Inspection on 07/06/05 for Timber Grove

This inspection was carried out on 7th June 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Timber Grove 26/10/07

Timber Grove 27/11/06

Timber Grove 07/11/05

Timber Grove 26/01/05

Timber Grove 24/09/04

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Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

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Paradise Lodge

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Upaya Ananda

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

CARE HOME ADULTS 18-65 Timber Grove Whitepost Farm London Road Rayleigh, Essex SS6 9DT Lead Inspector Nicola Dowling Unannounced 7 June 2005 10:00 a.m. th 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. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Timber Grove Address Whitepost Farm London Road Rayleigh Essex SS6 9DT 01268 780233 01268 784385 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) Elizabeth Fitzroy Support Ms Deborah Housman CRH 15 8 7 Category(ies) of Learning Disability (LD) registration, with number Physical Disability (PD) of places Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 26.01.05 Brief Description of the Service: Timber Grove provides care for up to fifteen younger adults that have a learning and physical disability Timber Grove is situated 3/4 of a mile from Rayleigh train station and buses stop outside the home. The home is approximately 1.5 miles to Rayleigh Town Centre and there are some local shops nearby. Timber Grove also has its own vechicles for transporting residents. The home is set in large grounds and car parking is available. It is understood that the registered provider is considering plans for rebuilding the home, to improve services and facilities that will be on the same site and more appropriate and conducive in meeting the residents needs The main area provides accommodation for twelve service users in single bedrooms on two corridors. There is also a self contained flat that accommodates three residents. All areas used by the residents are on the ground floor. Timber Grove has its own separate day care facility on site which is used only for the residents. Some of the residents attend other day care facilities in the local area. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over one day. The inspection consisted of a tour of the home, talking with staff and residents, observing the care given, and reading of documents. As there were no relatives at the home during the inspection their views have not contributed to this inspection report. There were seven staff working on the morning shift and one of these staff was from an agency. All the staff were familiar with the residents and there was a relaxed atmosphere in the home. Residents went out and came home at different times of the day with staff, who were assisting them with their daily activities. A thank you is extended to the staff and service users who took part in the inspection and for their help and hospitality. What the service does well: What has improved since the last inspection? Some of the residents have severe challenging behaviour. To cope with this behaviour there has been an increase in staff and the staff have all had training in managing aggression and physical restraint. This training has also Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 6 resulted in residents having individual plans for staff to follow on how to look after their specific behaviour. The staff spoken with felt that the training was very good and through the day this was demonstrated in the way they cared for the residents. The home has developed a “Grab File” for each resident. This file contains all the most important information on the resident that would be needed in a hospital. This means that in cases of an emergency the staff are prepared with all the correct information that will be required to pass on to hospital staff. 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. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 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 Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 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) 2 The staff at the home are good at communicating with the residents to help them achieve their desires and involve family members where possible. EVIDENCE: No new residents have been admitted to the home since the last inspection. The home have one vacancy that they are not filling as they are concentrating on meeting the needs of the current residents. This is being managed by training and increased staffing levels. Residents have a keyworker-day approximately once every three weeks. This means they go out with their key worker and do an activity of their choice. Other days are spent maximising their independence through life skills training either in or outside of the home. The residents families are consulted about the care provided and are involved in meetings and care planning. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 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 and 9 The written support plans and risk assessments are well written, clear and up to date. EVIDENCE: The written support plans gave a clear picture of the resident’s condition and the help that they needed. Included in these files were routines on how to look after the resident in the morning and evening and included the form of communication that the resident understood and responded to. The risk assessments also gave clear information and these corresponded with the resident’s intervention strategies on dealing with challenging behaviour. Pictures enclosed in these booklets gave the reader a good visual understanding of how to approach and help the resident when they are displaying this type of behaviour. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 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) 12, 15 and 17 The residents have fulfilling activities during the day and are enabled to keep contact with their family where possible. Good food is offered and is nutritious, varied and home cooked. EVIDENCE: The home has three vehicles to transport the residents about in, this means that residents can go out and do different things from each other. During this day there were two residents in the home all the others were either out on various shopping trips or at day centres. The residents keep in touch with families and can either go home with their relatives to stay for a day or overnight. Otherwise relatives visit the home. Some residents have pictures of relatives in their rooms and enjoy spending time with staff looking and communicating about them. These quieter activities and one to one time with staff was observed during the day. The home also has a sensory room, which was unable to be used because large items were stored there. Also the electrical equipment needed to be checked for safety. This type of activity is ideal for this group of residents and will be of benefit to them when it is restored back to its proper function. Chicken casserole was being prepared for the evening meal and one resident said that it was her favourite. The menu showed traditional food such as Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 11 sausages and mash or lamb chops. Food is cooked on the premises and is fresh rather than ready made or processed food. The residents’ food intake is recorded and alternatives to the menu are offered. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 and 20 The home manages the healthcare of the residents well. Policies and procedures are available to make sure that medicines are safely handled, however staff are not highlighting what is an “as required” medicine. EVIDENCE: Staff administer medication using the monitored dosage system. Printed medication sheets are received from the pharmacy. However “as required” medication is clearly marked on some sheets and not others. It is good practice for “as required” medication to be highlighted on all sheets to prevent errors occurring. For example as required medicine being given on a routine basis. The residents’ mental and physical health needs are monitored, for example seizure charts are in place, annual health reviews take place and psychiatrists are regularly involved in residents care. This ensures that their mental health is managed as well as their physical health. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 13 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) 23 Satisfactory arrangements are in place for the protection of the service users. EVIDENCE: Staff have received training in Protection of Vulnerable Adult procedures. The home has policies in place to follow regarding this process. The above procedures have been used as there have been adult protection issues in the home. Incidents that have occurred have all been between the residents. Following protection of vulnerable adult meetings, intervention strategies are now in place to manage these incidents. The home have been very good at reporting these incidents and are working towards reducing them. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 14 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) 24 and 30 The residents’ bedrooms are comfortable and clean. The layout of the communal areas are unsafe for some residents. EVIDENCE: The residents spoken to liked their rooms and were observed to have time in them to enjoy individual activities. The sensory room in the home was being used for storage and the equipment had not had a safety check. This meant that the residents were not able to use this room for its stated purpose. All the residents’ rooms were clean and well looked after. The bathroom and kitchen areas needed more attention to cleaning for example the fluorescent lights in the kitchen needed cleaning and light switches needed wiping to maintain standards of hygiene. There is an open plan dining and lounge area. The Commission for Social Care Inspection has received regular reports that residents behaviour problems often occur in these areas. For example residents either target each other or the furnishings to vent their anger and frustrations. Residents with poor mobility or those that use wheel chairs are vulnerable as they may not be able to move out of the way with sufficient speed to avoid an incident. To help Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 15 manage the environment along with the behaviours of residents extra staff have been employed. There is a long-term plan to build smaller units within the grounds of Timber Grove that will solve the environmental issues. Once approved by the planning department the plans should be submitted to the Commission for Social Care Inspection as a variation to the registration of the home and a site visit will needed. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 and 35 The recruitment records for care staff working in the home are good and the staff are well trained. The information held on a visiting therapist was poor. EVIDENCE: The staff records that were checked held relevant information regarding police checks, references and identification. There was some information supplied for a visiting therapist. However there was no evidence that a certificate of qualification for this person had been seen and there was no photograph of them. Staff demonstrated recent training that they had received on physical intervention, when carrying out their daily duties. The staff were observed talking and signing to the residents and giving them one to one time. Staff felt that the training offered to them was good, some staff have achieved NVQ ‘s whilst others are still in the process of completing them. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 17 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) 38 and 42 The home is managed well, however improvements are needed to maintain fire safety in the home. EVIDENCE: Staff spoken to at the home described the manager as having a good understanding of the home, being approachable and good at sorting out problems Safety certificates for gas, electric and fire equipment were checked and had all been maintained. Portable appliance testing was up to date for some appliances in the home but not for others. For example equipment in the sensory room had not had a check to make sure that it was safe to use. Fire equipment had been tested however records of fire drills could not be found. Staff said that fire drills were carried out however they could not remember when. For safety the home must record when fire drills occur and who takes part in them. Also for fire safety is was recommended in October 2003 that a Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 18 fire screen should be erected in the hatchway between the kitchen and dining room. As yet this is not in place. . Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 19 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 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x 3 x 3 Standard No 31 32 33 34 35 36 Score x x x 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Timber Grove Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 20 yes 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 1 schedule 1 Regulation Requirement Timescale for action 19.08.05 2. 20 13(2) 3. 24 23 4. 34 19 5. 39 24 The registered person shall compile in relation to the care home an updated written statement of purpose which takes account of the challenging behaviour which has to be addressed by the staff team and which must be reflected in a revised statement of the aims and objectives. A copy of this updated document must be sent to the Commission for Social Care Inspection. NOT INSPECTED The registered person must 8.08.05 ensure that as required medicine is clearly identified on the medicine sheets. The registered person must 5.9.05 submitt the plans for the new care home to the Commission for Social Care Inspection when they are available and keep the Commission informed of progress on this project. The registered person must 8.8.05 ensure that all recruitment records are obtained for therapists providing treatment in the home. The registered person shall Version 1.30 Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Page 21 6. 42 17 Schedule 4 (14) 7. 42 23(4)(a) 8. 42 13(4)(a) establish and maintain the system for reviewing at appropriate intervals and improving the quality of care provided at the care home which shall provide for consultation with residents and their representatives. NOT INSPECTED. The registered person shall maintain in the care home a record of every fire practice drill which should be no les than three monthly intervals. Staff involved in any fire drills should also be listed. Previous timescale of 31.03.05 not met. The registered person must ensure a fire screen is errected in the hatchway between the kitchen and dining room. The registered person must ensure that portable appliance testing is undertaken for all areas of the cre home. 8.8.05 8.8.05 8.8.05 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. 2. Refer to Standard 24 24 Good Practice Recommendations Review cleaning schedules to include ceiling areas and lights. The sensory room should be maintained for its proper purpose. Timber Grove I06-I56 S18036 Timber Grove V32170 070605 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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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