CARE HOME ADULTS 18-65
Timber Grove Whitepost Farm London Road Rayleigh Essex SS6 9DT Lead Inspector
Nicola Dowling Unannounced Inspection 7th November 2005 10:00 Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 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) Elizabeth Fitzroy Support Ms Deborah Housman Care Home 15 Category(ies) of Learning disability (8), Physical disability (7) registration, with number of places Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 07/06/05 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 vehicles 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 DS0000018036.V263524.R01.S.doc Version 5.0 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 brief tour of the home, talking with staff and residents, observing the care given, and reading of documents. There were seven staff working on the morning shift, along with four staff members from the Activities team. There was a mixture of core staff and agency staff however all the staff were familiar with the residents. Initially there were four residents out at various activities and others went out with staff through the day. Elizabeth Fitzroy Support has submitted plans to Rochford council planning department. This is for new smaller units to be built in the existing grounds of Timber Grove and these units will replace the existing home. It is estimated that approval for these plans will not be known until February 2006. 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?
There have been a number of improvements since the last inspection. There is a new procedure for the administration and recording of medication that is working well. Health and safety practices are up to date and proof of
Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 6 qualification of visiting therapist has been gained. Quality assurance is underway at the home and extra information about challenging behaviour has been written into the statement of purpose. Some residents have had their bedrooms redecorated to their individual liking and the communal area is also being upgraded. 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 DS0000018036.V263524.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 Information contained in the service user guide and statement of purpose is old. EVIDENCE: There have been amendments to the statement of purpose giving information about the challenging behaviour that some residents have. However there was old policy information and out dated contact names and addresses that will give readers of this document the wrong information. For future reference when it is known if the planning application is accepted these documents will need to be revised to set out the aims objectives and philosophy of each unit along with the services and facilities that it provides. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 The risk and support plans are good and residents are assisted in their decision making. EVIDENCE: The support plans gave a good guide to the care that the resident has. There is a detailed morning and evening routine that describes how to approach the resident as well as what to do to help them. As well as risk assessments some residents have strategy plans for how staff are to care for the resident when they are displaying challenging behaviour. Staff are fully aware of these plans and were able to work them. Residents are helped to make decisions in small ways. For example staff help residents choose what to have for breakfast by showing them what is on offer. Some of the core staff team are able to use Makaton to communicate with residents. On key worker days the residents choose the activity that they want to do for example going out and looking at boats or going on a train ride. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 the following standard(s): 13, 14 and 16 The staff provide good opportunities for the residents to get involved in activities and give the residents freedom to choose how they spend their time. EVIDENCE: There is evidence that the residents go out to use the local leisure facilities. Depending on their ability either one or two staff accompany them. Every resident has a regular key-worker day. This means that they choose the activity that they want to do. Most of the residents have had a holiday this year along with day trips out to places such as Woburn Safari Park and Leeds Castle. As mentioned earlier in the report the day centre that some residents use is closing down. The manager is currently in communication with other authorities regarding the transfer of funding so that, money can be made available for the residents to establish their individual activity plans. Money has been made available for some residents but not all. On a daily basis the staff in the home were observed interacting with the residents. Some residents chose to be on their own in their rooms and staff allowed them this time. When staff entered a resident’s room they knocked and asked to be invited in and explained the reason why they were there.
Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 the following standard(s): 18 and 20 The resident’s personal support and medication is well managed. However there is no written guidance for staff to follow on the care of the unconscious person. EVIDENCE: There is a new procedure for the administration of medication to make sure that medicines are not forgotten. Since this plan has been put into practice it seems to be working well. Some residents have risk plans for their medication. On these plans it is written that staff should care for the unconscious person however there is no guidance for staff to follow on this topic. Staff have undertaken first aid training and may be aware of what procedures should be followed, however for those staff that have not had or updated their training this could leave the resident at risk because staff are not familiar with what to do. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 There is an established complaints and protection of vulnerable adults procedure in place. However there has not been any update training for staff on the subject of abuse. EVIDENCE: The Commission for Social Care Inspection has not received any complaints about the home this inspection year. The manager has dealt with one complaint to the satisfaction of the complainant. There have been adult protection meetings at the home. These incidents have been between residents. Special measures have been implemented and these are working well. There has not been any update training for staff on the Protection of Vulnerable Adults however some staff are covering this abuse via other courses that they are on. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 the following standard(s): 24 The home is clean and individual bedrooms are comfortable. The layout of the communal areas are unsafe for some residents. EVIDENCE: The premises are warm, airy, clean and free from offensive odours. There is sufficient heating, lighting and ventilation. The home are in the process of redecorating the dining and lounge area and some of the residents bedrooms have also been redecorated. They now look homely and inviting. The environment does not meet the needs of all the residents. There is a communal dining and lounge area. This area can be the focus of challenging behaviour with residents venting their anger and frustration on either the furniture or fellow residents. Extra staff and special care plans are in place and are working well. However because of the range of abilities of the residents at the home this area is difficult to keep safe for all the residents that want to use it. . Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 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): 31 and 32 Residents are supported by trained staff. EVIDENCE: The staff spoken to demonstrated attitudes and characteristics important to the care of the service users. For example residents approached the staff when they wanted something and staff were observed to sit with the residents and spend time with them. The staff were clear about their roles and how they looked after the residents. New staff received induction training and staff have attended various other courses that are applicable to the care of this group of residents. Some staff are able to use Makaton and these skills have been passed on to other care workers. The staff on duty were familiar with the residents and were able to communicate with them by understanding their body language and gestures. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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 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, 39 and 42 There is good health and safety management and the home is run in the best interests of residents. EVIDENCE: A random sample of safety certificates was inspected and these were all up to date. There was evidence that the Landlords safety check had been carried out however no certificate had been issued for the work undertaken. There is an experienced registered manager who has the relevant qualifications to manage this home. Work on Quality assurance is not yet completed. The manager intends for this to be finished in the next month. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 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. 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 2 X X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 3 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Timber Grove Score 2 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x 3 x DS0000018036.V263524.R01.S.doc Version 5.0 Page 17 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 YA1 Regulation 6 Requirement Timescale for action 20/12/05 2 YA23 13(6) 3. YA24 23 The Registered Person must ensure that the information contained in the statement of purpose is up to date. The Registered Person must 20/12/05 ensure that staff receive regular training on the Protection of Vulnerable Adults. The registered person must 01/03/06 submit 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. ONGOING 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 YA18 Good Practice Recommendations There should be instructions for staff on how to care for an unconscious person.
DS0000018036.V263524.R01.S.doc Version 5.0 Page 18 Timber Grove 2. 3 YA24 YA42 The sensory room should be maintained for its proper purpose. The home should obtain the copy of the Landlords Safety Certificate for Gas. Timber Grove DS0000018036.V263524.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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