Inspection on 08/01/07 for Trelowen

This inspection was carried out on 8th January 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Trelowen 11/11/08

Trelowen 12/01/06

Trelowen 19/04/05

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 Key Unannounced Inspection 8th January 2007 15:30 Trelowen DS0000042694.V314813.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 Trelowen DS0000042694.V314813.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. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trelowen Address 1 Blowinghouse Lane St Austell Cornwall PL25 5AT 01726 65366 01726 66775 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 Mrs Anne-Marie May Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Trelowen is a care home registered to provide personal care and accommodation for up to 7 adult 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 have en suite bathrooms and toilet facilities, with over head tracking to assist service users with additional physical disabilities. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was organised to monitor the care provided at the home when the staff were unaware it would happen. I arrived at 3.30 pm and stayed until 7.00pm. During the visit I met service users, support staff and an assistant service manager. The registered manager was not on duty. I had a tour of the building and looked at various records maintained at the home to demonstrate care provided to service users. I was able to observe the routines at the home, the use of communal and bedroom areas as service users wished, how staff communicated and interacted with service users and the preparation for the evening meal. What the service does well: What has improved since the last inspection? What they could do better: A requirement is made for the registered manager to ensure records of care plans include all risk assessments and plans regarding all aspects of personal, social support and healthcare needs. The registered manager has made appropriate referrals to various agencies to provide for service users that present a range of complex care needs and dependency levels. A recommendation is made to record all care activity and continue to monitor dependency levels to ensure appropriate staffing is provided during the night. A requirement is made for the registered manager to inform the Commission of proposals and timescales to complete the RMA ands NVQ level4 in Care. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 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. 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 Home Farm Trust management manuals provide policies for assessment and pre admission procedures for any new referrals to the home. The registered manager would include the appropriate liaison with other agencies and trial visits and stays to assist in the admission of new service users. The statement of purpose and service users guide is available to service users, staff and visitors to the home. The existing service users have lived at the home for many years in a stable environment. The aspirations and needs of existing service users are recorded in the ‘Who am I’ documents to assist communication with support staff. All service users are supported through Adult Social Care and there is a fee of £774.00 per week. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7and 9. Quality in this outcome area is adequate. Care plans are provided for all service users and appropriate consultation is involved. The records do not include sufficient detail regarding service users needs and demonstrating how these are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A ‘Person Centred Planning’ approach has been used to complete plans of care and this process is appropriately applied in consulting and involving service users. The support staff discussed examples where clear benefits and development had been achieved for service users. An inspection of records and discussion with staff showed that the plans of care do not meet all the criteria of this standard and the records require regular updates to demonstrate progress and current developments. Service users present complex care needs regarding autism, dementia, self-injurious behaviour, seizures, relationships, sensory and mobility issues. The plans must cover all aspects of personal and social support and healthcare needs. This information and associated risk assessments are vital processes in demonstrating that appropriate care and staffing levels are provided by day or night to protect service users. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 10 An assistant Service Manager was present during part of this inspection and agreed that the requirement made in the report 12/01/06 to improve careplanning records had not been complied with. A requirement is made with an extended timescale provided to complete this process. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 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: A discussion with staff and records demonstrate that service users attend various day centres, adult education and a work placement. Transport and staff support are provided to assist service users. Service users enjoy trips to the shops, parks and places of local interest. Support is provided to assist service users with issues regarding relationships, service users have regular contact with relatives and also enjoy leisure activities organised with staff at the home. 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 DS0000042694.V314813.R01.S.doc Version 5.2 Page 12 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. 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: The home is providing care for service users with a range of needs and dependency levels. The Home Farm Trust has provided 2 rooms with overhead tracking to assist service users with additional physical disabilities access to the en suite bathroom and toilet facilities. The records require additional information regarding risk assessments and the planned interventions provided to ensure good practice and promote the welfare of service users. All service users are registered with a GP and are supported by the Learning Disability Team, community nursing and other professional services as required. 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. A recommendation is made regarding the signature required on records to show accountability for the prescribed medication issued where a service user is involved in a visit away from the home. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 13 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. 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 support staff were able to provide appropriate policy and procedure regarding Adult Protection. The discussion with support staff confirmed that staff would report any concerns to senior staff. The Home Farm Trust provide staff induction and in house training in the ‘Protection of Vulnerable Adults’ to ensure robust procedures are available to protect service users. The Home Farm Trust has demonstrated previously the appropriate action to report and investigate an alleged concern involving a member of staff. The support staff discussed the procedures to assist service users with their finances. A service users finances was checked and found to be the correct balance with appropriate records. A system with sealed wallets is used and regular audits by staff to protect service users. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 14 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. 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: A member of staff showed me the communal, bedroom, toilet and bathroom facilities at the home. The Home Farm Trust have recently increased 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. 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 DS0000042694.V314813.R01.S.doc Version 5.2 Page 15 The home was clean, warm and hygienic. Appropriate laundry facilities are provided and appropriate gloves, aprons and infection control training is provided. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35. Quality in this outcome area is good. The Home Farm Trust is providing competent support staff to provide for the welfare of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is normally a minimum of 2 members of staff available to provide for the welfare of service users. A sleeping night care worker is provided for service users that may require attention at night and an on call support system is provided. The registered manager is advised to continue to maintain detailed records of care activity at night and review the dependency levels of service users and the staffing required. 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, food hygiene, infection control, minibus safety, health and safety, fire precautions, moving and handling, dementia, epilepsy, diabetes and autism. 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 DS0000042694.V314813.R01.S.doc Version 5.2 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. The Home Farm Trust continues to provide for the safety and welfare of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has successfully completed the registration process and the completion of the Registered Managers Award and units of NVQ level 4 in Care are conditional to this registration. A requirement is made to complete these qualifications and inform the Commission of proposals with timescales. The staff expressed their approval of communication systems and staff meetings occur at regular intervals at the home. The Home Farm Trust has 2 other separately registered care homes in St. Austell; another 3 in the Wadebridge area and a short stay facility near Launceston. 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. Records showed that fire precautions are maintained, that Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 18 health and safety checks are completed and the homes liability insurance was appropriately displayed. Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME 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 3 34 3 35 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X 3 X X 3 x Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 20 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, aspirations and achieve goals. Previous requirement not met. The registered manager is required by regulation to obtain the NVQ 4 and Registered Managers Award to demonstrate she is qualified to run the home and meet its stated purpose of providing for service users with complex learning disabilities. Home Farm Trust and the registered manager are required to submit proposals and timescales to comply with this regulation. Timescale for action 31/03/07 2. YA37 9 31/03/07 Trelowen DS0000042694.V314813.R01.S.doc Version 5.2 Page 21 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 YA20 Good Practice Recommendations The registered manager should ensure that a signature is provided on records to show accountability for the prescribed medication issued where a service user is involved in a visit away from the home. 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