Inspection on 01/05/07 for Three Oaks Care Home

This inspection was carried out on 1st May 2007.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Three Oaks Care Home 30/05/06

Three Oaks Care Home 06/12/05

Three Oaks Care Home 25/04/05

Three Oaks Care Home 08/02/05

Three Oaks Care Home 27/09/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Gwynfa Close (14) 14 Gwynfa Close Welwyn Hertfordshire AL6 0PR Lead Inspector Pat House Unannounced Inspection 1st May 2007 11:45 Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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 Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Gwynfa Close (14) Address 14 Gwynfa Close Welwyn Hertfordshire AL6 0PR 01438 712939 F/P 01438 712939 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) Three Oaks Care Home Limited Mrs Tracy O`Dwyer Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (8), Physical disability (8), of places Physical disability over 65 years of age (8) Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home may accommodate people with a physical disability (when associated with a learning disability) 30th May 2006 Date of last inspection Brief Description of the Service: The home was first registered with the Hertfordshire County Council Inspection Unit on 28th October 1997. Gwynfa Close is a large detached bungalow set at the end of a cul-de-sac in the village of Welwyn. The building has been extended and converted for use as a residential care home for people with learning and physical disabilities. The home provides support to individuals in developing and maintaining links with the local community. The aim is to allow individuals to have a say in how the home is run regardless of their disability. Fees for the home range from £1259.86 to £1770.27 per week. A copy of the home’s Statement of Purpose/Service User’s Guide and a copy of the latest inspection report is kept in the entrance hall, where it can be viewed. Copies are also available from the office. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day with one inspector. The manager and proprietor were present during the visit, and residents and staff were observed and spoken with. Current residents have a wide range of physical and communication needs and their ages range from 33 to 60 years. Four residents were in the home initially and two more arrived home during the inspection. Lunch was served during the visit and all areas of the home were seen. A selection of records was examined and the financial records of one resident were spot-checked. The home currently has no vacancies and is fully staffed. What the service does well: What has improved since the last inspection? What they could do better: The home’s Statement of Purpose/Service User’s Guide should be produced in a pictorial or user-friendly format, so that all residents can be involved in the aims and facilities of the home. A requirement has also been made that records demonstrate that all new employees at the home are physically and mentally fit for the duties they will be performing. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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 Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users and families are given written information and have their needs fully assessed before moving into the home. This ensures that all parties can be sure that care provision in the home can meet all the individual resident’s needs. EVIDENCE: The Statement of Purpose and Service User’s Guide have been reviewed and updated and give a clear picture of the facilities, services and aims of the home. A signed service user contract was seen and provided clear information about charges for the home, methods of payment and what is included in the fees. The manager will also include the number of the room to be occupied on all future contracts. The manager also plans to produce these documents in pictorial form. The records of the two most recent residents to move into the home were checked and detailed written assessments from referring agencies were on file, together with the assessments completed by senior staff in the home. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good recording procedures ensure that care staff are aware of all individual care needs and how best to meet those needs. Residents are supported by staff to take risks where appropriate and therefore remain as independent as possible. EVIDENCE: The two care plans checked were detailed and contained appropriate information and thorough risk assessments. Involvement by the residents concerned was evidenced and the plans demonstrated how individual aspirations and choices were being met. The manager said that care workers had received training in “Person Centred Planning” and that staff were working to update care plans in line with this training. This area will be checked at the next inspection visit. All residents have bank accounts and staff assist with the use of personal allowances, to varying degrees. Financial records detailing the personal Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 10 allowance of one resident was tracked and details were accurate and receipts for all monies spent were in place. The manager said she has tried, without success, to find any external advocates for the home’s residents Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in the home ensure that residents receive well-balanced food, which they enjoy and that staff support individuals to maintain family contact and take part in appropriate activities so that they enjoy and are stimulated by their daily routines. EVIDENCE: During the inspection staff were observed helping and talking to the residents in a variety of situations and in all cases they treated everyone concerned with dignity and respect, seeking residents’ views where appropriate and explaining what each situation meant. Staff support, if required, residents to attend day centres and clubs. Residents attend an evening club once each week, and pictures painted and drawn by one resident were displayed around the home. Staff undertake the decoration in the building and the manager said that residents assist with this and are Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 12 always involved in choosing colours and any new furniture. The manager and proprietor said they would be getting a computer for the home although it was felt that only one resident would be able to use this. The home has a large fish tank and a pet cockatiel bird. Care staff spoken with said that relatives were encouraged to visit at any time and that one resident had an annual holiday with a parent. All residents have an annual holiday arranged by the home and have trips out provided. Lunch was served to the residents during the inspection and the week’s menus were displayed on the wall in the dining room in written and pictorial form. Some residents were able to feed themselves whilst staff assisted others. There was different food provided for different people and the whole mealtime was unhurried and relaxed. Residents were gently encouraged to eat the food and all assistance was provided discreetly and appropriately. The manager said that staff had tried a variety of napkins with the residents, to protect their clothing but that the bibs in use were the most appropriate form of protection they had found. Residents showed no objection to wearing this clothing. All members of staff are involved in food preparation and all staff complete annual Food Hygiene training. