Inspection on 25/10/05 for The Padova

This inspection was carried out on 25th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Padova 11/05/09

The Padova 15/05/07

The Padova 27/02/06

The Padova 25/02/05

The Padova 15/06/04

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 Padova 88 Bristol Road Quedgeley Gloucester Glos GL2 4NA Lead Inspector Mrs Helen James Unannounced Inspection 25th October 2005 09:30 The Padova DS0000016627.V255137.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 Padova DS0000016627.V255137.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 Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Padova Address 88 Bristol Road Quedgeley Gloucester Glos GL2 4NA 01452 728296 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) Miss Deborah Bayliss Miss Deborah Bayliss Care Home 9 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (2) of places The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th February 2005 Brief Description of the Service: The Padova is an extended detached house in Quedgeley near Gloucester that provides accommodation for up to nine adults with Learning Disabilities. The older part of the house has a ground and first floor. The new extension is single storey and meets current environmental standards with all rooms having en-suite facilities. On each floor is an assisted bathroom and toilet facility. On the ground floor is a lounge/dining room and a quiet room, kitchen, office and laundry room. The home is staffed twenty-four hours a day and the Registered Manager is in day-to–day charge of the home. There is also an appointed manager who takes on many of the management responsibilities. Both managers have completed their National Vocational Qualification level four Managers qualification. To the front of the property is car parking for several cars and to the rear is a large well-maintained garden with patio area. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over five and a half hours on one day in October 2005 and was completed by one inspector. Twenty-eight Care Standards for Adults (18-65) were assessed on this occasion. Of these one exceeded the standard, twenty-six met the standard, one almost met the standard. Time during the inspection was spent speaking with the Registered Manager Mrs Bayliss, staff and a resident at the home and listening and observing the interactions of staff and residents. The information gained was then crossreferenced with relevant documentation and care records. The one resident of the three at the home during the inspection who was able to converse with the inspector discussed admission, care, lifestyle and relationship with the care staff and managers at the home. The inspector spent time cross-referencing information about the care and welfare gained from talking to and observing the residents with the residents’ individual care records. There were no visitors to the home during the inspection. What the service does well: What has improved since the last inspection? There is now a Registered Manager and Home Manager at the Padova who shares the responsibility of managing the home and this appears to work well. Staff appear very well supported via the Managers with a comprehensive supervision and appraisal system that is now fully implemented. There are eight permanent staff and seven appear to be very motivated in terms of The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 6 learning and developing themselves and ensuring the best quality care for the residents. The Registered Manager has introduced quality assurance measures to demonstrate the quality of the service received by the residents and where they may need to improve to assist with the ethos of continuous improvement in the home. All records examined were complete and met the requirements of the Care Standards Act. 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 Padova DS0000016627.V255137.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 Padova DS0000016627.V255137.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): 2&5 Arrangements are in place to ensure that each prospective resident is fully assessed prior to admission and on admission, to ensure that all their specific care needs can be met by the Home. Each resident has a contract that contains all the required information. EVIDENCE: The Homes Statement of Purpose and Service Users Guide is at the printers after being updated, a copy is to be sent to the Commission. Residents are assessed prior to and on admission and documentation seen confirmed this. Copies of the admission assessments are in the residents care documentation; these provide specific details of care needs, next of kin and general information. The resident spoken with was able to confirm the reason for their admission, what their care needs were and this was confirmed in their care documentation. Risk assessments are documented for anything specific to the individual resident. There have been no new admissions since the last inspection. All residents have contracts for their care and these were seen on their files. The Padova DS0000016627.V255137.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, 9 & 10 The care planning system ensures that all members of staff have a clear understanding of the care each person requires and how assistance is to be given. Some minor amendments are required in the way this is written. Residents are assessed and reassessed when their personal needs change. Residents are treated with respect and dignity and facilitated to live as independent life as possible within their own limitations. Residents’ records are accurate, secure and confidential. EVIDENCE: On this visit to the Home the inspector was given the opportunity to read the care records relating to residents within the home and in particular the resident who was spoken with. In all cases thorough care plans had been prepared and developed, based on a full assessment of each person’s care needs. The care plans examined reflected the current needs of each resident. The Manager was advised that the assessment against the activities of daily