Inspection on 03/02/06 for Trelawney

This inspection was carried out on 3rd February 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trelawney 08/01/08

Trelawney 17/10/06

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 Announced Inspection 3rd February 2006 01:00 Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 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.V280787.R01.S.doc Version 5.1 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.V280787.R01.S.doc Version 5.1 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 Evelyn Margaret Slack Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 10th June 2005 Brief Description of the Service: Trelawney is registered to provide accommodation and personal care for 6 adults with a learning disability. The 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 has recently been completed to provide a staff sleeping in room. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection arranged to review the standards of care at the home. The registered manager has recently completed the registration process. I arrived at 1.00 pm and left at approximately 6.30pm. During the inspection I met service users returning home from day care activities, 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. The registered manager completed a pre inspection questionnaire and comment cards from a relative and 3 service users were received. 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.V280787.R01.S.doc Version 5.1 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.V280787.R01.S.doc Version 5.1 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. The homes statement of purpose and service user guide is available to the service users and their advocates; these documents provide details of the services and facilities in the home. 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 registered manager is aware of the assessment and pre admission procedures that would be 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 DS0000042698.V280787.R01.S.doc Version 5.1 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, 8 and 9. The home has developed a procedure to record the complex range of needs and aspirations for each service user. EVIDENCE: The registered manager is liaising with various professionals to ensure that all service users are assessed thoroughly and are receiving the support that is required. The comment card received from the relative of a service user stated,’ The home has been excellent in attending to her needs and this has given the family much reassurance’. The registered manager discussed the complex range of needs that are presented by service users and the records inspected detailed how this care is provided. The plans of care involved health care issues required as a duty of care and also the service users aims and aspirations in educational or social interactions. The service users are involved with key staff in writing their plans and various references to risk and appropriate responses are noted. The registered manager stated that various communication skills are required at the home and the use of symbols, signing and picture exchange systems would be developed. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 15 and 17. The home is ensuring that each service user has the opportunity for links with the community and participation in social and educational activities. The meals in this home are good offering both choice and catering for special needs. EVIDENCE: The registered manager 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 opportunities to access community facilities and additional staff are provided to assist in these activities. A discussion also occurred regarding the organisation of the rota; where a service user is contracted for services at a 1:1 staffing level. Menus evidence a good choice of meals and a dietician has been consulted, all staff have a responsibility for meal preparation. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 10 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 and 20. The health needs of service users are well met with evidence of multi disciplinary working taking place as required. EVIDENCE: The registered manager and 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. I met a relative of a service user at the home who expressed approval of the care and attention provided at the home. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 11 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. The home has appropriate policy, procedures and has provided in house training for staff to protect service users from abuse. EVIDENCE: The registered 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. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 12 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, 29 and 30. 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. 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 registered 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.V280787.R01.S.doc Version 5.1 Page 13 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, 35 and 36. The Home Farm Trust is providing competent support staff to provide for the welfare of service users. EVIDENCE: On arrival at this announced inspection there were 2 members of staff on duty to provide for service users needs in the home. The staff were observed to exhibit appropriate skills and attitudes in their interactions with service users. A discussion with the registered manager confirmed that recent recruitment had occurred, a stable staff team is now available to provide continuity and a consistent approach to care. The registered manager stated that a contract had been agreed for 1:1 staff support and that an additional member of staff is provided at the weekend and one evening during the week to support service user activities. The staff team are involved in NVQ training at levels 2 and 3 and other training has been completed in first aid, medication, health and safety and fire precautions. The registered manager is reviewing the care planning and practice issues in supervision with support carers. A recommendation is made to complete the staff training profiles and induction records. The registered manager assesses that a sleeping night carer is appropriate to provide for the welfare of service users. This only meets the minimum level of staffing and a discussion occurred regarding the dependency levels of service users regarding autism, sensory loss, dementia and epilepsy. A recommendation is made to regularly review these arrangements. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 14 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, 38, 41, 42 and 43. The registered manager has recently completed the registration process to be responsible for Trelawney House and has reviewed care plans and procedures at the home. EVIDENCE: The registered manager is registered to complete the NVQ level 4 in Care and then the Registered Managers Award. These qualifications are conditional to the registration process. The registered manager has begun a review of all procedures and staff expressed their approval of communication systems and the organisation at the home. The registered manager discussed quality assurance procedures and the various policies and procedures provided by The Home Farm Trust in management manuals. A review of records required to be kept occurred. An assistant service manager supports the registered 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 registered manager. A discussion occurred regarding the fire precautions when there is only 1 member of staff on duty at night. A requirement is made to consult the Fire Safety Officer and provide clear procedures. Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 15 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 X 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 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 3 X X 3 2 3 Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 16 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 YA42 Regulation 23 Requirement The registered manager must consult with the Fire Safety Officer and provide clear procedures for fire precautions when there is only 1 sleeping member of staff on duty at night. Timescale for action 28/02/06 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. The registered manager should 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’. DS0000042698.V280787.R01.S.doc Version 5.1 Page 17 2. YA35 Trelawney 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. Extracts may not be used or reproduced without the express permission of CSCI Trelawney DS0000042698.V280787.R01.S.doc Version 5.1 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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