Inspection on 17/10/06 for Trelawney

This inspection was carried out on 17th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trelawney 08/01/08

Trelawney 03/02/06

Trelawney 10/06/05

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 34 Brookside St Austell Cornwall PL25 4HL Lead Inspector Mike Stokes Key Unannounced Inspection 17th October 2006 04:00 Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 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) www.hft.org.uk Home Farm Trust Vacancy Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 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. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. There were 2 unannounced inspections arranged to review the standards of care at the home. On 17/10/06 I arrived at 4.00 pm and left at approximately 5.45pm. There was only 1 service user staying at the home that week as the others were on holiday. I returned on 30/10/06 from 3.30pm until 7.00pm to complete the inspection. During the inspection I met service users returning home from day care activities, the manager and the 3 members of staff on duty to discuss various issues arising from the first inspection and to inspect records kept to monitor the care provided to service users. I was also assisted with a tour of the home. 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 DS0000042698.V306040.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 the following standard(s): 1, 2, 3 and 4. Quality in this outcome area is good. The home has a statement of purpose and service users guide that provides information about the home in an appropriate format. Prospective service users will receive a thorough assessment to record their individual aspirations and needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The 6 service users have been resident in the home for 14 years and there are no plans to change this stable environment. The statement of purpose document is in place and meets all the requirements of The Care Homes Regulations (2001). The service user guide is service user friendly and includes pictures to give examples of the kind of home that Trelawney is. The manager is aware of the pre admission procedures that are provided in the policy and procedures manual and that a Home Farm Trust service manager and social worker would also assist in this process. The local authorities support all service users and the standard fee is £213.35 per week. The fee for one service user receiving 1:1 staff support is £1026.26. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 the following standard(s): 6,7 and 9. Quality in this outcome area is adequate. The records inspected were organised to provide information regarding the welfare of service users. The records should be improved with the introduction of the new process discussed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager has been in post since August 2006 and is liaising with her line manager, key staff and various professionals to ensure that service users are receiving the support that is required. The plans of care involved health care issues, educational and social interactions. The manager discussed the complex range of needs that are presented by service users and stated that various communication skills are required at the home; and the use of symbols, signing and picture exchange systems would be developed. The service users are involved with key staff in writing their plans and various references to risk and appropriate responses are noted. The Home Farm Trust provides an internal review of care plans with service users and advocates. The manager is reviewing the plans of care to ensure they reflect the current needs and aspirations of all service users. A discussion occurred regarding the new procedures for care plans and the corporate format that The Home Farm Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 Page 9 Trust are providing for all their care homes to use. These systems will be inspected at the next visit to review the improvement and progress in this area. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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, 14, 15 and 17. Quality in this outcome area is good. A range of social and recreational opportunity is provided with regard to assessed preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager confirmed that service users are involved in a range of appropriate activities and maintain contact with relatives. These are recorded in individual plans and I observed the service users returning to the home from their day care activities. The Home Farm Trust provides opportunities to access community facilities and additional staff is provided to assist in these activities. A discussion occurred regarding the organisation of the rota; where a service user is contracted for services at a 1:1 staffing level and where other service users receive 1:1 support for specific activities such as swimming and attendance at college. Menus evidence a good choice of meals and a dietician has been consulted to provide healthy eating options. Service users are weighed and are involved in exercises in response to assessments regarding their health and welfare. The home has a minibus to assist in the transport requirements of service users. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 the following standard(s): 18, 19 and 20. Quality in this outcome area is good. The personal and health care needs of service users are met with evidence of promoting privacy, dignity and good multi disciplinary working taking place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A discussion occurred regarding the planned admission of a service user to a hospital for a short period. The manager is involved in complex arrangements regarding the additional staff support, funding issues, communication needs and the preparation to assist the service user. The manager and the support staff are ensuring 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 with equipment and support as required. The monthly reviews of care also monitor individual care needs and access to a range of services is organised. Assessments dictate that self-medication by service users is not appropriate and appropriate procedures are used to assist service users. Medication administration training is provided and an internal audit occurs to manage these procedures. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23. Quality in this outcome area is good. The support staff have a clear understanding of ‘Adult Protection’ issues and procedures that will protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager understands the appropriate procedures to report issues of concern regarding service users welfare. In house training is provided for staff and The Home Farm Trust have appropriate policy and procedures to support senior staff. The policy refers to ‘No Secrets‘ and the need to refer concerns to the Social Services as the ‘lead’ agency. Advice regarding various forms of potential abusive situations and procedure are available to staff and are raised during induction training. The homes policy and residents charter state the complaints procedure and this is presented in a relevant format for service users and for those acting on their behalf. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 the following standard(s): 24, 25, 27, 28, 29 and 30. Quality in this outcome area is good. The Home Farm Trust continues to develop the environmental standards. The overall quality of furnishings and fittings is good and service users live in a safe, clean and homely environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: I was escorted on a tour of the home. A recent extension has been completed that provides a staff sleeping in room and office space. The manager discussed further plans to improve access to the ground floor shower, redecorate the lounge and to extend the ground floor area to provide additional communal space. The furnishings and fittings are of good quality and service users live in a comfortable and homely environment. The home is in keeping with the local community and offers service users access to local amenities as stated in its aims and objectives. Toilets and bathrooms are provided in sufficient numbers and offer privacy to the service users. New furniture has been provided in the lounge and dining room. The home is maintained appropriately and service users rooms are individually decorated and personalised with various equipment and belongings. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is adequate. The Home Farm Trust is providing competent support staff to provide for the welfare of service users. The registered provider must ensure that the arrangements for induction, training and supervision are appropriate for relief staff working in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Inspection visit 17/10/06: There was one relief member of staff on duty and one service user at home that required a 1:1 staffing level. All other service users, manager and various staff were away on a holiday. The member of staff had received a handover discussion with a colleague and was able to discuss the needs of the service user and was organised to provide for his welfare. A support manager arrived at the home to monitor this situation and the ‘on call’ support system is available. The discussion with staff raised issues about a lack of fire precautions training and supervision in relation to working in this home. This inspection and other visits to homes within The Home Farm Trust have raised issues about how ‘relief staff’ receives induction, training and supervision opportunities to the same standard as other staff. These processes must be recorded to demonstrate compliance and be available for inspection. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 Page 15 Inspection visit 30/10/06: A discussion with the manager confirmed that a stable staff team is providing continuity and a consistent approach to care. The support staff have completed NVQ training at levels 2 and above. Other training has been completed in first aid, person centred planning, moving and handling, health and safety and fire precautions. A requirement is made to provide the staff training profiles that demonstrate the training completed and the completion of induction processes and records for staff recently recruited. The manager will discuss work issues and development during supervision meetings with individual staff, staff meetings and service user meetings at regular intervals. During the afternoon and early evening the 3 staff on duty were observed to exhibit appropriate skills and attitudes in their interactions with service users. The manager should regularly review the arrangements for the level of staffing at night to respond to the dependency levels of service users regarding autism, sensory loss, dementia, epilepsy and fire precautions. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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, 39 and 42. Quality in this outcome area is adequate. The Home Farm Trust continues to provide for the safety and welfare of service users. The Home Farm Trust needs to register and retain a registered manager to provide for the welfare of service users with a stable and consistent approach. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 17/05/06 – The previous registered manager resigns and a new manager is appointed in August 2006. The Home Farm Trust needs to register and retain a registered manager to provide for the welfare of service users with a stable and consistent approach. The new manager has completed the Registered Managers Award and must register on the NVQ level 4 in Care. These qualifications are conditional to the completion of the registration application being processed by the Central Registration Team. The manager has reviewed all procedures and staff expressed approval of communication systems and the organisation at the home. The manager discussed quality assurance procedures and the various policies and procedures provided by The Home Farm Trust in management manuals. An Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 Page 17 assistant service manager supports the manager and completes a monthly report on the conduct of the home. The Home Farm Trust provides other administrative and financial support functions to the manager. Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 3 x Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 YA6 Regulation 15 Requirement The registered manager must develop and agree with each service user an individual Plan which may include treatment and rehabilitation, describing the services and facilities to be provided by the home, and how these services will meet current and changing needs and aspirations and achieve goals. The registered manager must maintain staff training profiles and induction procedures that ensures there is a staff training and development programme which meets the Sector Skills Council workforce training targets and ensures staff fulfil the aims of the home and meet the changing needs of service users’. The Home Farm Trust must register and retain a registered manager to provide for the welfare of service users with a stable and consistent approach. Timescale for action 31/12/06 2. YA35 18 31/12/06 3. YA37 8 31/12/06 Trelawney DS0000042698.V306040.R01.S.doc Version 5.2 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 YA33 Good Practice Recommendations The registered manager should regularly review the arrangements for the level of staffing at night to respond to the dependency levels of service users regarding autism, sensory loss, dementia, epilepsy and fire precautions. 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