living should be reviewed at a minimum yearly to ensure that the assessment demonstrated improvement or decline in the individuals’ health and identified The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 10 increased care needs. This could be done with the yearly contract review that is done by the home with the resident for the social services department. The Manager reported that the care plans and activity plans are discussed with the individual residents. But there is no signatory evidence on care plans to demonstrate resident involvement in the preparation of these plans. The resident spoken with did confirm that their care and activity plan had been discussed with them and stated that changes had been made to it that had made them happier. There was evidence that care plans were reviewed on a monthly basis. All the relevant information was contained in the care plans but there needs to be a slight adjustment to the way in which it is written. The inspector recommended the following: 1) That the care need should state what the need was rather than how the need was to be met. 2) Where continence was an identified need the care plan actions should state the toileting routine and state the size and type of pad used. General and specific risk assessments are well documented and reviewed appropriately. Daily entries were completed. Through discussion with the Manager and a resident it was evident that personal autonomy and choice are promoted fully at Padova House within the confines of the residents ability. Staff were observed knocking on doors when entering rooms and addressing residents respectfully by the name they prefer. Residents are able to entertain visitors either in their own rooms, or in the communal lounge/or sitting areas of the home if they wish. Visitors are welcome in the Home at any time. The Padova DS0000016627.V255137.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, 14, 15 & 16. Residents participate in age, peer and culturally appropriate activities through engagement in social activities of their choice and liking. Residents are encouraged and facilitated to have appropriate relationships with friends and family. Resident rights and responsibilities are recognised and respected. EVIDENCE: Six out of the nine residents have ‘Personal Diaries’ where entries are made about the activities they have participated in and with whom. These give a valuable insight into the diversity of activities that the residents’ engage in and demonstrates that not everyone does the same thing. There is good recording of group activities and the Manager has implemented recording in the care record and diary of the ‘one to one’ individual activities that residents do with their keyworker or a member of staff. The feedback about the diary from parents/relatives has been good, comments such as “I didn’t know he did so much until I read the diary” have been made to the Manager. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 12 The residents have been on holiday this year and all were involved in the planning of it and it was thoroughly enjoyed by all. The home appears to run like an extended family home where everyone interacts and assists one another and everyone has choice around everything that they do. Staff interact appropriately with residents dealing with them respectfully and in a kind, polite and considerate manner. The Padova DS0000016627.V255137.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 & 21 Residents receive personal support in the way they prefer and require. All residents Health Care needs are fully met. The residents’ wishes in respect of aging, illness and death are respected. EVIDENCE: The resident spoken with confirmed that they can do ‘what I want when I want to’ and that no one tells them or their fellow residents what they can and cannot do. They have the freedom of choice around their daily activities within their own limitations and this takes into consideration any individual risk assessment they may be guided by. All medical and healthcare visits and checks are clearly recorded and comply with the health checks required by the individual. Residents are able to arrange through the care staff visits to appropriate health/welfare professionals at their request. All equipment needed for residents’ health care is supplied appropriately by the Community Nursing services or the GP. The residents’ wishes in respect of death and dying are recorded in care files. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 14 Medication was not assessed at this inspection but the inspector and Manager discussed the use of Midazolam Buccal liquid for Status Epilepticus. This has been prescribed for one resident by the hospital Consultant and they are hoping to have this prescribed for other residents who are ‘at risk’ of seizures in the home. The home has a Protocol in place, which has been agreed with the Gp and is acceptable. There appears to be some difficulty in getting this prescribed for other residents. The Inspector needs to seek advice relating to this difficulty from the Pharmacist for the Commission and will report back the outcome to the Home Manager. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 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 the following standard(s): 22 Complaints procedures are in place. EVIDENCE: The Home’s Complaints Policy is included in the Statement of Purpose and brochure. The home is in the process of updating the address and telephone number of the Commission (CSCI) on the policy at the present time. Complaints and concerns are raised with the Manager and care staff and are dealt with immediately. No formal complaints have been received since the home opened. The resident spoken with confirmed that everyone at the home is very approachable about anything you wish to raise. