Inspection on 15/08/06 for Tresillian

This inspection was carried out on 15th August 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Tresillian 15/11/05

Tresillian 13/07/05

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 Alan Pitts Key unannounced Inspection 15th August 2006 09:30 Tresillian DS0000009231.V299397.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 Tresillian DS0000009231.V299397.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. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 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 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) Mr Nigel William Hart Mrs Sharon Dawn Hart Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users to include up to 6 adults with a physical disability (PD) Total number of service users not to exceed a maximum of 6 Date of last inspection 15th November 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. Mr Hart and a team of experienced carers support her. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 15th August 2006 over a period of approximately 5 hours. The inspector met with the registered providers, staff, four residents, toured the premises, and inspected documentation. Service users’ records were inspected and time was spent with Mr & Mrs Hart discussing the care needs and capabilities of the residents. 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. The registered providers have a detailed knowledge of the residents, and were able to demonstrate a resident focused approach to care provision. What the service does well: What has improved since the last inspection? There is a stable and committed staff team. There is a commitment to staff training. The residents have enjoyed two holidays since the last inspection. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 6 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. Tresillian DS0000009231.V299397.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 Tresillian DS0000009231.V299397.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 The inspector considers Tresillian to provide a good level of service in the ‘Choice of Home’ standards. Service users are provided with the information they need in order to make informed choices. Service user’s care needs and aspirations are regularly reviewed, and service users are involved in the admission process for new/prospective service users. EVIDENCE: A Statement of Purpose and Service User Guide are in place, and have been reviewed annually. As discussed, the registered providers should do a more detailed review of these documents to ensure that they clearly state the service offered, including, for example, transport provision. The service user group remains stable. No one has arrived or left since the last inspection. Service users are involved in regular reviews with the registered providers and care professionals. Prospective service users are invited to visit the home, the last admission stayed for two periods of one week (day care) and two weeks before the admission was confirmed. Tresillian DS0000009231.V299397.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 The inspector considers Tresillian to provide a good level of service in the ‘Individual Needs and Choices’ standards. Service users are actively encouraged to take charge of their lives and are given the opportunity to be fully involved in making choices. EVIDENCE: The home is proactive in developing individual plans for the service users. Care plans are kept in individual folders that service users can read if they wish, but few choose to do so. Residents are consulted every month about things that they wish to accomplish or arrange and these are recorded, but the registered provider should, where possible, obtain the residents’ signature at reviews to show their involvement. The identified goals are varied and can include areas of personal care or activities and hobbies. When first arriving at Tresillian, encouragement to make decisions and think independently was a new concept for some. People are encouraged to do this and it is rare for a decision to be made arbitrarily without the involvement of the person concerned. Should this occur via outside agencies, the staff would support and help a resident challenge this. The assessment of risk underpins the activities and actions provided by the home. Discussions about changing care needs include all those who need to know. Individual risk assessments have been Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 10 drawn up with regard to each person’s abilities, the care they need and the premises etc. The residents spoken with, whilst not providing information specific to care provision and self-determination, where complimentary about their lifestyle at Tresillian. Tresillian DS0000009231.V299397.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 The inspector considers Tresillian to provide a good level of service in the ‘Lifestyle’ standards. Residents 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. Meals are provided in a manner that reflects a family home. EVIDENCE: The care documentation clearly shows resident involvement in a variety of activities and their inclusion in local events, such as the village carnival. Mr & Mrs Hart and their staff are very involved in helping the residents take part in all aspects of community life and provide encouragement and help to maintain and explore new opportunities. The residents have been on two holidays since the last inspection. All of the residents attend external placements, and two residents are undertaking NVQ training. One resident has a local work placement. One resident in particular was enthusiastic about their activities outside of the home. The care documentation shows good communication with other agencies. The inspector and the registered providers discussed the difficulties the group had in forming and maintaining friendships that other Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 12 young people of their age would expect as their right. Staff and residents were seen to interact as a group, in a relaxed manner. All the residents have family or someone to represent their interests. Mail is delivered unopened to the residents, though assistance is given as needed. Tresillian welcomes any of the residents’ 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. Spontaneous meals out, as a group or on an individual one to one basis, occur frequently. Meals are planned on a daily basis, with the residents deciding what they would like. The residents spoke highly of the food provided. The home does not have adapted transport of its own, making use of locally available adapted taxis for trips out. There may be some cost to the residents for arranged trips. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 13 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, 20 The inspector considers Tresillian to provide a good level of service in the ‘Personal and Healthcare Support’ standards. Service users are provided with the help and assistance they need to be personally independent within their assessed abilities. EVIDENCE: Residents are encouraged to be as independent as possible in their own personal care. The consequences of any problems are fully discussed with the resident. The care documentation shows a flexible and varied lifestyle, and the residents’ care needs and capabilities are clearly indicated. The community nursing services are supportive and aware of the need to coordinate any help with the residents’ lifestyle. The care documentation shows that referrals to specialists are on going for some residents, including physiotherapy, speech therapy, wheelchair clinic, and occupational therapy. All the residents are registered with a GP. Residents are encouraged to look after their own medication wherever possible, with a discreet overview provided by staff. Four of the six residents do this. To facilitate this Dosset 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 Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 14 administration record sheets; staff then sign when they give the boxes to the service users. This system works satisfactorily. The Medicine Administration Records were seen to be in order, and medicines are stored securely. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 15 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, 23 The inspector considers Tresillian to provide an adequate level of service in the ‘Concerns, Complaints and Protection’ standards. The ethos of the home ensures that residents’ views are taken into account. Residents are protected. EVIDENCE: The Commission for Social Care Inspection has not received any complaints about this home since the last inspection. The residents are able to express themselves, and have the opportunity to do so both at home and at external activities. There is a complaints procedure included in the Statement of Purpose and Service User Guide. There is a Protection Of Vulnerable Adults procedure. Both of these documents need amendment to ensure that accurate information is given. The registered providers should review the complaints procedure to ensure that it states that complainants can approach the Adult Social Care Department or the Commission for Social Care Inspection at any time, including the relevant contact details. The registered providers should amend the Protection Of Vulnerable Adults procedure to ensure it gives clear instructions, including relevant contact details (Adult Social Care Department), as to the steps to be taken in the event of an allegation of abuse. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 16 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, 30 The inspector considers Tresillian to provide a good level of service in the ‘Environment’ standards. The environment has been designed to provide a safe and suitable home for physically dependent service users. EVIDENCE: The home is on level ground and is accessible for wheelchair users internally and externally. The surrounding locality is generally flat and accessible on foot or wheelchair. The spatial standards of the home meet current guidance. Each service user’s room displayed decorations and fittings, etc, appropriate to the individual’s preference and needs. The home provides spacious adapted facilities for showering and toileting with wash hand basins being provided at wheel chair or standing height according to needs. The toilet and bathing facilities are organised to provide a choice of shower or bath with rails and chairs to promote independence. The home provides a large lounge/diner for service users, as well as their own rooms. The lounge has large comfortable chairs. Equipment was noted in the home to assist independence. In some cases there were specialised items, which the staff use with service users to promote improved posture and mobility. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 17 As a group the residents like to spend time together, but may also retreat to their own rooms when they wish. The residents said they enjoyed each other’s company, though as in any family there can be occasional disagreements. The home was seen to be clean and tidy throughout. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 18 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, 34, 35 The inspector considers Tresillian to provide a good level of service in the ‘Staffing’ standards. A stable, experienced staff team, who have worked with the service users for some considerable time, supports the registered person. EVIDENCE: The inspector spoke with the registered providers and one staff member. There is a clear managerial hierarchy operating at the home. All three staff employed have achieved NVQ Level 2 or above. The registered providers demonstrated a clear and in-depth understanding of the residents’ needs and capabilities. There has not been a change to the staffing complement for some considerable time, which is of obvious benefit to the residents. The registered providers are fully aware of the need to implement a robust employment procedure when the need arises. Staff records show regular and frequent supervision and an ongoing commitment to staff training (though it was noted that refresher courses are due for 1st Aid and manual handling training). There is always two staff members on duty at all times. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 19 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, 42 The inspector considers Tresillian to provide a good level of service in the ‘Conduct and Management’ standards. Tresillian is managed in an efficient and open manner that includes residents’ opinions and views. EVIDENCE: There has not been a change to the staffing or managerial arrangements at the home for some considerable time. Mrs Hart has achieved a National Vocational Qualification Level 4 in care, and has considerable experience in caring for younger disabled people. Mr Hart as joint registered person already has managerial qualifications. The home has comprehensive policies and procedures, though, as discussed, it would be of benefit to review these to ensure that they are current and accurate. Residents are aware that records are kept about them, and the registered providers said that staff would be happy to discuss any entries with people on an individual basis. The registered providers hold quarterly, minuted, staff meetings. A small sample of returned quality assurance questionnaires was seen. The registered providers should consider how best to show any action taken as a Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 20 result of quality assurance feedback and how best to publish a summary of the findings (as discussed the Service User Guide may be an option). The home and the equipment in use are well maintained and provide safe, comfortable accommodation to the residents. Maintenance and safety check documentation was inspected and was seen to be in order. The home has appropriate insurance cover. Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 21 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 2 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 X 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 3 X 3 X 2 X X 3 X Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement 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. Refer to Standard YA1 Good Practice Recommendations The registered providers should do a more detailed review of the Statement of Purpose and Service User Guide to ensure that they clearly state the service offered, including, for example, transport provision. The registered providers should, where possible, obtain the residents signature at care plan reviews to show their involvement. The registered providers should review the complaints procedure to ensure that it states that complainants can approach the Adult Social Care Department or the Commission for Social Care Inspection at any time, including the relevant contact details. The registered providers should amend the Protection Of Vulnerable Adults procedure to ensure it gives clear instructions, including relevant contact details (Adult Social Care Department), as to the steps to be taken in the event of an allegation of abuse. The registered providers should consider how best to show DS0000009231.V299397.R01.S.doc Version 5.2 Page 23 2. 3. YA6 YA22 4. YA23 5. Tresillian YA39 any action taken as a result of quality assurance feedback and how best to publish a summary of the findings (as discussed the Service User Guide may be an option). Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 24 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 Tresillian DS0000009231.V299397.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!