Inspection on 13/07/05 for Tresillian

This inspection was carried out on 13th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Tresillian 15/08/06

Tresillian 15/11/05

Tresillian 01/02/05

Tresillian 23/09/04

Tresillian 05/03/04

Similar services:

The Vicarage

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Tresillian 41 Eastcliffe Road Par, St Austell, Cornwall PL24 2AJ Lead Inspector Philippa Cutting Unannounced 13 July 2005 03:00 p.m. 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. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Tresillian Address 41 Eastcliffe Road Par St Austell Cornwall PL24 2AJ 01726 814834 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) Mr Nigel William Hart Mrs Sharon Dawn Hart Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 01.02.2005 Brief Description of the Service: Tresillian provides care for six adults with physical disabilities. The house, which is privately owned, is a large, attractive dormer bungalow set in its own grounds. These have been landscaped to be accessible to wheelchairs. It is close to the local amenities and public transport. The accommodation for service users comprises six single rooms, a large lounge/dining room, kitchen, bathroom /WC and a wet floor shower room/WC on the ground floor. All rooms have a call bell. Mr & Mrs Hart, the registered providers, live upstairs with their family and provide much of the care for the service users. There is car parking . The registered provider, Mrs Hart, has had considerable experience in caring for younger adults who are physically disabled. She is supported by Mr Hart and a team of experienced carers. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 3.0p.m & 6.30p.m so that the service users would be in the home, having returned from their various daytime activities. The inspector talked with them as a group and individuals, apart from one who was sleeping. Mr & Mrs Hart were on duty. Service users’ records were inspected and time was spent with Mr & Mrs Hart discussing the problems that the home finds in promoting the service users’ independence and activities via various agencies. The home has prepared systems and policies that address the national minimum standards to a satisfactory standard and demonstrates a sound awareness of the needs of this group of service users. What the service does well: What has improved since the last inspection? What they could do better: This was discussed with Mr & Mrs Hart. They are proactive in the help they provide and appear to be alert to changes in legislation and care. They are keen to involve all professionals but can be hampered by their (the professionals’) slow response. At this time no significant areas needing improvement were identified. Tresillian D52-D04 S9231 Tresillian V227820 130705 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. Tresillian D52-D04 S9231 Tresillian V227820 130705 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 Tresillian D52-D04 S9231 Tresillian V227820 130705 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) Service users have made a positive choice to remain at Tresillian. EVIDENCE: The service user group remains stable. No one has arrived or left. Service users are asked whether they wish to remain at Tresillian during reviews with their Social Worker and have stated that they do. Tresillian D52-D04 S9231 Tresillian V227820 130705 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) 6,7,8,9,10 Service users are actively encouraged to take charge of their lives and are given the opportunity to be fully involved in making choices etc. EVIDENCE: Care plans are kept in individual folders that service users can read if they wish but few choose to do so. They are consulted every month about things that they wish to accomplish or arrange and these are recorded. The identified goals are varied and can include areas of personal care or activities and hobbies. Individual risk assessments have been drawn up with regard to each person’s abilities, the care they need and the premises etc. They are reviewed regularly but they and the assessments of each person’s functional abilities, would benefit from being re assessed (as opposed to be reviewed) where they have been on going for several years, even though in most cases there have been few changes. A new assessment would ensure that differences that the staff have become used to are recorded objectively. This can be helpful in looking back at a person’s physical well being and needs. Tresillian D52-D04 S9231 Tresillian V227820 130705 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) 11,12,13,14,15,16,17 Service users are encouraged and enabled to be as active as they are able and wish. Staff provide any assistance that is needed and activities are planned within a risk assessed framework. EVIDENCE: Mr & Mrs Hart and their staff are very involved in helping the service users take part in all aspects of community life and provide encouragement and help to maintain and explore new opportunities. The service users can experience frustration at the lack of meaningful work placements or a shortage of funding to support them in this. The inspector and the Harts discussed the difficulties the group had in forming and maintaining friendships that other young people of their age would expect as their right. Tresillian welcomes any of the service users’ visitors and would give help and guidance for any personal relationships if needed. A varied diet is provided and all are encouraged to follow a healthy eating plan. Meals out, as a group or on an individual one:one basis, occur frequently. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 11 Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20 Service users are provided with the help and assistance they need to be personally independent within their assessed abilities. EVIDENCE: Service users are encouraged to be as independent as possible in their own personal care. The consequences of any problems are fully discussed with the service user. The community nursing services are supportive and aware of the need to coordinate any help with the service users’ timetable. Referrals to specialists are on going for some service users but they often experience long delays in getting appointments. Any other agencies that could be involved in a service user’s needs (such as day centres etc) are contacted by Tresillian staff to ensure that correct information accompanies the service user. Service users are encouraged to look after their own medication wherever possible, with a discreet overview provided by staff. To facilitate this dosette boxes are prepared. Although this is secondary dispensing it seems to be the most practical & safe way to give service users maximum control. Mrs Hart prepares the boxes and signs the medication administration record sheets; staff then sign when they give the boxes to the service users. This system works satisfactorily. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 13 Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 14 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) 22,23 Service users ensure that their views are taken into account. EVIDENCE: The home has not had any complaints. Service users appeared to be a group who would speak out if anything untoward happened. It seems highly likely, having observed their interaction, that others would alert someone if another service user was in any form of difficulty. Staff are all aware of the need for vigilance with regard to the protection of vulnerable adults. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 15 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) 24,25,26,27,28,29,30 The environment has been designed to provide a safe and suitable home for physically dependent service users. EVIDENCE: There is level or appropriately ramped access throughout the home both inside and out. Each person’s room reflects his/her taste and needs with specialist equipment being provided. Staff have been trained to use this with the relevant service user. The toilet and bathing facilities are organised to provide a choice of shower or bath with rails and chairs to promote independence. The communal space allows for wheel chairs and easy chairs. As a group the service users like to spend time together but also retreat to their own rooms when they wish. They said there were rarely disagreements between them and they enjoyed each others’ company. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,36 The registered person is supported by a staff team who have worked with the service users for some considerable time and know them well. EVIDENCE: The staff who support Mr & Mrs Hart were not on duty at the time of this inspection but they remain as a stable work force with the addition of one person who is able to provide support when needed. All staff have had Criminal Records Bureau checks. Service users appeared to be happy with the staff and the support they provided. Two are undertaking their National Vocational Qualifications: all staff are receiving regular supervision with an annual appraisal. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 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 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) 37,38,39,43. Tresillian is managed in an efficient and open manner that includes service users’ opinions and views. EVIDENCE: The home has full policies and procedures. These have been inspected on previous visits and found to be satisfactory. Service users’ views are sought when any changes are contemplated and the registered persons are open in their approach. A survey of service users’ views has been conducted in the past but the registered person commented that the service users were bemused as to why they were being asked. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tresillian Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x 3 D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 19 yes 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 Regulation Requirement There are no statutory requirements Timescale for action 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 YA6, YA9 YA29 Good Practice Recommendations Assessments of personal activities of daily living/functional abilities should be renewed, rather than reviewed, where these have been in force for a number of years. The registered person should ask for written verification that when the Loan Store checks hoists, this is done in accordance with Regulation 9 of the Lifting Operations and Lifting Equioment Regulations 1998, Health & Safety at Work Act 1974. This requires a thorough examination as opposed to a service. Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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 Tresillian D52-D04 S9231 Tresillian V227820 130705 Stage 4.doc Version 1.30 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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