Inspection on 03/01/06 for Udal Garth

This inspection was carried out on 3rd January 2006.

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

Udal Garth 30/04/07

Udal Garth 01/08/05

Udal Garth 28/02/05

Udal Garth 12/10/04

Udal Garth 22/03/04

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 Udal Garth Udal Garth 2 North Road Torpoint Cornwall PL11 2DH Lead Inspector Philippa Cutting Unannounced Inspection 3rd January 2006 09:30 Udal Garth DS0000045077.V271945.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 Udal Garth DS0000045077.V271945.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. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Udal Garth Address Udal Garth 2 North Road Torpoint Cornwall PL11 2DH 01752 815999 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) Peninsula Autism Services & Support Limited Miss Emma Jane Holman Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Two named service users under the age of 18 years and standards applicable are met. 1st August 2005 Date of last inspection Brief Description of the Service: Udal Garth provides care and accommodation for adults with a learning disability that falls within the autistic spectrum. The house is situated centrally in Torpoint. It is an older detached house with a garden whose boundaries have been made safe and secure for the service users. It offers accommodation on two floors in single rooms. There is communal space on the ground floor with additional areas that can be used for quiet or one:one activities in portable buildings in the garden. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection during the day from 9.45am to 4.40pm. Time was spent talking with various members of staff and the registered manager, a tour of the home was made and general observation of the interaction between service users and staff noted. Records relating to service users, medication and general topics were inspected. The outcome was satisfactory with good care being identified for a group of potentially demanding service users. It showed that Udal Garth provides care and accommodation for a younger group of adults who, due to their learning difficulties need an environment where they can be helped to develop personal and social skills. All have difficulty in adjusting to the norms of a wider society. Service users are assessed and programmes drawn up for them on an individual basis. This may involve staff in one:one activities with them or a group of service users and staff may undertake a trip or outing together if this is beneficial to all. The staff receive regular support and training to enable them to respond appropriately to the service users. A number of service users are currently supported on a respite programme in the home. What the service does well: What has improved since the last inspection? A revised communication system was being introduced on the day of this inspection. This had been devised following an audit and recommendations by the National Autistic Association. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 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. Udal Garth DS0000045077.V271945.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 Udal Garth DS0000045077.V271945.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): EVIDENCE: There have been no new service users. These standards were not inspected. Udal Garth DS0000045077.V271945.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 A comprehensive assessment with regular reviews is undertaken for all service users in order that they can be provided with care that meets their needs. Where possible choice is offered but for many this is in a limited field. EVIDENCE: Care plans for service users are detailed in their aims and objectivity. The amount of active consultation that each person can contribute to his or her care plan varies enormously. People are able to demonstrate dissatisfaction clearly but the staff use observation and a non confrontational approach to gain interest and cooperation, coupled with professional advice. Risks are identified and steps taken to minimise or remove them as much as possible. Udal Garth DS0000045077.V271945.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): 11,12,13,14,154,16,17 All service users are encouraged and helped to maximise their personal development. In many cases progress is slow but records indicate that it is generally positive. People are introduced gradually to new situations or stimuli to help expand their experience. EVIDENCE: The development of personal and social skills underpins the care offered. Service users go out frequently and are encouraged to become part of the local community in settings appropriate to individual needs. Contact with families and friends is encouraged although it is recognised that this varies from person to person. Meals are provided at regular times throughout the day. Service users may eat together or individually if this is better for them. Drinks are served during the day. For some this is in accordance with guidelines in their care plan. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users receive personal care and healthcare support according to their individually assessed needs and preferences, which are fully recorded. EVIDENCE: The physical health of the service users is generally good and they access medical services as needed. More specialist help from members of the Learning Disability team is sought when needed or on a regular review basis if this is indicated. Staff are aware of trigger factors for certain service users and will respond to these if something occurs. More frequently they anticipate a problem and divert a service user’s attention whenever possible. Care plans provide careful details on each person’s preferred support approach. Should a problem arise other staff assist to ensure everyone’s safety. None of the service users is able to manage medication on his or her own behalf. Its administration is undertaken by two staff, working together, and carefully recorded. The staff said that they have not experienced any problems with service users refusing to take proffered medication. All staff receive training in the safe administration of medication. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 12 Medication administration record sheets were fully completed. Medication is stored carefully in a locked cupboard. An aide mémoire of the procedures is displayed by cupboard, which staff are required to sign. Udal Garth DS0000045077.V271945.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 Udal Garth takes steps to ensure that all service users are protected from harm or abuse. EVIDENCE: The home has a complaints procedure but it is unlikely that a service user could instigate this for him or herself. Parents etc are made aware of it. People are encouraged to talk to staff about any problems or difficulties so that these can be sorted out before escalating into a complaint. The home has policies and procedures on the protection of vulnerable adults (PoVA). Staff receive training regarding the prevention of abuse. One PoVA meeting has been needed since the last inspection and it demonstrated that staff were alert to any potential abusive situations. Udal Garth DS0000045077.V271945.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 planned to meet service users’ needs. It is safe and well maintained with individual safety precautions installed where required. EVIDENCE: Some alterations have been made to enable the communal space to be divided into two rooms. This was undertaken as a direct result of a service user’s assessed needs. Each person has a single room decorated and furnished according to personal preference. Consequently this varies from rooms with pictures, personal mementoes and ornaments to rooms that are very plain with locked cupboards and guarded windows to ensure the occupant’s safety. All rooms have an en suite facility. The mattress in one room was felt to be in need of replacement as it was lumpy. The registered manager said the home was looking to buy a new bed (& therefore mattress) as the occupant had particular needs. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 15 Some redecoration is indicated, especially by one room where paintwork has become chipped and scuffed. This had been noted and the staff member responsible for maintenance will be dealing with it. The home is painted in low arousal colours. The cleaning team were working in the home on the day of the inspection. The arrangement whereby they come weekly from a considerable distance seemed unusual. A more local source with more frequent visits could be more practical as staff obviously have to attend to any spills etc in between the cleaning staff’s visits. Externally the garden is secure with equipment (swings) for service users’ enjoyment. There are plans to add another stand alone garden room where people will be able to go for individual sessions or simple craft & music activities etc. Staff said that they could carry a portable alarm system with them, in case of difficulty, if they were going to be working alone in the garden room. This was not perceived to be a problem. The fencing around the garden makes it look austere. The benefits of cladding the walls with non toxic plants should be considered and weighed against the constraints needed for some service users. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Staff appeared to be well motivated and observant. They have developed a sound awareness of the service users’ needs with training and supervision to help them respond appropriately. EVIDENCE: Staffing levels are high as most service users need one:one attention. However various people are out by day so the home did not feel overcrowded. A new communication system had been introduced that morning in response to feedback from staff and recommendations from the National Autistic Association. Consequently people were referring to guidance notes and each other but the first impressions were positive. Staff said they felt supported by each other and the management team; all were enthusiastic about their work and said they found working with the service users rewarding. They receive regular supervision. A new member of staff was observing practice & familiarising himself with the home during the day. References, Criminal Records Bureau & PoVA checks are made on all people who work in the home prior to them starting. If agency staff are needed the home prefers to use one agency that knows the particular requirements of Udal Garth and tries to allocate the same people for continuity. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 17 Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 18 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): 37,38,39.40,41 The home is well run with the interests and needs of the service users at its core. EVIDENCE: The registered manager is well qualified and enthusiastic. The company’s senior management team visit or are available for advice if needed. A training officer pays monthly visits to the home. It was she who was introducing the new communication system so she made sure that she was available initially to answer any queries. Full & thorough records are maintained to meet statutory requirements and health & safety provision. Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 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 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Udal Garth Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 X X DS0000045077.V271945.R01.S.doc Version 5.0 Page 20 3 Udal Garth DS0000045077.V271945.R01.S.doc Version 5.0 Page 21 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 YA24 Good Practice Recommendations The benefits of including suitable plants in the garden should be considered. 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