Inspection on 24/08/05 for Tregonwell Lodge & Two Wells

This inspection was carried out on 24th August 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 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

Tregonwell Lodge & Two Wells 02/08/07

Tregonwell Lodge & Two Wells 18/08/06

Tregonwell Lodge & Two Wells 04/01/06

Tregonwell Lodge & Two Wells 24/03/05

Tregonwell Lodge & Two Wells 07/09/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Tregonwell Lodge & Two Wells Salisbury Street Cranborne Dorset BH21 5PU Lead Inspector Marion Hurley Unannounced 24 August 2005 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. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tregonwell Lodge & Two Wells Address Salisbury Street Cranborne Dorset BH21 5PU 01725 517458 01725 517918 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) The Regard Partnership Limited Mrs Violet Rosetta Alcock CRH PC - Care Home only 16 Category(ies) of LD Learning Disability (16) registration, with number of places Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 24 March 2005 Brief Description of the Service: Tregonwell Lodge and Two Wells is owned by The Regard Partnership, which is a national organisation with several residential homes around the country. This organisation took over ownership of the home in April 2003. Tregonwell Lodge and Two Wells provide accommodation for 16 adults. The home specialises in providing care and support to people who have a learning disability. The current age range of service users living at Tregonwell is 19 to 45 years old. Tregonwell Lodge is a large country property in extensive grounds in the rural village of Cranborne in Dorset. Two Wells is a separate house next door to Tregonwell Lodge. Staff and service users can easily transfer between the two premises. The home is situated in the middle of the rural village, and has easy access to the local shop, pub, post office and restaurant. The accommodation comprises of the main lodge, which has 10 first floor bedrooms, communal lounge, kitchen, dining room and bathrooms, and a staff sleep in room. In the courtyard is a further accommodation block, providing 3 bedrooms and one bathroom. One of these bedrooms has been arranged as a bed-sit. Two Wells is a 4 bedroom property, providing accommodation to 3 service users, a staff sleep in room, lounge, dining room, conservatory and kitchen. The grounds include extensive vegetable plantings, greenhouses, lawn areas, woodland trails, ducks, courtyard with seating, toilets and workshops for carpentry. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection has been undertaken as part of the statutory inspection process in accordance with the Care Standards Act, 2000. Tregonwell Lodge & Two Wells were assessed according to the Care Homes for Adults (18-65), National Minimum Standards. The overall time spent to complete the inspection process was a total of nine hours, three of which were spent at the Home. In the course of the inspection three residents were spoken with privately whilst a further three joined in a general discussion. The Registered Manager was available and provided information and access to all records requested. Two staff files were checked and five resident’s records were read. Staff and residents morale was good and very positive on the day of this inspection and throughout the visit it was evident from observations and discussions that the staff work well together and genuinely side by side with the residents. What the service does well: The home provides a friendly and open atmosphere, which encourages and supports the residents to participate in all aspects of the running of the home. This is achieved through regular formal consultations and surveys and informally on a daily basis. Residents are encouraged to be as independent as possible and enjoy a wide range of both social and educational and leisure activities predominantly in the community. This includes going to Salisbury College, and local work experience placements. During College Holidays a daily activity programme is followed and includes such activities as rambling, pottery, swimming, weaving, and adult literacy. The Registered Manager with the staff team are working towards total communication and the Service User Guide and other documents are available in video format, reading tape and can be made available in other formats if requested, this is a positive move. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standards were assessed as no new service users had been admitted to the home since the last inspection. The key standard will be assessed at the next inspection visit. EVIDENCE: Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7 & 9 • Person Centred Plans are being introduced, which involve the resident in identifying their abilities, needs and lifestyle preferences. Personal care plans had been regularly reviewed with the residents to ensure their changing needs were reflected and their plans adjusted accordingly. Within the limits of each person’s vulnerabilities, residents are supported to take risks; this promotes independence and self-determination. • EVIDENCE: A sample of four resident’s files were examined as part of this inspection. Two included their Person Centred Plans which incorporate both realistic goals and “their individual dreams and aspirations”. All the residents have comprehensive care assessments/plans which detail their strengths, likes and dislikes and areas and skills they specifically wish to develop and learn. The Person Centred Plans are very indivual and one resident said it had been quite difficult especially looking back and writing their own “social history”. At this stage there are several different formats of plans in use and the Registered Manager, staff and residents need to decide which format suits them all best and which offers the most practical method of identifying the residents needs combined with their aspirations and mostly importantly how Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 10 these are to be achieved through the level of care and support provided. In addition to their Care Plans/Person Centred Plans each resident has a Client information Pack which contains lots of useful information for the residents and for those supporting them. Included in this file are the following: - Service User Guide, Terms & Conditions (those checked had all been signed), details of service provision/facilities, complaint and fire procedures, inventories, quarterly questionnaires, profile including missing persons profile with photographs, medical information, risk assessments and daily record of events/activities plus a section containing “sensitive information”. Residents may access their records at any time and may chose to kept their own Person Centred Plans rather than file them with other records. One of the Plans was graphically illustrated and presented in the form of a large poster. Each resident has been actively involved in choosing their current key worker and each resident is then allocated three hours each week for one to one time with their keyworker. