Inspection on 10/06/05 for Trelawney

This inspection was carried out on 10th June 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

Trelawney 08/01/08

Trelawney 17/10/06

Trelawney 03/02/06

Trelawney 19/10/04

Trelawney 18/05/04

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 Trelawney 35 Brookside St Austell Cornwall PL25 4HL Lead Inspector Mike Stokes unannounced 10 June 2005 14:30 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. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Trelawney Address 34 Brookside St Austell Cornwall PL25 4HL 01208 815614 01208 815618 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) Home Farm Trust Vacancy CRH Care Home 6 Category(ies) of Learning Disability, 6 registration, with number of places Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 19 October 2004 Brief Description of the Service: Trelawney is registered to provide accommodation and personal care for 6 adults with a learning disability. Home Farm Trust are providing a domestic style home and those currently living at Trelawney have been resident for a number of years. Each service user has their own bedroom and use of the communal lounge and family style kitchen. There is a small garden to the rear of the property, which overlooks the adjacent primary school. Trelawney is conveniently placed to allow the service users to participate in local activities, education opportunities and day care. The home has a mini bus for the range of activities and outings that are provided. Parking is available in the grounds of the home for staff and visitors. Building work is due to commence at the home to provide staff with a sleeping in room for their duties during the night. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection where the staff did not know I was visiting to review the standards of care at the home. I arrived at 2.30 pm and left at approximately 6.30pm. During the inspection I met service users returning home from day care activities, 3 members of staff and a Service Manager. I looked at records kept to monitor the care provided to service users and was escorted in a tour of the premises. What the service does well: 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. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 6 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 Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 7 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) 1, 2 and 3. The homes statement of purpose and service user guide, provide the service users and their advocates with details of the services the home provides. EVIDENCE: The service users have been resident in the home for many years and there are no plans to change this stable environment. The home is aware of the assessment and pre admission procedures that are required to assist prospective service users. The statement of purpose document is in place and meets all the requirements of The Care Homes Regulations (2001). The service user guide is very service user friendly and includes pictures to give examples of the kind of home that Trelawney is. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 8 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 and 8. The home has developed a procedure to record the needs and aspirations of service users. The records show that a complex range of information is maintained but a consistent approach towards care planning and the outcomes for service users is recommended. EVIDENCE: A member of staff on duty explained that service users have key staff and showed me the procedures for recording information regarding plans of care. The home uses the “Who Am I” document, which is completed by the service user and is in pictoral format. This is complemented by the individual support plan that is completed by the key worker and service user. There is evidence of regular reviews occurring. An inspection of 3 plans showed that staff are producing variations of this process. A recommendation is made to produce a procedure that demonstrates clearly the identified needs and aspirations of service users, how this is to be achieved, daily recording, risk assessments and a link to the review process to monitor progress. This has been discussed with a representative of the Home Farm Trust and is recognised as an area for development. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 9 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 and 17. The home is ensuring that each service user has the opportunity for links with the community and participate in social and educational activities. The meals in this home are good offering both choice and catering for special needs. EVIDENCE: The staff on duty confirmed that service users are involved in a range of appropriate activities and maintain contact with relatives. These were recorded in individual plans and I observed the service users returning to the home from their day care activities. The Home Farm Trust provides transport to assist service users. The staff recognised that when 2 members of staff were on duty, there are limited opportunities to organise leisure activities and the Home Farm Trust provide a third member of staff occasionally to assist in this area. A discussion also occurred regarding the organisation of the rota and responding to service user needs, where a service user is contracted for services at a 1:1 staffing level. The kitchen where the service users eat their meals is bright and spacious. Menu’s evidence a good choice of meals and all staff have responsibility for meal preparation. The service users are involved in meal planning and records are kept of all meals eaten as required by legislation. It was noted on the day of the inspection that healthy eating is encouraged and supported by the staff. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 10 Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19. The health needs of service users are well met with evidence of multi disciplinary working taking place as required. EVIDENCE: All health care services are available in St Austell and documentation is in place that evidences that the service users are receiving health care services as required. The key worker role is responsible for ensuring that the identified needs of service users are monitored and that services are provided as required. The 6 monthly reviews of care also monitor individual care needs and access to a range of services is organised. