Inspection on 19/04/05 for Trelowen

This inspection was carried out on 19th April 2005.

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 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

Trelowen 11/11/08

Trelowen 08/01/07

Trelowen 12/01/06

Trelowen 05/10/04

Trelowen 05/05/04

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 Trelowen 1 Blowinghouse Lane St Austell Cornwall PL25 5AT Lead Inspector Mike Stokes Unannounced 19 April 2005 14:00 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. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Trelowen Address 1 Blowinghouse Lane St Austell Cornwall PL25 5AT 01726 65366 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 Mrs Anne-Marie May CRH 6 Category(ies) of Learning Disability registration, with number of places Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 05/10/04 Brief Description of the Service: Trelowen is a care home registered to provide personal care and accommodation for service users with a learning disability. The home is in a residential area of St. Austell and conveniently placed for service users to access community facilities. The Home Farm Trust have recently completed building work at the home to provide 2 additional ground floor bedrooms and additional communal space. Service users are accommodated in single rooms on the ground and first floors, the new rooms are en suite, with over head tracking to assist service users with physical disabilities. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was organised to check on the care provided at the home when the staff were unaware it would happen. I arrived at 2pm in the afternoon and stayed until 5.30pm. During the visit I met 3 members of staff who have worked at Trelowen a long time and enjoy their work. I had a tour of the building, looked at various records and met the visiting relative of a service user. I was able to meet service users and observe their use of communal and bedroom areas as they wished, how staff communicated and reacted to people and the organisation and preparation for the evening meal. What the service does well: What has improved since the last inspection? What they could do better: The home was seen to be organised and records inspected were mainly accurate and up to date. Some records regarding plans of care and incidents must be maintained to ensure current information is available to demonstrate that the home is meeting the service users aspirations, goals and safety needs. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 6 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. Trelowen D52-D04 S42694 Trelowen V284998 190405 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 Trelowen D52-D04 S42694 Trelowen V284998 190405 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) 1 and 2. The home has a statement of purpose and service users guide that provides information about the home in an appropriate format for service users and their representatives. Prospective service users will receive a thorough assessment to record their individual aspirations and needs. EVIDENCE: The member of staff on duty was able to provide the appropriate records for inspection. The statement of purpose and service users guide will need amending to reflect the recent changes. The previous inspection report was in the hallway and available to relatives, staff and visitors to the home. The member of staff stated that the 6 service users were the same during the 5 years she had worked at the home. The aspirations and needs of existing service users were recorded in the ‘Who am I’ documents. A discussion occurred regarding a prospective new service user and this process would be completed for this person. Trelowen D52-D04 S42694 Trelowen V284998 190405 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 and 7. The home ensures that appropriate support is provided to assist service users in recording their aspirations and needs. The home must continue to update the results of assessments and reviews by ensuring records are signed and dated to demonstrate they are providing for all aspects of service users welfare. EVIDENCE: The member of staff on duty was able to provide appropriate records. The care planning documentation is presented in a pictorial format and is completed by the service user with support from a key worker. The plans of care are reviewed at 6 monthly intervals. An inspection of records and discussion with staff showed that some entries required updating, were not signed or dated by staff and charts to record seizures were not maintained. This information and associated risk assessments are vital processes in determining appropriate staffing levels by day or night to protect service users. Staff stated that 5 of the 6 service users had regular contact with relatives, who were consulted about welfare issues concerning service users. Records showed that service users were accessing home visits and that relatives were visiting the home. A relative of a service user was visiting the home to have the evening meal with the service user and she confirmed that appropriate consultation took place. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 14, 16 and 17. The home ensures that service users have access to a range of opportunities for development and leisure activities. The home provides a varied menu and service users exercise choice over what they eat. EVIDENCE: A discussion with staff and records demonstrate that service users attend various day centres, Truro College and a work placement. Transport and staff support are provided to assist service users. Service users have regular contact with relatives and enjoy leisure activities organised with staff at the home. Service users enjoy trips to the shops, parks and places of local interest. The menus showed 3 choices for the evening meal and packed lunches are provided for service users attending day activities. Service users may assist staff in preparing meals as part of living skills development and also in domestic routines within the home. Trelowen D52-D04 S42694 Trelowen V284998 190405 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) 18 and 20. The personal and health care needs of service users are met with evidence of promoting privacy, dignity and good multi disciplinary working taking place. EVIDENCE: The Home Farm Trust has provided 2 rooms with overhead tracking to assist service users access the en suite bathroom and toilet facility. A discussion with staff and records show that service users needs are reviewed regularly. All service users are registered with a GP and are supported by the Learning Disability Team and