CARE HOME ADULTS 18-65
The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG Lead Inspector
Lynda Kirtland Announced 15 June at 10.00 am & 23 June 2005 at 6.30pm 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 Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION
Name of service The Peacocks Address 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG 01209 218271 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) Ms Margaret Hinchliffe Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 3 November 2004 Brief Description of the Service: The Peacocks is a registered care home offering long term care for a maximum of three younger adults with a learning disability. The home provides accommodation and personal care according to individual needs. The house is a large double fronted property set in a rural area but within easy reach of local towns and coastline. The service provider has two private vehicles that are used to transport service users on outings or appointments. The home operates on a family style with provider and service users going on holiday away from the area several times each year. Service users friends and family are welcome to visit the home and there is a spare bedroom in the home that can be used as a guest room. Service users here generally attend weekday activities which are arranged and commissioned by the local Social Services Department as part of their overall package of care. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited The Peacocks on the 15 June 2005 and spent the day at the home. This was an announced visit and the inspector met with the registered provider, assistant manager, examined records, policies and procedures. The inspector visited the home on the 23 June to meet with three service users resident at the Peacocks. They showed the inspector around the home. As this is a small care home their individual comments are not included in this report to respect confidentiality. However the three service users all gave permission that in the report the inspector could comment that they were satisfied with the care and accommodation that they receive at the home. This report summarises the findings of this inspection. What the service does well: What has improved since the last inspection?
Since the last official inspection the registered provider has developed the care plans further. The care plans now address all individuals’ needs and include participation with the resident. The assistant manager is currently attending the Registered Managers Award, NVQ level 4 course, to ensure that the home comply with the national minimum standards plus to continue to update their practice in learning disability care. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 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 Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 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) 1,2,3,4,5 The Peacocks have informative documents that explain the services that the home provides, admission processes and expectations of the placement. EVIDENCE: The Peacocks have an informative statement of purpose / service users guide which accurately details the services that the home provides. The registered provider is currently considering how this document can be presented to reach a wider audience The Peacocks residents are long-term placements and therefore admission processes/ trial visits have not needed to be used. However the registered provider was aware of the homes criteria for admission, expectations of admission to the home from referring agencies and trial visits processes. All service users are provided with a satisfactory statement of terms and conditions. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 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 Each resident has a care plan that outlines their care needs and aspirations. Resident’s health needs are identified and liaison with appropriate health professionals is undertaken. Resident’s views on the service are continuously sought. EVIDENCE: There were individual care plans for each service user covering all health and social care needs. The care plans evidenced that service users had participated in their formation and were involved in the reviews of their care needs. Individual decision making and choice was evident from documentation and from discussion with service users and the registered provider. Monthly residents meetings with the registered provider ensures that all service users paricipate in the descions made at the Peacocks. The registered provider has developed risk assessments to ensure that appropriate decisions regarding care whilst ensuring that risk is minimised are taken. The home adheres to maintaining confidentiality and all records are maintained and adhere to the Data Protection Act. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 10 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) 11,12,1,3,14,15,16,17 Links with the local community are good and support and enrich resident’s social, educational and leisure opportunities. The systems for resident’s consultations are good with a variety of evidence that indicate that resident’s views are both sought and acted upon. EVIDENCE: It was evident from discussion with residents, the registerd provider, plus documentation, that the Peacocks actively encourage residents to maintain links with the community, family, and support residents to develop personal friendships and partake in their interests/ hobbies in the community. Residents are involved in making decisions in the planning of their day and assist in some household tasks which encourages development of independent living skills. From the inspectors observation it was evident that that the registered providers and assistant manager ensure that the principles of privacy and dignity are adhered too. Residents commented positively about the meals provided by the home and that they are involved in the development of menus within the home.
The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 11 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 The registered provider has a good understanding of the residents support needs. This is evident form positive relationship that has been formed between the registered provider and residents. EVIDENCE: From discussions with residents and the registered provider plus documentation inspected it was evident that health needs are identified accurately and appropriate medical advice sought. Access to local health and specialist services was evident as was obtaining residents wishes and views when seeing these professionals. Health notes showed that access to health services is not a difficulty. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 12 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 home has a satisfactory complaints system with evidence that residents feel that their views are listened to and acted upon. Staff have good knowledge of adult protection issues, the written policy needs to reflect this. EVIDENCE: The Peacocks has a complaints policy, which explains how the home will investigate any concerns raised. Residents commented that if they had any concerns they could raise these at their residents meetings or with the registered provider directly. The home has an adult protection policy this needs to be updated to reflect current legislation. The registered provider agreed to ensure that the policy is written in line with POVA guidance. The inspector gave the registered provider some written information in respect of POVA guidance. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 13 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) Not inspected EVIDENCE: Residents did show the inspector their private rooms; no issues were noted at this time of inspection. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 14 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, The Peacocks is a registered care home for three adults, the registered provider and her assistant manger staff the home. EVIDENCE: Throughout the inspection the inspector observed the registered provider and assistant manager to interact with residents in a friendly, clear manner. As The Peacocks is a small care home the registered provider and her assistant manager staff the home 24 hours a day. The assistant manager is currently attending the NVQ level 4 Registered Managers Award course. The registered provider has 2 volunteers who she is able to use in emergency situations. Both are CRB checked and have NVQ at level 2. The volunteers know the residents and therefore there is consistency in their care. The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 15 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, 41 The registered provider provides a structure, which creates an open, positive and inclusive atmosphere. The Registered Managers Award has not been obtained. EVIDENCE: The registered provider has not undertaken the Registered Managers Award but her assistant manager is attending this course. They are considering an application for the assistant manager to undertake the registered manager role in the home. They hold complimentary roles and responsibility to ensure that they provide 24-hour cover at the home, which meets resident’s needs. It is evident that the registered providers ensure that residents and their relatives are consulted about how they view the service that The Peacocks provides. The home is currently reviewing its quality assurance process. The registered provider has ensured that relevant policies and procedures are in place. Records are kept up to date, accurate and stored in a confidential manner
The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 16 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 3 3 Standard No 22 23
ENVIRONMENT Score 3 2 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 x x x x x x x Standard No 11 12 13 14 15
The Peacocks 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x x x x x
Version 1.20 Page 17 D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 3 x x 3 x x The Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 18 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. 2. Standard 23 37 Regulation 13 (6) 18 Requirement Timescale for action 30/10/05 The adult protection policy must be updated to reflect current legislation. Achievement of the Registerd 30/01/06 Managers Award must be gained. 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 Peacocks D52-D04 S9079 The Peacocks V221034 150605 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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