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The home has policy, procedures and has provided in house training for staff on Protection issues that protects service users from abuse. EVIDENCE: An adult protection policy and procedure is in place at the home and the Home Farm Trust has provided training to staff in adult protection. All the service users in the home have been provided with appropriate information on the process for complaints. The Home Farm Trust have been involved in Protection proceedings recently that has resulted in them taking disciplinary action against a member of staff. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27 and 30. The overall quality of furnishings and fittings is good and service users live in a safe, clean and homely environment. EVIDENCE: A member of staff assisted me in a tour of the premises. Service users rooms are individually decorated and personalised with possessions and equipment. There are adequate bathroom and toilet facilities for service users. Service users privacy is respected through the provision of locks on bedroom, bathroom and toilet doors. The Home Farm Trust is investing in this home through the provision of an extension that will provide a staff sleeping in area and office space. The Services Manager also stated that an extension to the existing lounge to create a sunroom is being considered. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33 and 35. The 2 members of staff at the home and identified by Home Farm Trust to work the afternoon and evening shift were inexperienced and have not been provided with appropriate induction and training opportunities, which places service users at potential risk. EVIDENCE: When I arrived at the home for this unannounced inspection, a member of staff that had appropriate experience met me and I was assisted in looking at records of care and reviewing procedures at the home. 2 other members of staff arrived for their duty and they were also interviewed as part of the inspection. One carer described himself as ‘peripatetic’ but had worked continuously at the home for 7 months. He stated that he had not received induction or any training opportunities during this period. The other carer was a relief worker with a few months experience. A carer stated that he had not completed formal induction training and had not been provided with fire precautions, medication, health and safety, Protection of Vulnerable Adults Procedures or food hygiene training. The staff confirmed that no guidance had been provided regarding the response to service users with seizures or behavioural issues that may be presented. The home does not currently have a registered manager that is qualified and experienced to meet its objectives. The home is experiencing staff turnover and is attempting to manage the recruitment and retention of suitable staff. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 15 The Home Farm Trust Service Manager arrived at the home at 6pm, he was responsible for the sleeping in duty that evening and stated that he had come in early to support the less experienced staff. A discussion occurred regarding my concerns at the organisation of the rota and lack of basic induction, supervision and staff training opportunities, a requirement is made regarding these issues. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 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 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) 37 and 42. The home does not currently have a registered manager that is qualified and experienced to meet its objectives. EVIDENCE: The Home Farm Trust have discussed a proposal to provide an accelerated training package for a senior carer and then make an application as the registered manager. A Service Manager provides direct support to this senior carer. The service manager is responsible to the ‘Responsible Individual’, the named person acting on behalf of the Home Farm Trust. It was observed that the mini bus keys were left in the laundry area cupboard that stored hazardous substances and this was left unlocked for convenience. A discussion occurred with the Service Manager to comply with COSHH Regulations. A requirement is made to review standard 42 – ‘safe working practises’; the review must include a response for the provision of radiator guards and regulators to all hot water outlets fitted to protect service users. The current delegated management of the registered managers responsibilities have resulted in concerns identified in this inspection regarding staffing issues. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 17 The Commission requires the Home Farm Trust to produce agreed action plans and attend a strategy meeting to seek improvement in identified concerns that will negate the need for potential enforcement action. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 18 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 3 3 3 x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 x x 3 Standard No 11 12 13 14 15 16 17 3 3 x x x x 3 Standard No 31 32 33 34 35 36 Score x 2 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Trelawney Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 19 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 32,33 and 35. Regulation 18 Requirement The Home Farm Trust must ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of service users. Written proposals are required regarding induction, training and supervision for all staff, including relief and peripatetic staff. The Home Farm Trust must produce written proposals, with timescales, regarding the application for a registered manager and the interim management support provided to ensure that standards are met. The Home Farm Trust must review standard 42 – ‘safe working practises’; the review must include a response for the provision of COSHH, radiator guards and regulators to all hot water outlets fitted to protect service users. Timescale for action 31/8/05 2. 37 8 31/8/05 3. 42 23 31/8/05 Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 20 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 6 Good Practice Recommendations A recommendation is made to produce a procedure that demonstrates clearly the identified needs and aspirations of service users, how this is to be achieved, daily recording, risk assessments and a link to the review process to monitor progress. Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell Cornwall 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 Trelawney D52 -D04 S42698 Trelawney UI V226927 100605 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. 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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