Inspection on 15/11/05 for Tresillian

This inspection was carried out on 15th November 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

Tresillian 15/08/06

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 Unannounced Inspection 15th November 2005 10:00 Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 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.V265972.R01.S.doc Version 5.0 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.V265972.R01.S.doc Version 5.0 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.V265972.R01.S.doc Version 5.0 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 13th July 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. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 15th November 2005 over a period of approximately 5.5 hours. The inspector met with the registered providers, staff, 5 service users, 1 visitor, toured the premises and inspected documentation. 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: Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 6 At this time no significant areas needing improvement were identified, though Mrs Hart undertook to ensure that the care plans clearly describe the interventions required in order for staff to provide appropriate personal care. 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.V265972.R01.S.doc Version 5.0 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.V265972.R01.S.doc Version 5.0 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, 4 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 is in place. The service user group remains stable. No one has arrived or left since the last inspection. Service users are involved in regular reviews with 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.V265972.R01.S.doc Version 5.0 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, 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. The home is proactive in developing individual plans for the service users. Annual reviews with social workers are sought, and within the home monthly ‘targets’ are discussed to help people move forwards in what they want to achieve. People are encouraged to make independent decisions, 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 service user challenge this if necessary. The assessment of risk underpins the activities and actions available to the service users. There have been instances where it has been re-evaluated due a change in circumstances. The discussions include all those who need to know. Service users confirmed that the staff would employ a strategy of informing rather than enforcement if it was felt that a service user was making a ‘bad’ decision, and acknowledged that the home had their best interests at heart. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 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 the following standard(s): 11, 12, 13, 14, 15, 16 Service users are encouraged and enabled to be as active as they are able and wish to be. 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 discussed the difficulties the group had in forming and maintaining friendships that other young people of their age might expect as their right. Tresillian welcomes any of the service users’ visitors and would give help and guidance for any personal relationships if needed. Reviews and assessments are targeted to promote independence and living skills for the service users. These are met via various day centres and placement opportunities. Each service users has a daily plan of activity, which Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 11 is organised and agreed with them. Service users are active in the community and avail themselves of the facilities available, both locally and further afield. Families and friends are encouraged to visit and remain in contact with the service users. A wish by a service user not to see someone would be respected. Independence and choice are promoted. The staff and service users were seen to have a good, relaxed relationship with each other. Service users gave the impression that they viewed the staff as enablers who facilitated what they (the service users) wanted to do. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 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 the following standard(s): 21 Service users are provided with the help and assistance they need to be personally independent within their assessed abilities. EVIDENCE: The registered providers have, since the last inspection, had discussions with each service user in respect of their wishes (illness, dying) and have recorded these along with the service user’s signature. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The ethos of the home ensures that service user’s 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, and one service user did confirm that they would feel able to express any dissatisfaction or concerns. It seems highly likely, having observed their interaction, that others would alert someone if another service user were in any form of difficulty. Staff are all aware of the need for vigilance with regard to the protection of vulnerable adults. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following 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: 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 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. The home was seen to be clean and tidy throughout. The registered provider stated that they are considering upgrading the existing laundry facilities to an industrial-type washing machine with a sluice cycle. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 35 A staff team who have worked with the service users for some considerable time and know them well supports the registered persons. EVIDENCE: The inspector spoke with the registered providers and two staff members. The staff have a clear understanding of their role and the managerial hierarchy operating at the home. Two staff have achieved NVQ Level 3, one NVQ Level 2, and one is undertaking Level 2 training. The registered providers and staff demonstrated a clear and in-depth understanding of the service user’s needs and capabilities. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 16 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, 40, 41, 42 Tresillian is managed in an efficient and open manner that includes service users’ opinions and views. EVIDENCE: Mrs Hart has completed her National Vocational Qualifications 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 and staff confirmed that they are aware of these and regularly update themselves. Service users are aware that records are kept about them, but the registered providers said they rarely asked what was being written although staff would be happy to discuss any entries with people on an individual basis. The premises are maintained to a high standard. Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 17 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 3 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 3 4 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 4 17 Standard No 31 32 33 34 35 36 Score X 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Tresillian Score X X X 3 Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 3 X DS0000009231.V265972.R01.S.doc Version 5.0 Page 18 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. Refer to Standard Good Practice Recommendations Tresillian DS0000009231.V265972.R01.S.doc Version 5.0 Page 19 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. 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