community nursing. Service users are supported with their needs regarding speech and language, diabetes, chiropody, dentistry and opticians. The medication system and procedures were reviewed. The medication is kept in a locked cabinet and appropriate records are kept. Some gaps were noted in the records and a recommendation is made to ensure staff sign on each occasion they have administered medication to service users. Trelowen D52-D04 S42694 Trelowen V284998 190405 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 Staff have a clear understanding of Adult Protection issues and procedures that will protect service users from abuse. EVIDENCE: The member of staff on duty was able to provide appropriate policy and procedure regarding Adult Protection. The discussion with other staff members confirmed that staff would report any concerns to senior staff. A discussion with a visiting relative confirmed that the complaints procedure was discussed and that The Home Farm Trust deals with issues appropriately. A recommendation is made to organise training in ‘Protection of Vulnerable Adults’ with the local social services to ensure robust procedures are available to protect service users. Trelowen D52-D04 S42694 Trelowen V284998 190405 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, 28 and 29. Recent structural changes to the homes environment have provided more communal space, offering choice and flexibility for service users and visitors. These changes have significantly improved the facilities for service users with a physical disability. EVIDENCE: A member of staff showed me the communal, bedroom, toilet and bathroom facilities at the home. The Home Farm Trust have made an application to increase the registered numbers from a maximum of 6 to 7 service users. 2 en suite bedrooms with overhead tracking and an additional communal space have been provided as part of this application. Trelowen provides a homely and comfortable environment in a domestic style dwelling. The Kitchen has been refurbished as part of the building work and maintenance programme. There is ramped access to the front and rear. The single bedrooms are individually decorated and furnished. Regulators to control hot water, radiator covers and restrictive window opening devices have been fitted to provide a safe environment for service users. Trelowen D52-D04 S42694 Trelowen V284998 190405 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 and 33. The Home Farm Trust is providing competent support staff, in appropriate numbers to provide for the welfare of service users. EVIDENCE: On arrival at this unannounced inspection there was a member of staff on duty and 2 service users in the home. The other service users were out on day care activity and 4 other members of staff were attending a training opportunity in ‘Challenging Behaviour’. Service users returned to the home later in the afternoon when there was only one member of staff on duty and 2 members of staff arrived shortly afterwards. There are normally 2 members of staff available to provide for the welfare of service users. A sleeping night care worker is provided at night for service users that may require attention and an on call support system is provided. A discussion with staff confirmed that a stable staff team is available that is providing continuity and a consistent approach to care. The staff team are involved in NVQ training at levels 2, 3 and 4. Other training has been completed in first aid, health and safety, fire precautions and moving and handling. The staff on duty also confirmed that the registered manager discusses work issues and development during regular supervision meetings. During this visit staff were confident in their Knowledge of the service users needs and presented as confident and organised. The staff were also observed to exhibit appropriate skills and attitudes in their interactions with service users. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 15 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, 40 and 42. The manager is supported by Home Farm Trust in delivering appropriate services to service users and staff demonstrate an awareness of their roles and responsibilities. EVIDENCE: The registered manager was not on duty during this inspection. The staff expressed their approval of communication systems and the organisation at the home. The member of staff on duty provided various policies and procedures asked for through reference to the management manuals. The registered manager has successfully completed the registration process and is completing the NVQ 4 and Registered Managers Award. The Home Farm Trust has 2 other separately registered care homes in St. Austell and another 3 in the Wadebridge area. An assistant service manager supports the registered manager and other administrative and financial support functions are provided. An assistant service manager completes a monthly report on the conduct of the home and a copy is sent to this Commission. Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 16 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 2 3 x 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 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x 3 3 3 x Standard No 11 12 13 14 15 16 17 3 3 x 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Trelowen Score 3 x 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x 3 x 3 x D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 17 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 6 Regulation 15 Requirement The service user plans must be maintained in sufficient detail to ensure appropriate action is taken to meet the service users needs. These plans and risk assessments must be kept under review. Timescale for action 30/6/05 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. 2. Refer to Standard 1 20 Good Practice Recommendations The statement of purpose and service users guide should be amended to reflect the changes at the home and copies supplied to the Commission. The records regarding the administration of prescribed medication to service users should be completed on each occassion to demonstrate responsibility for service users welfare. Training with the local social services would reinforce the existing Protection of Vulnerable Adults procedures at the home. 3. 23 Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection John Keay House Tregonissey Road St Austell 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 Trelowen D52-D04 S42694 Trelowen V284998 190405 Stage 4.doc Version 1.30 Page 19 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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