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26, 29 & 30 Residents live in a warm, comfortable and homely environment, which benefits from regular maintenance. EVIDENCE: The Home is extremely well maintained and the environment provides a homely comfortable ambience for the residents. All the required furnishings are supplied in communal areas and in residents’ rooms if required. All rooms are decorated in consultation with the resident and some bring their own furniture, pictures and belongings making the rooms individual, personal and homely. Residents can have keys to their room and several lock their doors regularly. Cleanliness is of a high standard and no infection control issues were identified. The Padova DS0000016627.V255137.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): 32, 34, 35 & 36 Staffing is adequate to meet the care needs of the residents living in the Home at the present time. Staff are well supported and supervised. Residents’ safety and well-being is paramount at all times. EVIDENCE: On the day of the inspection, there were nine residents living at the home. Three residents were at home during the inspection the other six were at sessions identified in their activity diaries. Two staff were on duty as well as the Registered Manager. During the day from 7am until 2-30pm and 2-30pm until 9-30pm there are two staff on duty. At night9-30 until 7am there is one waking member of staff on duty and the manager on –call. Evidence was seen via training records for staff that they all receive the appropriate mandatory training and that this is ongoing. One member of staff appears to have not attended all the required mandatory training this year and it is required that this person attends this all as they are at risk by not being updated. There are eight permanent staff and seven appear to be very motivated in terms of developing themselves: - of these two have achieved National The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 18 Vocational Qualification (NVQ) level 4 Managers Award, one has achieved NVQ level 2 and is now starting NVQ level 3. Three other staff have started NVQ level 3 and one is doing NVQ level 2. The Registered Manager arranges other training to underpin knowledge, enhance and improve skills and abilities of all staff to enhance the care for the residents at the home. This training is supported by regular supervision sessions and yearly appraisals. This is well recorded in the home and demonstrates a proactive approach to staff personal development. The duty rota identifies monthly staff meetings and all supervision sessions for the month. The recruitment record (personnel file) of the one new staff member was examined at the inspection and it was found to contain all the required information. All the Criminal Record Bureau/Protection Of Vulnerable Adults (CRB/POVA) checks were seen for all the staff at the home. Following this the Registered Manager was advised to destroy them to comply with Data Protection. It was recommended that the Manager keep a record of the CRB/POVA check number and the date received for future reference. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 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 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, 41 & 42 There is good leadership, guidance and direction to staff from the cohesive management team at the home (The Registered Manager and Home Manager). This ensures residents receive consistent quality care and results in practice that promotes and safeguards the health, safety and welfare of the people using the service and staff. EVIDENCE: The Registered Manager and Home Manager have achieved their NVQ level 4 Managers Award and evidence of this achievement must be sent to the Commission. Staff appear to get good support and leadership from the Managers and their ethos for the home is to provide the best quality care and lifestyle for their residents and this underpins everything they do and their commitment to the home. The staff team is small and staff meetings take place monthly they look at the improvements that the team can make and what they are doing well. This means that staff are involved in the management of the home and this appears The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 20 to increase staff commitment to the home and its residents. Staff appear extremely motivated and appear to enjoy their work and working environment. The Manager has developed a questionnaire that goes out to relatives/next of kin/ advocates, which allows them to comment on the Home. The inspector saw evidence of the comments returned. It was recommended that the Manager gain feedback using this questionnaire from the GP and Professionals that visit the home. The fire safety checks are being completed satisfactorily. There was evidence that all staff have been trained in Fire safety within the home. The gas, electrical, water and equipment checks will be examined at the next inspection. The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 21 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 3 X X 3 Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 4 3 X X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Padova Score 3 3 X 3 Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 3 X DS0000016627.V255137.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO 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 YA22 YA32 Regulation 5(1e & f) 13(6) & 18(1a) Requirement Send a copy of the amended Complaint procedure to the Commission. Ensure that all staff attend all the required mandatory training. Timescale for action 28/12/05 28/12/05 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 YA6 Good Practice Recommendations The following care planning recommendations were made:1) That the care need should state what the need was rather than how the need was to be met. 2) Where continence was an identified need the care plan actions should state the toileting routine and state the size and type of pad used. The Registered Manager to send a copy of the NVQ level 4 Managers Award Certificate. Using the Homes’ Quality Questionnaire gain from views from the GP and Professionals that visit the home. 2. 3. YA32 YA38 The Padova DS0000016627.V255137.R01.S.doc Version 5.0 Page 23 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. 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