Inspection on 21/09/07 for Veilstone (Atlas Project Team)

This inspection was carried out on 21st September 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 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

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 Vielstone (Atlas Project Team) Vielstone Buckland Brewer North Devon EX39 5NT Lead Inspector Sue Dewis Unannounced Inspection 21 September 2007 10:30 Vielstone (Atlas Project Team) DS0000069581.V342841.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 Vielstone (Atlas Project Team) DS0000069581.V342841.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. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vielstone (Atlas Project Team) Address Vielstone Buckland Brewer North Devon EX39 5NT 01237 451127 01237452101 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) Atlas Project Team Ltd Mr Jolyon Forester Marshall Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning Disability (Code LD) The maximum number of service users who can be accommodated is 5. 2. Date of last inspection None Brief Description of the Service: The service is registered to provide accommodation and personal care for up to five people who have a learning disability. The house is a large detached farmhouse type property set in several acres of countryside. There is a large pond and a mini-golf area as well scope for growing vegetables and further development of the area. The home has transport to enable people living there to access local facilities. Accommodation is provided in single occupancy rooms only and the home is decorated and furnished to a high standard. There is a large kitchen, loungediner and conservatory for communal use. Reports of visits made by the Commission will be available from the office. Fees for the home are approximately £2000 per week. General information about fees and fair terms of contracts can be accessed from the Office of Fair Trading web site at http:/www.oft.gov.uk . Vielstone (Atlas Project Team) DS0000069581.V342841.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 over approximately 8 hours, one day towards the end of September 2007. This was the first inspection since the home opened. During the inspection 2 people were case tracked. This involves looking at peoples’ individual plans of care, and speaking with the person and staff who care for them. This enables the Commission to better understand the experience of everyone living at the home. As part of the inspection process CSCI likes to ask as many people as possible for their opinion on how the home is run. We sent questionnaires out to people living at the home, their representatives, health and social care professionals (including GPs and care managers) and staff. At the time of writing the report, responses had been received from 2 people living at the home, 2 representatives and 2 health and social care professionals. Their comments and views have been included in this report and helped us to make a judgement about the service provided. During the inspection 2 people living at the home were spoken with individually, as well as observing staff and people living at the home throughout the day. We also spoke with 2 staff, the owner and the manager. A full tour of the building was made and a sample of records were looked at, including medications, care plans, the fire log book and staff files. What the service does well: The organisation that owns the home has several other homes across the country and has a good reputation for providing a quality service. The approach implemented within Atlas homes is to provide people with as ‘normal a life’ as is possible within a normal social context. The home provides a safe, comfortable, relaxed and friendly home for the people living there. There are good relationships between people living and working at the home and there is good training and care plans available to ensure care needs are identified and met. The rights and choices of people living at the home are respected and independence is encouraged. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 6 One staff member said that they thought the individuals’ life is ‘absolutely brilliant’ at the home. People living at their home and their representatives all commented that they thought the home was excellent and one representative felt that ‘all homes should be like this’. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Vielstone (Atlas Project Team) DS0000069581.V342841.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 Vielstone (Atlas Project Team) DS0000069581.V342841.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 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking of moving into the home are assured that their care needs can be met. EVIDENCE: There is detailed Statement of Purpose and Service User Guide for the home. Both documents were drawn up when the home became registered in March 2007. As much information as possible is gathered on the person before admission. This will include visits to see the individual where they currently live, assessments from Care Managers and speaking with family. The home makes a full assessment of the person to ensure their needs can be met. People may visit the home prior to moving in if they wish. However, this may not always be possible for example if it is an emergency admission, and sometimes the individual may choose not to visit. Vielstone (Atlas Project Team) DS0000069581.V342841.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, 7, 8, 9 and 10 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There is a clear care planning system in place, that provides the information that staff need in order to satisfactorily meet the day to day needs of individuals. Peoples’ choice is sought and acted upon where possible. EVIDENCE: Everyone living at the home will have a detailed care plan. However, not everyone had a detailed plan at the time of this visit. This is because plans are completed as the home gets to know the individuals. However there is enough information available to ensure the needs of individuals can be met on a day to day basis. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 10 One full care plan was seen for someone who lived in another home run by the owners. The care plans are based around the assessments of identified risks for each person and goals are planned with the individual and clear boundaries are set. When risks are identified, for example going shopping, ways are looked at to ensure there is a controlled and monitored exposure to these risks. In this way individuals are then helped to move towards independence through a gradual reduction of the risk. Each individual at the home has different abilities, but are each encouraged and helped to make decisions about their lives within a safe environment. The day is usually planned over breakfast and people can decide how they want to spend their day. There are also rough plans for each individual for the week and month. One staff member explained how people are encouraged to take part in the home’s Development Initiative, where they are paid for completing household tasks. The member of staff said that through this people are often unaware they are learning new skills. Daily recordings are well maintained and appropriate. Staff use these recordings to ensure they are up to date with the current needs of the individuals. All incidents within the home are recorded and ‘triggers’ looked for so that similar incidents can be avoided. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection indicates that in order to improve the service the home intends to consolidate what has been achieved and prepare for the needs of two new service users. Vielstone (Atlas Project Team) DS0000069581.V342841.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, 14, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from being offered a variety of activities and opportunities, links with the community are good enriching their social opportunities. Meals are nutritious and balanced and offer a healthy and varied diet for everyone. Individuals’ rights are respected and recognised within the home affording them as much independence as possible. EVIDENCE: Information in care plans, as well as talking with people shows that they are able to go shopping or take part in various leisure activities of their choice. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 12 As this is a new home with new people there is a lot of ‘finding out’ going on, including what people want to do and what is available in local area. Staff said that they may look to use North Devon College if there are appropriate courses available. One person told us that they were joining a local gym, and the home is looking at ways to develop the site to possibly include a workshop. There are large grounds with a pond, and mini golf area, which again the home is looking to develop to provide more activities for those living there. The home currently employs someone to organise outdoor activities such as fishing and rambling. People are encouraged to write a ‘wish list’ at the beginning of the month of things they would like to do. It was evident, through observation and speaking with people during the visit, that people consider this to be their home and are empowered to make decisions, in negotiation with the staff team. We were told several times by people that this was the best place they had ever lived in. During the visit one person came back from a shopping trip and another went out. One individual told us about how much they had enjoyed their recent holiday to Centre Parcs. The home has two cars that ensures people are able to take part in different activities if they wish. People are encouraged and helped to keep in touch with, and see, family and friends. One relative commented via a survey that their relative was able to ring them at any time. Other relatives said that they had been encouraged to visit the home. There is always a choice of meals, and people help to choose the menu, and shop for the ingredients. A light snack is usually taken at lunch time with the main meal in the evening. Snacks and drinks are always available and people are encouraged to make these themselves with supervision from staff. Records are kept of meals provided and show a good variety and well balanced diet is provided. Vielstone (Atlas Project Team) DS0000069581.V342841.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have a good understanding of the personal support needs of individuals, and people benefit from the positive relationships they have with staff. To ensure the safety of individuals, all medicines are stored securely, administered appropriately, and good records maintained. EVIDENCE: People living at the home require low levels of physical personal care, usually needing only prompting and encouraging from staff. However, there is a good mix of male and female staff so that people can receive personal care from a member of the same sex when needed. As people are new to the home few of them have had much involvement with local health care professionals. However, where there has been involvement it is clearly recorded and outcomes of the visits are shown. Records were also Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 14 available to show the involvement of psychologists and other specialists where necessary. The organisation has its own system for the administration of medication which they have tried and tested over many years, and believe that it is the most appropriate system for them. All medication is counted when received into the home. Two managers then put a one week supply into ‘dose it’ boxes and each signs to say this is accurate. A care worker may then administer the medication and sign to confirm this. Medication is stored securely and records relating to the administration are clear, well kept and accurate. Vielstone (Atlas Project Team) DS0000069581.V342841.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints are dealt with appropriately and individuals are protected by staff who are able to recognise abuse and know their duty to report poor practice. EVIDENCE: There is a clear and simple complaints procedure for the home, which is available in a pictorial format if needed. The owner and manager said that they would respond to and deal with any concerns raised immediately. People who we spoke with during the inspection said that they would tell the staff if they had any concerns about anything. Everyone living at the home will have their own bank account, though not all do at the moment. Individuals are helped to learn to budget, and there are agreements on how much is spent at a time. The account that was seen was well managed and there were double signatures for all transactions. Staff that were spoken with had received some POVA (Protection Of Vulnerable Adults) training and were able to describe several differing types of abuse. They were clear about their duty to report any suspicion of abuse, and knew who to report it to, including outside agencies. Vielstone (Atlas Project Team) DS0000069581.V342841.