Inspection on 19/12/05 for Tregarne

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Tregarne 05/07/07

Tregarne 12/09/06

Tregarne 16/08/05

Tregarne 22/03/05

Tregarne 14/09/04

Tregarne 23/03/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

CARE HOME ADULTS 18-65 Tregarne Hostel North Street St Austell Cornwall PL25 5QE Lead Inspector Elaine Bruce Unannounced Inspection 19th December 2005 09:30 Tregarne Hostel DS0000041927.V267295.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 Tregarne Hostel DS0000041927.V267295.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. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Tregarne Hostel Address North Street St Austell Cornwall PL25 5QE 01726 72429 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) philip@cornwall.gov.uk Cornwall County Council Mrs Elisabeth-Anne Philp Care Home 16 Category(ies) of Learning disability (16), Physical disability (16), registration, with number Sensory impairment (16) of places Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Service Users to include 16 adults with a Physical Disability (PD) Service Users to include 16 adults with a sensory impairment (SI) Service Users to include 16 adults with a learning disability (LD) Total number of service users not to exceed a maximum of 16. Date of last inspection 16th August 2005 Brief Description of the Service: Tregarne is a split level detached property within walking distance of St Austell town centre. The home is a social services establishment that provides short stay care for up to sixteen service users with a learning disability. The accommodation is located on the ground and first floors. Each floor is self contained and therefore has the ability to function independently. One floor of the home has been adapted to meet the needs of service users with a physical disability. The home has the benefit of a fully equipped sensory room and a small computer suite. The property has pleasant spacious gardens to three sides and a parking area. Tregarne Hostel DS0000041927.V267295.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 on the 19th December 2005 over three hours and was carried out as an unannounced inspection. The inspection was shorter than usual due to a lack of information being available in regard to particular standards. This is commented on in more detail in the main body of the report. The environmental standards were not inspected as there are plans for the whole environment to be updated and improved. The home is in need of attention to the environment as generally the appearance internally is very shabby and institutionalised. Two of the service users were at the home during the first part of the inspection with everyone else out at their various day care activities. Tregarne is providing short stay accommodation to service users with a complex range of needs, dependency levels and ages from 18 to 70 years. The home generally offers service users planned respite. On the night of the inspection nine service users were to be staying at Tregarne for respite care. The registered manager was unavailable on the day of the inspection. She is covering duties and responsibilities for her line manager who is presently on long term sickness. An acting manager is covering the registered managers post at this time. She was expected on duty later in the day. A formal application to cover the registered managers post should now be submitted to the Commission for Social Care Inspection. What the service does well: What has improved since the last inspection? Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 6 One good practice recommendation of the inspection report dated the 16th August 2005 has been met. 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. Tregarne Hostel DS0000041927.V267295.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 Tregarne Hostel DS0000041927.V267295.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): 3 All service users access the home by the care management process that involves a social care and financial assessment. EVIDENCE: All service users access the home by the care management assessment process that involves a social care and financial assessment. The assessment is requested at the time of referral and is then discussed at a pre admission “panel meeting” with senior staff of social services and Tregarne. The staff member in charge on the day of the inspection stated that there had been no new assessments since the last inspection as all the service users were existing clients. Each service user should be provided with an individual written contract or statement of terms and conditions re their placement. On the day of the inspection this information was unavailable. It is recommended that the staff member in charge is aware where they can access this documentation if required. Tregarne Hostel DS0000041927.V267295.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): 6,7,9 The service users health, personal and social care needs are evidenced as being met in care planning documentation. EVIDENCE: Each service user has a plan of care that is generated from the assessment received at referral and from information gained at the pre-admission meeting and previous knowledge of the service user. The care plans are detailed and very service user focused. They are supported by daily records. Risk assessment information is included in the care planning documentation. The home operates a key worker system which gives the responsibility of care planning to that staff member. There is evidence in place that the care plans are being reviewed monthly. Tregarne Hostel DS0000041927.V267295.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): 12,13,15,16 and 17 Care planning documentation evidences that the social care needs of the service users have been assessed and the daily recording evidences how these needs are being met. EVIDENCE: Tregarne is a short stay facility and therefore all service users have established on-going family or carer links. The home operates an open door visiting policy and everyone is asked to sign the visitors’ book on arrival to the home. All visits to the service users are documented. Care planning identifies where a particular service user enjoys an activity which can be for example shopping, bowling and going to the pub. The daily records evidence when this activity has taken place. Weekly overview sheets are in place for the service users who attend local adult training centres. Records indicated that this week end the service users had a trip out to see local Christmas lights followed by a meal out. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 11 The menu at the home rotates over a three week period. The main meal of the day is in the evening and on the day of the inspection was toad in the hole, beans and chips followed by rhubarb crumble. The cook is off long term sick and agency cover is being provided at this time. The menu did not appear to offer an alternative choice which should be addressed. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 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 the following standard(s): 21 Although staff have read the medication policy and procedure it should be changed to include the name of Tregarne and not another home run by Cornwall County Council EVIDENCE: The good practice medication policy and procedure recommendation of the inspection report dated the 16th August 2005 has been addressed. It is now recommended that the policy be amended to have the correct name of the home Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 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 the following standard(s): 22 and 23 Evidence was not fully in place that the service users are being listened to when they have raised a concern. Staff must receive adult protection training as a priority. EVIDENCE: One care plan evidenced that a service user had raised a serious concern and action had initially appeared to have been taken but no follow up information was available. This was left with the staff member in charge to follow up as a priority and to advise The Commission for Social Care Inspection of the outcome. Another care plan required further documentation again in relation to a service user incident. The staff member in charge was unable to comment if staff had received adult protection training as recommended in the inspection report of the 16th August 2005. This is now included in this inspection report as a statutory requirement. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 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 the following standard(s): The environmental standards were not assessed at this inspection as there are plans for considerable changes to take place which are essential. EVIDENCE: Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 15 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): The staffing standards (in particular the standard for recruitment) were not able to be assessed as the staff member in charge could not access this information. It is recommended that this information is available for inspection if required. EVIDENCE: Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 16 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 Tregarne is presently in a transition period due to the absence of the registered manager and planned changes to the environment. A new manager must be registered to ensure that the service users benefit from a well run home. EVIDENCE: The temporary arrangements at Tregarne must now be formalised to ensure that the service users are benefiting from a well run home. The person in charge on the day of the inspection, although helpful was unable to access important information which must be addressed to ensure that The National Minimum Standards are met. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 17 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 3 x x Standard No 22 23 Score 2 1 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 x x x x x x x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tregarne Hostel Score x x x 2 Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x DS0000041927.V267295.R01.S.doc Version 5.0 Page 18 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 YA23 Regulation 18(1)© Timescale for action To ensure that staff receive adult 31/03/06 protection training as a priority. Requirement 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. 3. 4. 5. 6. 7. 78. Refer to Standard YA5 YA20 YA17 YA23 YA33 YA34 YA37 YA22 Good Practice Recommendations To ensure that the staff member in charge can access the written contract on behalf of each service user. To ensure that the medication policy and procedure is individualised to Tregarne and not another Cornwall County Council home. To evidence on the menu an alternative choice to the meal being provided. For staff to receive adult protection training. To monitor the staffing levels to ensure that they meet the care needs of the service users at all times. To access staffing information if required for inspection. To register a new manager at the home following the changes in the management structure. To provide the information requested by The Commission for Social Care Inspection as a priority. Tregarne Hostel DS0000041927.V267295.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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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