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures for supporting residents in the home and for administering medication ensure that residents are protected and have care provided in the way they wish. EVIDENCE: Care plans contained details of external specialist involvement in appropriate areas and weight checks were seen recorded. Care staff said that the weight of all residents was stable at present and that meal planning had been conducted with help from the visiting dietician. Currently no resident has any pressure sores, although two individuals use wheel chairs permanently. Care staff had been concerned about two residents who had been coughing and the doctor called during the inspection. Examinations took place in private. Staff spoken with said they had very good relations with G.Ps and local District Nurses. During the inspection staff were observed helping and talking to the residents in a variety of situations and in all cases they treated everyone concerned with dignity and respect, seeking residents’ views where appropriate and explaining Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 14 what each situation meant. The photographs of everyone’s “key worker” member of staff are displayed on the wall. The system for administering medication was checked and no errors were found in the records, which were checked against the actual drugs being stored. Record sheets contained written information about specific events or changes and the manager is aware that two staff signatures should be in place when any written instructions are included. The storage temperature for the medication was at a safe level and the manager will now keep a thermometer in the storage cabinet and checks will be recorded. All staff receives medication training before they can administer drugs and Lloyds Pharmacy is about to provide certified training for all staff at the home. No current resident is able to administer his or her own medication. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Procedures in the home ensure that residents are protected form abuse and can be confident that any concerns they might have will be understood and listened to. EVIDENCE: Written policies on Complaints, Adult Protection and Whistle Blowing are in place, which staff are aware of. The information given to prospective residents and their families includes a copy of the Complaints Policy. This policy is also produced in pictorial form and is displayed in the entrance hall. The manager is revising the CSCI details included in the policy. All staff have had training in Safeguarding Adults (Adult Protection) and this topic will also be included in induction training for new staff. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a home which is well maintained and kept clean and hygienic, so that the risk of infection is minimised EVIDENCE: All areas of the home were visited briefly and all areas were clean and well decorated. Bedrooms were bright and had mostly been personalised by the residents. One bedroom was more bare than others but the manager said that information in the care plan demonstrated why this was so. Currently, care staff were trying to keep pictures around the walls of this room, and outcomes were being monitored. A broken toilet seat, noted at the last inspection has been replaced and the laundry contained paper towels and liquid soap. The home has a sluice washing machine for dealing with soiled washing and staff said there were always good supplies of disposable gloves available. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment procedures at the home help to ensure that residents are protected and thorough staff training means that residents are supported in a professional and appropriate way. EVIDENCE: There were three staff on duty both in the morning and in the afternoon during the inspection and the manager said that at night there is always one waking and one sleeping care worker on duty. Staff spoken with said there were always enough members of staff on duty, in proportion to how many residents were in then home at the time. Care staff provide domestic tasks in the home, with much of the “quiet” cleaning completed at night. The home has already achieved the requirement that 50 of care staff complete NVQ training and all staff should have completed this training within the next year. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 18 Care staff spoken with confirmed that any training courses they need are provided at the home and all staff have to complete basic mandatory training, within an accredited induction course, once they join. One care worker spoken with, who has been employed for just over one year has completed all mandatory training and also has the NVQ level 3 qualification. The recruitment files of the two most recently employed staff were examined and evidence of the appropriate checks were seen. The manager was aware that a full employment history must be provided for every member of staff, but currently no health declaration is requested or provided by applicants. The manager must be sure that staff employed are fit for the job they will be doing and a Requirement has been made in this report that this area is checked with prospective staff. However, the manager does ask all job applicants to collect application forms from the home in person, so that they are fully aware of the care provision at the home and can be sure the job will be right for them. The manager said that currently there are no volunteers working at the home. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their daily lives enhanced by living in a well-run home where their views are taken into account and where procedures followed promote the health and safety of both residents and staff. EVIDENCE: The manager of the home is registered with the CSCI and staff spoken with said that management was open and supportive. The proprietor also works at the home from time to time and the manager said there were really good relations between them both. The home has a written Quality Assurance Policy but the manager is aware that this needs expanding and plans to update the quality systems. Questionnaires are sent out to relatives, but all management monitoring needs Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 Page 20 to be included in the system and a report produced. Care staff clearly have close relationships with the residents and are able to represent the views of those who are unable to express their wishes verbally, as was demonstrated during the inspection. Care staff also felt their views were listened to and records of staff supervision were seen. There had been a visit from the Environmental Health Officer one month previously and all recommendations had been actioned. The fire officer had also been consulted about the procedure for fire drills in the home. The advice given needs to be incorporated into the home’s written Fire Safety policy, and the manager said this would now be done. Emergency lighting checks are now being completed and recorded and no hazardous substances were seen around the home during the inspection. Care staff have all had vaccinations against Hepatitis B infection. Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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 2 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 3 23 3 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 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Gwynfa Close (14) DS0000054490.V338822.R01.S.doc Version 5.2 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 YA34 Regulation 19(5)(c) Requirement Evidence must be obtained that everyone employed to work at the home from this time is physically and mentally fit for the purposes of work he or she is to perform. Timescale for action 01/06/07 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 YA1 Good Practice Recommendations Information about the home (Statement of Purpose) and Service Users’ guide should be in a user-friendly format for service users. THIS RECOMMENDATION IS CARRIED FORWARD FROM THE LAST INSPECTION REPORT. 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