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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 standard(s) 11,12,13 & 14 • All residents are encouraged to lead active meaningful lives. Links with the community are excellent and enrich residents’ social and educational opportunities. Residents have many opportunities to join in local clubs and social events outside the home. Members of staff treat residents with respect and this forms the foundation of a positive and respectful relationship between staff and residents. • EVIDENCE: The evidence for these standards was obtained from discussion with residents, staff and reading the daily records and timetable of events. This inspection coincided with College holidays and it was good to see that the Home had prepared for this by producing a “Daily Programme for College Holidays”. A variety of activities had been scheduled from, rambling, swimming, gardening, cookery through to more sedentary ones like weaving, pottery, adult literacy. The programme also named the specific staff allocated to lead each activity. On the day of this inspection a group of three people were cooking the mid-day meal and two others were out swimming. A third returned from the morning spent at their work experience placement. Another resident was enjoying their Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 12 own company listening to music in the main lounge. Observations throughout the inspection showed that staff interacted fully with residents. Residents had unrestricted access to all communal areas of the home or could choose to spend time in the privacy of their own rooms. The residents have chosen four different summer holidays and at the current time one small group is holidaying in France, another two trips have been planned for Greece and Tenerife and one group have elected to stay in England and go to Minehead. The Providers allocate a sum of money for each resident towards their annual holiday if the holiday exceeds this amount then residents are encouraged to save to ensure they can make up the difference. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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 standard(s) 18,19 • • The home offers personal support with individual preferences taken into account. Residents’ health care needs are provided for and from the records and in discussion with the Registered Manager there was evidence of good multi-disciplinary work taking place on a regular basis. EVIDENCE: All residents are registered with the local GP Practice and have annual check – ups. There was evidence from the health care records that residents are receiving regular dental treatment and attending optical appointments/treatment when required. All aspects of the residents’ health care needs are identified in their records and a note of all related appointments was included with the records. The home operates a designated keyworker to provide consistency and continuity of support for each resident. The home is currently working with a Speech and Language therapist and a Community Psychiatric Nurse. There is a support chart in the staff room, which indicates the residents that require personal care support and any preferences they may have regarding the gender of the staff supporting them. The Registered Manager stated that where possible all preferences are taken into account however, there are more female staff than male. None of the residents spoken with during the course of this inspection raised this as an issue and all spoke very positively about “ their workers”. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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) 22 &23 • Systems within the home provide residents with an open and encouraging environment where their views are listened to and acted upon. The complaints procedure is available to all residents and staff ensure everyone has an understanding of the complaints procedure. The home is currently ensuring that all staff complete training relating to the Protection Of Vulnerable Adults and Physical Interventions, and is aiming to reinforce this learning through formal supervision. Dorset County Council is currently running a series of training events and the Registered Manager is liaising to ensure all staff are able to access a course. • EVIDENCE: From discussion with the residents who were present on the day of this inspection it was clear they would feel quite confident in approaching either their keyworkers or the Registered Manager if they had any concerns. There is currently one resident who has an advocate and this is privately funded. All residents complete monthly questionnaires with the support of their keyworker. This information is then analysed and concerns are dealt with by the Registered Manager or through staff meetings. Residents’ questionnaires and the complaints procedure are produced in”wiggit”. The Registered Manager said that all the residents have been through the complaints procedure with their keyworkers. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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) 24 & 30 • • Residents live in a large comfortable family style home. The home had no unpleasant odours. EVIDENCE: A tour of the main house and Number 2 Wells were completed. All communal areas, were viewed and some of the resident’s bedrooms. Those bedrooms viewed had been decorated and personalised according to the individual wishes of the residents and greatly varied in style. Tregonwell Lodge is a large older style property accommodating thirteen people, which includes three living in the “Stable Block” and a further two residing at Number Two Wells, which is accessed through the gardens of the Lodge. There is ample communal space, though the lounge is rather “institutional” with all the chairs placed round the outside of the room. The carpets throughout the main building are beginning to look worn and whilst not presenting a hazard will need to be replaced in the near future. There is a separate dining room arranged with small tables, which seat up to four/six people. Tregonwell Lodge has three and half acres of grounds, which are accessible to all residents. The grounds and external fabric of the building look to be reasonably well maintained. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the above standards were assessed. The key standard will be assessed at the next inspection. EVIDENCE: Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 & 42 • • The home’s management creates an open and supportive environment, which both staff and residents benefit from. Health and safety records examined demonstrated safe working practices were implemented, thereby protecting residents and promoting their well being. EVIDENCE: Discussions and observations during the course of this inspection visit provided evidence to indicate that the Registered Manager has created a very relaxed and homely atmosphere at Tregonwell Lodge and both staff and residents were seen to be relaxed and at ease in the Manager’s company. There is good communication between the Manager, the staff and all the residents both informally on a daily basis and through regular staff meetings and the resident’s weekly meetings. Records were checked which indicated that equipment was regularly serviced and the testing of services/facilities provided in the home were completed Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 18 within the required timescales. The maintenance officer employed at Tregonwell Lodge completes the checks and tests. Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tregonwell Lodge & Two Wells Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 3 D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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 23 Regulation 13(6) Requirement The Registered Manager must ensure that all staff receive training in the Protection of Vulnerable Adults. Timescale for action 31:10:05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 24.10 Good Practice Recommendations The Registered Manager should consider replacing aspects of the furniture in the main lounge and consider a general refubishment of this room to create a more homely and comfortable feel. Consideration needs to be given to replacing carpets thoughout the home in the communal areas which are beginning to show signs of wear and tear. 2. 24.6 Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Unit 4, New Fields Business Park Stinsford Road Poole BH17 0NF 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 Tregonwell Lodge & Two Wells D55 S34481 Tregonwell Lodge & Two Wells V233423 240805 Stage 4.doc Version 1.30 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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