Inspection on 07/09/05 for Treehaven

This inspection was carried out on 7th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Treehaven 05/11/07

Treehaven 08/11/06

Treehaven 18/01/06

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 NR27 9LT Lead Inspector Lella Andrews Unannounced 7 September 2005 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. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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 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 Ms Jennifer Meek Care Home 12 Category(ies) of Learning Disability (12) registration, with number of places Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Twelve (12) Service Users of either sex, with a learning disability, who are aged over 18 years may be accommodated. Date of last inspection 8th February 2005 Brief Description of the Service: Treehaven is a large detached house situated on the edge of the village of West Runcton. 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 I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place over two hours on Wednesday 7th September 2005. The Commission has recently agreed, on a temporary basis, an increase in the number of tenants living at the Home Therefore there are currently thirteen tenants living at the Home. The Manager was available to provide information, both verbally and in written format, during the Inspection. The Inspector spoke to a member of staff on an individual basis, looked at records and inspected the medication system. Due to the needs of the tenants it is difficult for the Inspector to spend time with the tenants during an unannounced Inspection without this causing the tenants considerable anxiety. The Inspector spent a short period of time in the Home with the tenants. Very few standards were measured during this Inspection. The Home has recently been re-inspected by the National Autistic Society Accreditation assessor and have maintained their accreditation. What the service does well: What has improved since the last inspection? The Home continues to develop effective communication systems The Home continues to encourage and support tenants to develop their social and communication skills Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 6 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 I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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 Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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) None of these standards were measured EVIDENCE: N/A Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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) 7 Effective communication is recognised by the staff team as being vital when supporting tenants to make their own choices. EVIDENCE: The importance of effective communication is recognised by the organisation and appropriate training is provided to staff with regard to this. Each of the care plans contains information about how the tenant is able to communicate and what form this communication takes. Staff recognise that behaviours are a form of communication. A variety of forms of communication are in use within the Home, including symbols, photographs, pictures, signing and objects of reference. One of the members of staff has undertaken additional training and is responsible for assessing the tenants individual communication needs and for devising their communication plan. This member of staff will shortly be employed solely to undertake this work on a part time basis. Staff are aware of the importance of supporting tenants to make their own decisions but also of how this can be very difficult for some tenants due to their autism. Any restrictions on choice are recorded within the care plans. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11 and 16 Tenants have opportunities for personal development The rights of the tenants are respected EVIDENCE: Each tenant has a very structured daily plan which includes opportunities to develop social, communication and independent living skills. The style of the activities and the amount of time spent on each is dependent on the needs of the tenants. Some of the tenants take part in household tasks, such as cooking, laying tables for dinner. The use of structure is based on research with regard to supporting people with complex needs with autistic spectrum disorders. The tenants individual preferences and choices are taken into account when planning the activities and they are encouraged to take part in them even if this is for a very short period of time. Individual plans are regularly reviewed and changed as necessary. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 11 Risk assessments are undertaken with regard to whether tenants are able to hold their own bedroom key. Staff were heard to knock on doors prior to entering. The tenants have access to the communal areas and the large garden in addition to their bedrooms. One of the tenants is spending a great deal of time in their room at present due to a health need and the staff are very aware of the risk of isolation and have plans in place to prevent this happening. One of the tenants smokes and arrangements are in place to facilitate this safely. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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) 18, 19 and 20 Tenants receive personal support in the way they prefer and require Tenants physical and emotional health needs are met The medication procedures promote the health of the tenants EVIDENCE: The care plans contain information about how tenants prefer to receive personal support. Staff receive training with regard to this during their induction. Staff are aware of the importance of respecting the privacy and dignity of the tenants. Staff advised that tenants choose when to get up and to go to bed. Tenants are encouraged to develop their own sense of style with regards to clothes and hairstyles. One of the tenants is currently requiring one to one staffing and the Manager spent time to ensure that this small team of staff are liked by the tenant and that the staff have the appropriate skills to carry out this role effectively. The tenants physical and mental health needs are given a high priority in the Home. The care plans show evidence of health professionals being involved in Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 13 the tenants care and records of any guidance and advice provided by these professionals. Staff maintain a variety of monitoring records which provide the basis on which health care plans can be reviewed and updated. One of the tenants has a particular physical health need at present and there are very clear written procedures in place to improve their health whilst not presenting a risk to any other tenants or staff. The staff are aware of the procedures and advised that these procedures are followed. Staff are also aware of the possible effects on the emotional health of the tenant and have put steps in place to prevent this from deteriorating during this period of ill health. Due to the communication difficulties it can be difficult to ascertain what the cause of a tenants ill health is and the Inspector was given good examples of the additional time and efforts that staff take to try to find out the cause. This can often involve professionals within the local Learning Disability Team and also the Behaviour Support Manager employed by the organisation. The Home has a thorough medication procedure and medication is stored appropriately. All staff who are responsible for medication receive training provided by the organisation. One of the Managers within the organisation is responsible for the provision of this training. The records of administration are maintained appropriately and there are clear guidelines for the administration of PRN (as required) medication as necessary. The care plans show evidence of attempts made to ensure that the tenants only take medication that is absolutely necessary and that any decisions about this involve the multi-disciplinary team, including the GP and Psychiatrist. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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 standard(s) None of these standards were measured EVIDENCE: N/A Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 15 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) None of these standards were measured EVIDENCE: N/A Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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 36 Tenants are protected by the Homes recruitment procedures Staff feel well supported but the records of this support need to be maintained EVIDENCE: The Inspector looked at two of the personnel records which contain the records relating to the recruitment of the staff. The records show that two references and a Criminal Records Bureau disclosure are obtained for new members of staff prior to them starting work at the Home. Staff are asked to complete a health questionnaire and evidence of checks on proof of identity are kept. The staff spoke highly of the support that they receive from the Manager and the other senior staff. They advised that they always feel able to discuss any issues with them and have confidence that any concerns will be addressed. The organisation provides an on call system which ensures that a Manager is always available during the evenings and at weekends. Some of the behaviour of the tenants can be “challenging” to staff and staff advised that there are always other staff around who can be asked to assist and that a “debriefing” takes place by a senior member of staff after any incident. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 17 The formal supervision records show that these have not taken place very regularly but the Manager advised that she is aware of this and that plans are in place to ensure that these take place more regularly and that records are kept of this. Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 18 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) None of these standards were inspected EVIDENCE: N/A Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 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 x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 x x x x 3 x Standard No 31 32 33 34 35 36 Score x x x 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Treehaven Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 20 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 Regulation N/A Requirement Timescale for action 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 36 Good Practice Recommendations It is recommended that the formal supervision sessions take place every two months and that records are kept of these Treehaven I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 21 Commission for Social Care Inspection 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 I55 s27391 Treehaven v243824 UN 070905(4).doc Version 1.40 Page 22 - 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. 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