Inspection on 18/01/06 for Treehaven

This inspection was carried out on 18th January 2006.

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

Treehaven 05/11/07

Treehaven 08/11/06

Treehaven 07/09/05

Treehaven 08/02/05

Treehaven 05/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Treehaven Sandy Lane West Runton Cromer Norfolk NR27 9LT Lead Inspector Mrs Lella Andrews Announced Inspection 18th January 2006 09:30 Treehaven DS0000027391.V272032.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 Treehaven DS0000027391.V272032.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. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Treehaven Address Sandy Lane West Runton Cromer Norfolk NR27 9LT 01263 837538 01603 279529 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) Jeesal Residential Care Services Limited Jennifer Meek Care Home 13 Category(ies) of Learning disability (13) registration, with number of places Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered for twelve service users plus one additional service user who is named in the Commissions records. This condition will be reviewed in three months (December 2005). 7th September 2005 Date of last inspection Brief Description of the Service: Treehaven is a large detached house situated on the edge of the village of West Runton. There is a large secure garden and an area set aside for horticultural work. There are workshops to the rear of the Home with one of these having been converted to house a small gym. The Home provides a service for up to twelve adults who have autistic spectrum disabilities. Accommodation is provided on the ground and first floors. All service users have a single bedroom. There are several communal rooms including a sensory room. The Home is owned and managed by Jeesal Residential Care Services Ltd Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was announced and took place over 7 hours on Wednesday 18th January 2006. The Manager was present and provided information verbally and in the form of records. The Inspector spoke to two members of staff on an individual basis and to other members of staff on a more informal basis throughout the Inspection. The Inspector joined tenants for lunch and spent time observing staff and tenants in the house. The tenants who live at the Home have Autistic Spectrum Disorder and associated challenging behaviours. Several of the tenants find it difficult when visitors are in the house and so the Inspector and the Manager had planned the Inspection prior to it taking place with the aim of ensuring appropriate information could be obtained without causing too much anxiety to the tenants. The Inspector spent approximately 45 minutes in the house and the rest of the time in the office which is located next to the house. Ten completed comment cards were received from relatives and three were received from health professionals. One of the health professionals states that the Home provides an “ excellent service.” The member of staff who takes a lead for communication training spent time with some of the tenants and assisted them to complete comment cards. However, the style of the comment cards are not conducive to the tenants being able to understand them easily or to completing them without help. What the service does well: The Home provides a good service for adults with a learning disability with autistic spectrum disorders and associated challenging behaviours. The service is based on current research and good practice. The staff recognise the importance of communication and work hard to find alternative methods of effective communication with each tenant. The staff are enthusiastic about their roles and show a lot of care and respect for the tenants. The staff receive good support and training so that they are able to carry out their jobs effectively. The Home is well managed by a Manager who has high standards and a positive style of leadership. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? 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. Treehaven DS0000027391.V272032.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 Treehaven DS0000027391.V272032.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): 2 The Home has appropriate procedures in place to facilitate effective assessments of prospective tenants. EVIDENCE: The Home has not had any new referrals recently but does have appropriate procedures in place for assessing prospective tenants. Treehaven DS0000027391.V272032.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 and 9 The care plans provide effective guidance to the staff about how to meet the tenants needs Tenants are supported to take risks as part of an independent lifestyle EVIDENCE: Two of the care plans were seen and these contain detailed information about the individual tenant and their particular needs. The care plans are based on the autism triad of impairments and provide detailed guidance to staff about how to meet the tenants needs. Staff sign the care plans to evidence that they have read and understood them. The importance of effective communication is recognised by the organisation and training is provided to staff with regard to this. The care plans contain information about how the tenant is able to communicate and what format the communication takes. Staff are aware of the differing forms of communication and the ways in which individual tenants communicate. The care plans contain detailed information about the behaviours that each tenant has with clear plans available with regard to aggressive or self harming Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 10 behaviour. The focus is on the role of these behaviours as a form of communication and the need for staff to respond effectively. The care plans contain detailed risk assessments for each tenant which cover a range of issues. The staff work with tenants to increase their skills with regard to independence and risk assessments are carried out in relation to these areas. The staff recognise that risks taking is part of a persons way of learning but this is managed in an effective way to reduce the risks to the tenant and others around them. There is evidence that the careplans and risk assessments are regularly reviewed and updated. There is also evidence that health professionals are involved in the planning of care for individual tenants. The comment cards completed by health professionals states that the staff have a clear understanding of the tenants needs. