Inspection on 27/02/06 for The Padova

This inspection was carried out on 27th February 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 Padova 11/05/09

The Padova 15/05/07

The Padova 25/10/05

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 27th February 2006 09:30 The Padova DS0000016627.V277871.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 Padova DS0000016627.V277871.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 Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Padova Address 88 Bristol Road Quedgeley Gloucester Glos GL2 4NA 01452 883764 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.V277871.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 25th October 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.V277871.R01.S.doc Version 5.1 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 February 2006 and was completed by one inspector. Seventeen Care Standards for Adults (18-65) were assessed on this occasion. Of these one exceeded the standard, fifteen met the standard and one almost met the standard. Time during the inspection was spent speaking with the appointed Manager Miss Clare Thomas, staff and three residents at the home. The inspector observed and listened to the interactions of staff and residents. The information gained was then cross-referenced with relevant documentation and care records. Two of the three residents at the home during the inspection had limited conversations with the inspector about the home and relationship with the care staff and the manager at the home. The inspector spent time crossreferencing 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? What they could do better: The care and daily lives of individuals is well managed by the care staff and the general environment of the home has a homely comfortable ambience that is The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 6 kept in a good state of repair and meets health and safety requirements. There are a few requirements that the home needs to address. 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.V277871.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 Padova DS0000016627.V277871.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 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. EVIDENCE: There have been no new admissions to the home since the last inspection. Individuals are assessed prior to and on admission and documentation seen confirmed this. Copies of the admission assessments are in the persons care documentation; these provide specific details of care needs, next of kin and general information. Each individual is then reassessed on a monthly basis to ensure that changing needs are identified. The interactions and care observed during the visit was confirmed in the care documentation. The home is in the process of planning the Annual reviews for individuals with the Placing Authority, although it appears that the placing Authority very rarely attends the Annual review. Evidence was seen in records of annual reviews. Other agencies involved in the individuals care programme attend and minutes of these reviews are sent to the Social Worker or Social Services if there is no allocated Social Worker. Risk assessments are documented for anything specific to the individual resident. The Padova DS0000016627.V277871.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, 8, 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. People are assessed and reassessed when their personal needs change. Residents are treated with respect and dignity and facilitated to live as independent a life as possible within their own limitations. Residents’ records are accurate, secure and confidential. EVIDENCE: Comprehensive information is maintained for people living at the home. This is being regularly monitored, reviewed and updated. Two care records were examined for two people, both were observed during the inspection and spoken with albeit they could give limited responses. The care records contained all the required documentation and were very clear in how the individuals were to be managed regarding their care. Care plans and activity plans are discussed with the each individual resident and signatory evidence on The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 10 care plans is now being sought to demonstrate individuals’ involvement in the preparation of these plans. People living at the home were spoken too and addressed properly and interactions were appropriate. Staff confirmed that they are involved in the annual reviews of individuals. It was evident from their daily notes and observation that staff adhere to care plans and risk assessments. Any restrictions to choice or freedom are recorded on people’s files. Through discussion with the appointed manager and observations at the home it was evident that personal autonomy and choice are promoted fully at the Padova. A full range of risk assessments are in place for a variety of activities both inside and outside the home and several of these were examined. These are signed and are regularly reviewed. People living at the home have opportunities to help with the day-to-day running of the home. One person spoken to was asked by the carer if they wanted to unload the dishwasher during the visit, which they wanted to do. The Padova DS0000016627.V277871.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): 11, 13 & 17 Residents participate in age, peer and culturally appropriate activities through engagement in social activities of their choice and liking. Individuals are offered a healthy diet and enjoy their meals. EVIDENCE: People living at the home have individualised programmes of daytime activities during the week. The ‘Personal Diaries’ where entries are made about the activities they have participated in and with whom, give a valuable insight into the diversity of activities that the residents’ engage in and demonstrates that not everyone is doing the same thing. It also demonstrates that they are part of the wider Community. One individuals needs have changed and they are no longer able to go to the Adult opportunity centres so alternative outings are arranged that they like and choose to do. This was evidenced in their personal diary. Individuals are encouraged to eat a healthy balanced diet and educating the individuals about the importance of a healthy diet is ongoing. This is done through involvement of individuals in shopping and preparation of the meals. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 12 Weight monitoring for loss and gain is undertaken monthly and recorded. Where this is being done routinely to monitor weight then this must be included in the care plan actions. Appropriate action is taken to address any issues raised that may impact on the health of the individual. Two people have a coarsely mashed or pureed diet to aid swallowing and most receive assistance with cutting food. Breakfast is eaten as people are up and ready for their breakfast, lunch tends to be sandwiches when they go out or if they are at home soup or what they would like. The main meal of the day is usually in the evening and staff and residents eat together in the dining room and discuss the day’s events and what they would like to do for the evening. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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 Residents receive personal support in the way they prefer and require. The personal needs of people living at the home are met and there was evidence of good multi disciplinary working to ensure all healthcare needs are fully met. EVIDENCE: People in the home appear to have the freedom of choice around their daily activities within their own limitations and this takes into consideration any individual risk assessment or assistance they may require, as seen in care records. As many people living at the home have communication difficulties the fact that there is a stable team of staff who are very familiar with individual’s behaviour ensures that their needs are always met. They know through behaviour/ gestures etc when they require assistance or need something. It was observed during the visit that a total Communication Approach is taken with communication using a range of objects of reference, pictures, photographs, symbols etc. Of the two care files examined it was very clearly identified how they were supported in their care plans and personal profiles. There appears to be The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 14 flexibility in routines dictated by the needs and disposition of the people living at the home. People are referred to the Community Learning Disabilities Team and to the appropriate health and welfare professionals at their request or when necessary. All medical and healthcare visits and checks are clearly recorded and comply with the health checks required by the individual. All equipment needed for residents’ health care is supplied appropriately by the Community Nursing services or the GP. One individual is being reassessed for mobility/seating aids to assist their comfort due to a deterioration in their ability. District nurses visits on request and when they need to provide care. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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): Complaints procedures are in place. EVIDENCE: A minor amendment to the complaint procedure is required so that it includes the timescales for action when a complaint is received. An anonymous complaint about attitude of staff has been received at the Commission and this has been passed to the Manager to investigate and send a written report to the Commission of the investigations and findings. The inspector has visited the home twice now unannounced and the attitude of staff with people living at the home has always been impeccable, polite and very respectful and appropriate. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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 & 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 people living here. The front door bell is not working so the care staff do not know when people enter the home this must be addressed. The fire extinguisher that is standing on the floor needs to be re-hung on the wall; this was knocked off the wall. All the required furnishings are supplied in communal areas and in individuals’ rooms if required. Cleanliness is of a high standard and no infection control issues were identified. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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 Staffing is stable and staff appear to work positively with people living at the home to improve the quality of their lives. EVIDENCE: On the day of the inspection, there were nine people living at the home with one person being in hospital for an acute illness. Two people were at home during the inspection the other six were at sessions identified in their activity diaries. During the day from 7am until 2-30pm and 2-30pm until 9-30pm there are two staff on duty. At night 9-30pm until 7am there are two waking staff on duty and the manager is on–call. The duty rota identifies monthly staff meetings and all supervision sessions for the month. Evidence was seen via training records that all staff receive the appropriate mandatory training and that this is ongoing. There are eight permanent staff who all appear to be very motivated in terms of developing themselves and many of them have achieved their National Vocational Qualifications. Training is well 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 home is currently recruiting one new staff member and the recruitment The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 18 records (personnel file) of this person were examined at the inspection and it was found to contain all the required information. The home was waiting for the Criminal Records Bureau (CRB) and Protection of Vulnerable Adult check (POVA) to be returned. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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 There continues to be 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. EVIDENCE: Staff appear to get good support and leadership from the Managers. The ethos of the home is to provide the best quality care and lifestyle for the people living here 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 to increase staff commitment to the home and its residents. Staff appear extremely motivated and appear to enjoy their work and working environment. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 20 The Manager has developed the quality assurance questionnaire and is now sending it out to Professionals who visit the home as well as relatives/next of kin and advocates. This enables the home to gain feedback on the service they provide for people living at the home. The feedback sheet returned by the GP was seen and this indicated complete satisfaction with the Padova. The Manager is now going to send this to the Adult Opportunity Centres that individuals attend to gain their feedback on the Padova. The Padova DS0000016627.V277871.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 3 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 3 LIFESTYLES Standard No Score 11 4 12 X 13 3 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 3 X X X X X The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA22 Regulation 5(1e & f) • Requirement The amended Complaint procedure must include the timescales for action on it. A copy of the amended procedure to be sent to the Commission. 28/04/06 Timescale for action 28/04/06 • 2. YA6 15(1) 3. YA24 12(2b) Where weight is being routinely monitored for health reason then this must be included in the care plan actions. The following maintenance issues to be addressed: • Mend the front door bell at the entrance to the home. • Re-hang the Fire Extinguisher on the wall. 28/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 23 The Padova DS0000016627.V277871.R01.S.doc Version 5.1 Page 24 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 Padova DS0000016627.V277871.R01.S.doc Version 5.1 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. 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!