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a high standard of décor throughout and ensures that individuals live in a safe, homely and comfortable environment. EVIDENCE: The home is set in beautiful extensive grounds and there are several buildings on site, that will be developed over time, when their best use has been found. The owner told us that when he is looking for a new property he thinks whether he would like to live there himself. If the answer is yes, then he considers it a suitable home for others. The home is newly decorated throughout and all the furnishings and fittings are comfortable, of domestic quality a contemporary design. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 17 There is a large kitchen area, lounge and dining area, though the laundry is small it is suitable for the needs of the people living there. There is a conservatory just off the lounge and there are plans to develop this area so that it is more in keeping with the rest of the home. Two bedrooms share a bathroom while the others have en-suite facilities. The bedrooms are decorated and furnished to suit the needs and wishes of the individual. Someone was moving into the home during the visit and they expressed much pleasure with their new environment. People already living at the home also said that they thought their environment was excellent and a member of staff said that they were constantly improving the building. The home was clean throughout and there were no unpleasant odours. Effective infection control practices are in place. Vielstone (Atlas Project Team) DS0000069581.V342841.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are well trained and are available in sufficient numbers to meet the needs of the individuals living there. The procedures for the recruitment of staff are generally robust and offer protection to individuals. EVIDENCE: On the day of the visit there were three staff on duty at the home including the manager. The deputy manager, the owner and the manager from another home were also at the home to welcome the new person moving in. Staff said that they felt that staffing levels were good and gave them time to spend one-to-one with people or to take them out of the home if they wished to. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 19 The manager and owner said that if there were concerns with individuals or if people wanted to do several different things, then more staff will be brought in to facilitate this. Staff said that they received regular training and are able to work for NVQ (National Vocational Qualifications). The deputy manager is due to start NVQ 4 soon. Staff have also received training in first aid and POVA (Protection Of Vulnerable Adults) issues. Staff have a thorough induction that is equivalent to the LDAF (Learning Disability Award Framework) induction. However, much of the training that takes place at the home is ‘on-the-job’, where staff are continually learning about the people living there, about their needs and about the best way to meet them. Staff also receive SCIP (Strategies for Crisis Intervention and Prevention) training that teaches them how to diffuse situations or as a last resort how to safely restrain individuals. Following all incidents at the home, there is a thorough de-brief for all staff when they discuss what could have been done better. Managers are trained at the Tizard Centre (part of the University of Kent and a centre for the study of learning disability and community care), and also receive training in behavioural management. The AQAA (Annual Quality Assurance Assessment) submitted prior to the inspection states that ‘there are no desk jobs in ATLAS, all managers including Directors of the company work on shift within the home, this allows easier access to support and guidance for the staff whilst enabling the people with the clinical expertise to see first hand what the real day to day issues are’. Two staff files were looked at and both contained the required information, including evidence of proof of identity, written references and satisfactory CRB (Criminal Records Bureau) checks. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 20 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. This judgement has been made using available evidence including a visit to this service. The home is well managed resulting in practices that generally promote and safeguard the health, safety and welfare of people living and working there. The systems for consultation with people living, working and visiting the home are good, with a variety of evidence that indicates that their views are both sought and acted upon. EVIDENCE: The registered manager for the home (Jolyon Marshall) has several years experience of working with this client group. He has NVQ level 4 in care and Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 21 the Registered managers Award. He is well supported by a deputy manager at the home, as well as managers from other homes and the owner. All people living and working at the home said that they felt supported by him and that he would do all he could to help. A range of methods are used to look at the quality of care provided at the home. As well as a formal system there is the more informal processes, for example, regular meetings, chatting to everyone involved with the home to find out what they think about the home. Staff also watch the behaviour of people living at the home and try to focus on what makes them happy. The AQAA (Annual Quality Assurance Assessment) submitted prior to the visit, provided evidence that Veilstone complies with health and safety legislation in relation to maintenance of equipment, storage of hazardous substances, health and safety checks and risk assessments. The fire logbook, record of fire safety training and accident and incident records were found to be accurate and up to date. So that the risk of burning from hot surfaces is minimised, all radiators within the home are covered. All windows above ground floor level are fitted with restrictors, in order to minimise the risk of any resident falling from these windows. Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 22 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 X 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 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 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 23 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 Vielstone (Atlas Project Team) DS0000069581.V342841.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Vielstone (Atlas Project Team) DS0000069581.V342841.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. 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