changing health needs. This has involved regular visits from members of the local Community Learning Disability Team. Examination of the medication administration across the site at the previous inspection identified some shortfalls, these included: • • Gaps in recording when a service user had received their medication. The medication sheet key not being used correctly. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 13 At this inspection the inspector examined the medication administration for the two units. In both cases medication was seen to be being managed correctly by staff and no shortfalls were identified. The inspector examined the personal file of one service user in depth. It contained information relating to their wishes in ageing, illness and death. This was a really good piece of work that appeared to have been handled appropriately and sensitively. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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): EVIDENCE: At the previous inspection both of these standards were inspected and no shortfalls were identified. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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, 30 The home provides the service users with a good standard of accommodation and extensive grounds that exceed these standards. EVIDENCE: The inspector completed a tour of the communal areas of the Gallery flat. It was homely and comfortable, decorated to a good standard and personalised by the service users living there. The flat was clean and hygienic. Other areas of the site were inspected at the previous inspection. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 16 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): 33, 35 The staffing rota showed that staff are available to support service users specific needs. Training provided to staff addresses the service users changing health needs. EVIDENCE: Since the previous inspection the inspector has been contacted by the social worker of one of the residents living in Chandler house. They were satisfied with the care and support that their client was receiving but asked that the inspector look at the staffing of the house. The inspector spoke to the service manager and deputy manager about the staffing. They explained that they were going to review the staffing and funding levels in the house as the needs of the service users has changed since the last review had been completed. The social worker’s client has a significant number of enhanced hours (additional hours to the standard hours identified in their contract) and rotas showed that named staff were delivering these. These staff were usually provided to complete specific activities. The rota for the house showed that a “core” staff member was on duty for each shift (core staff are team members for that house) and then staff were named to support specific service users. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 17 The manager stated that they are currently recruiting staff to work at weekends only as they have identified a shortfall in staffing during those periods. The inspector spoke to the team leader of sunset flat. She explained that with the changing health needs of one service user that training in dementia is being completed with the staff team and some of the service users. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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): 39, 42 Fire equipment monitoring and tests have improved but still do not meet the criteria of the regulations and are therefore still putting the service users at unnecessary risk. EVIDENCE: The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 19 HFT have a number of methods to monitor the quality of their services. The manager explained that in October ’05 the assistant regional director had completed a mini audit. The inspector has been supplied with a copy of this document and may sample the home’s progress towards meeting the identified goals at the next inspection. In addition to this audit the organisation’s health and safety officer completes an annual audit identifying risks and measures to minimise them. The home also has a health and safety committee that meet regularly to discuss issues across the site. Up until recently regulation 26 visits have been completed regularly but due to sickness a number of these have been missed recently. The inspector and manager discussed this and the need to ensure that the visits are completed each month. 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. The inspector examined the records completed since the previous inspection which showed a marked improvement in the home’s practices, but some shortfalls still remain. The manager must ensure that: • The emergency lighting for the main house is tested as prescribed in the regulations. • That when fire drills are completed (one since previous inspection) that the time taken to evacuate the building is recorded. Both of these issues were brought to the attention of the manager on the day of the inspection. The inspector examined accident recording in one of the units (Sunset flat). The accident recording is computerised and the team leader went through the recording of two accidents with the inspector. The records seen were comprehensive. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 3 X X 2 X X 2 X The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 21 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. 2. Standard YA5 YA39 Regulation 4, 5 26 Requirement The manager must ensure that all of the service user’s contracts are completed thoroughly. The manager must ensure that regulation 26 visits are completed as prescribed by the regulations. The manager must ensure that staff complete and record the fire equipment tests as required by the regulations. Timescale for action 17/03/06 17/03/06 3. YA42 23 c, d, e, v 17/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA6 Good Practice Recommendations The manager must ensure that the plan to monitor a person’s weight regularly should be followed. The manager should ensure that service users have an inventory of personal possessions. The Old Quarries DS0000016623.V284424.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Gloucester Office Unit 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 DS0000016623.V284424.R01.S.doc Version 5.1 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!