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 and 17 The tenants each have a programme of activities but there has recently been some reduction in these taking place due to staffing difficulties. Tenants are supported to maintain contact with relatives. The tenants are offered a healthy diet with choices available at each meal. EVIDENCE: The tenants each have a programme of activities detailed within their care plan. The activities are planned based on individual needs and choices. The activities are a mix of in house activities such as crafts, person centred planning work, using the gym and garden as well as making use of community facilities such as the library, shops and local attractions. The tenants need a high level of staff support when using community facilities and the staffing rota is planned to reflect this. However, due to recent staffing difficulties the activities have not always been able to take place. The completed comment cards from tenants indicate that activities have not always taken place. The staff are aware of the difficulty that the tenants have in Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 12 understanding change to their regular routines and work hard to ensure that as many activities have taken place as possible. The staffing difficulties are being addressed and are expected to be short term therefore, activities should all be able to take place as planned. The care plans contain details about the arrangements in place to enable the tenants to keep in contact with relatives. Transport is provided to those tenants who need this in order to visit relatives. The completed comment cards indicate that relatives are made to feel welcome by staff when they visit. The Home has a cook who works five or six days per week. The cook is responsible for preparing the menus after discussions with the staff and tenants. He cooks the lunchtime and evening meals. Staff assist tenants to get breakfast and supper. The Inspector joined a small group of tenants for lunch. The meal was freshly prepared and tasty. The menus are on display in symbol format and there is always a choice. The cook asks each tenant during the morning what they would like from the menu. At lunch time it was clear that the tenants are able to have a wide choice of meals as several tenants had different meals to that which were on the menu. Discussions with the cook show that he knows many of the individual dietary likes and dislikes. The kitchen is locked due to the risks to the tenants of having free access to the kitchen. However, tenants did go into the kitchen with staff support. Some tenants were involved in setting the tables and clearing them after the meal. Many of the tenants find mealtimes a difficult time and the tables are arranged so that small groups of tenants are able to sit together in each of the lounge/dining rooms rather than everyone eating together. The staff are aware of the individual support that some tenants need at mealtimes. Conversations with staff and the tenants comment cards indicate that there have recently been some problems with the quality of the meals due to changes in the procedures for purchasing food but that this had been raised with the organisation and has now been resolved. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were measured EVIDENCE: N/A Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 14 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 are systems in place to enable tenants to raise any concerns that they might have. Procedures and staff training are present to protect the tenants from any form of abuse. EVIDENCE: The Home has a complaints procedure which is also available in symbol format. The staff are aware that the majority of the tenants would find it difficult to make a complaint due to their communication difficulties and are aware of other indicators eg. Behaviour, of a tenant being unhappy about something. The keyworkers carry out a monthly summary of needs for each tenant and try to involve the tenants with this as much as is possible. A representative from the Home is able to attend the Tenants Forum which is held at the head office of the organisation and this is also an opportunity to raise any concerns or issues. The relatives comment cards indicate that seven are aware of the complaints procedure. The health professional comment cards state that they have not received any complaints about the service. The Manager advised that she has not received any complaints about the service in the last twelve months. A record is kept of any complaints made. The Home has extensive policies and procedures which aim to protect the tenants from abuse of any form. Staff all receive relevant training within their induction with regard to the protection of vulnerable adults. Staff also receive Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 15 detailed training about working with tenants with challenging behaviour and how to respond appropriately to this. The organisation deals with any allegations appropriately and is aware of the role of the joint procedures in place with regard to Adult Protection. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The Home receives very hard wear and tear and there are some unpleasant odours in some parts of the Home. EVIDENCE: The Inspector looked around the communal areas of the Home and was shown two of the bedrooms by tenants. The building receives hard wear and tear and this is showing. However, the organisation has plans to redesign the inside of the building so that it provides four self contained flats so that the tenants are able to live in smaller groups. This will be a positive step and it is expected that this work will begin shortly. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 35 The tenants are supported by competent and qualified staff who receive good levels of training and support. The staffing levels have been reduced recently which has meant that tenants are not always able to access planned activities and staff can feel more vulnerable. EVIDENCE: The staff who spoke to the Inspector are enthusiastic about their roles and seem to really care about the tenants. It can be difficult to support the tenants due to the range of behaviours that are shown but the staff said that they receive appropriate training and support to do this effectively. The tenants spoke highly of the staff and said that they like them and that they “help them out”. The comment card from the health professional states that the staff have a clear understanding of the care needs of the tenants and that they are satisfied with the overall care. Nine of the relatives comment cards stated that they are satisfied with the overall care. The organisation has recently built two bungalows next door to this Home and so there has been a complete reorganisation of staff roles for the management and staff at the Home. It is intended that staff from Treehaven will also work at the bungalows on a rotating shift system. The emergency admission of the Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 18 first tenant to the bungalows has meant that the staffing levels at Treehaven have been reduced on occasions as the new staff who have been recruited have not finished their induction training yet. However, five new staff will shortly start work at the site and the Manager is still recruiting for additional staff. Due to the needs of the tenants it is difficult for agency staff to work effectively in the Home and so the existing staff tend to cover extra shifts to cover for vacancies. The staff who spoke to the Inspector said that they receive good levels of training which is relevant and effective. They said that they receive updates of mandatory training on a regular basis. The staff training files confirm that appropriate training is provided to the staff. The organisation has its own training department who are working towards increasing the number of staff who have achieved NVQs. The Manager and others within the management team of the Home have many years experience of working with the tenants and are able to provide good support to less experienced staff. The organisations Behaviour Specialist is currently spending additional time at the Home and working alongside the staff with the tenants at Treehaven and at the bungalows. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38 and 42 The tenants and staff benefit from the ethos and leadership of the Home. The health, safety and welfare of tenants and staff are promoted and protected. EVIDENCE: The Manager has worked at the Home for many years and was previously the Deputy Manager before becoming the Manager approximately a year ago. The Manager has her own high standards and is able to effectively communicate these to the staff. She works alongside the staff team on occasions as well as undertaking the necessary management tasks. The staff speak highly of the support that she provides, both formally and informally. As previously mentioned, there has been a complete reorganisation of the management team at the Home as they will now also manage the two new bungalows next door. The Manager has very regular meetings with the rest of the management team as they are in the early stages of working together as a Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 20 team. The Manager receives good support from the General Manager of the organisation. Staff receive Health and Safety training within their induction. They also receive regular updates for Fire, Food Hygiene and other mandatory health and safety training. The Manager has completed detailed fire risk assessments for the building and for each of the tenants. The tenants risk assessments include how their autism may impact on their understanding and ability to respond to fire alarms, whether in a drill or for real. A selection of service certificates were seen for the fire safety equipment. A fire safety audit is carried out on a monthly basis, as is a more general health and safety audit. The Inspector was told that the temperature of the hot water is regulated. The temperatures are checked and recorded on a monthly basis. Any problems identified within the routine checks are recorded and passed to the maintenance department for action. The tenants care plans contain individual risk assessments. Staff receive training about autism and working with tenants with challenging behaviour and how to respond to these behaviours appropriately. Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 2 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 2 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Treehaven Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 X DS0000027391.V272032.R01.S.doc Version 5.0 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 YA33 Regulation 18 (1) Requirement It is required that at all times there are sufficient numbers of staff on duty to meet the needs of the tenants Timescale for action 15/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Treehaven DS0000027391.V272032.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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