CARE HOME ADULTS 18-65
Wheatridge Court 40 Shergar Court Abbeydale Gloucester GL4 4AL Lead Inspector
Mrs Helen James Unannounced Inspection 23rd January 2006 09:30 Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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 Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Wheatridge Court Address 40 Shergar Court Abbeydale Gloucester GL4 4AL 01452 500669 01452 410448 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) Gloucestershire County Council Mrs Lesley Ann Gamm Care Home 6 Category(ies) of Physical disability (6) registration, with number of places Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th July 2005 Brief Description of the Service: Wheatridge Court is a purpose built home owned by Gloucestershire County Council for people with a physical disability. The home provides two services, a registered respite unit for up to six service users and a supported living project. The respite unit provides accommodation in six bed-sits, each with its own front door. They have a bedroom, en suite facilities and sitting area. There are additional bath and shower facilities nearby. People staying at the unit share a lounge and dining room with a small kitchenette. There is a central communal area which can be used by the people accommodated for respite or supported living, which has a television and pool table. They can also use the quadrangle, which provides a patio area with seating and garden. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four and a half hours on one day in January 2006 and was completed by one inspector. Thirteen Care Standards for Adults (18-65) were assessed on this occasion. Of these ten met the standard and three almost met the standard. There were three people staying for respite at the home during the inspection. Two people were spoken to in addition to two members of staff, the third person staying at the unit was out at work. A tour of the unit was conducted and a sample of rooms were seen. Time during the inspection was spent speaking with the Registered Manager Mrs Gamm, two staff and two residents at the home and listening and observing the interactions of staff and residents. The information gained was then cross-referenced with relevant documentation and care records. Records examined included files for new admissions, care plans and new staff records. The care of the two people staying at the unit and spoken with was case tracked, this involved examining their care files and cross-referencing information that people had shared during the inspection. What the service does well:
The unit provides an environment conducive to the needs of the particular people that are accommodated here. There are specific risk assessments and rehabilitation that people may agree to on admission. People staying at the unit are afforded as much freedom as they wish and are allowed to dictate how they spend their time outside or in the home. Each person has their care requirements fully assessed before they are admitted to ensure that the unit is able to meet their needs. Assistance, advice and support in the care is also continued from other agencies who work with the person at home whilst the person is staying at the home. All comments from the two people spoken with were very positive about the Manager, staff and the care they receive. They felt that they were given choice and the freedom to do what they wanted and their wishes were respected. One person commented that “the staff are so nice, really care, are really friendly and will always help you”, “ they are helping me regain my independence, so I can go home”. People staying at the unit have use of pleasantly decorated accommodation. They are encouraged to be as independent as possible. People staying for respite indicated that staff support was available should they need help. Access to the home’s occupational therapist ensures that people wishing to stay on the unit have access to a range of specialist adaptations and equipment.
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 6 The home invests in good basic mandatory training for all staff and ensures it is completed. Implemented alongside this are regular individual supervision and appraisal sessions for all staff, documented evidence was seen of this. This all assists in the staff development programme and several of the staff are undertaking National Vocational Qualifications (NVQ). 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. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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 Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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): 3 The Statement of Purpose and Service User Guide gives people staying at the unit and people wishing to use the service, information about the services provided. This enables them to make an informed decision about staying for respite care. The home has a comprehensive admissions process that must be followed to ensure that the appropriate people are admitted to the unit. EVIDENCE: Records for three admissions to the service were examined. The records for two of the people admitted showed that people have the opportunity to visit the home prior to them wishing to use the service. Care needs assessments are obtained from their placing authority and information is provided from previous placements if appropriate. The home’s occupational therapist also makes a visit to prospective people wanting to use the service to assess their needs to determine whether any additional specialist equipment needs to be provided before they stay at the home. The home keeps records of all initial enquiries and visits. Evidence of assessments was seen on two files (albeit it was from previous admission to the home) but the third persons file did not contain the assessment information. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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 Care planning in the unit is generally good promoting the development of skills and independence. Risk assessments encourage and support people staying at the home to deal with their lives. People staying at the unit are supported to make decisions about aspects of their daily living enabling them to live an independent lifestyle. EVIDENCE: People who talked with the inspector confirmed that they were treated with respect and dignity and that they had choice in their daily routine. It was observed that they were addressed by staff in a manner that they were comfortable with. They were not told what they could do or could not do discussion about what they would like to do and what they wanted to eat was observed. People are assessed prior to and on admission some documentation seen confirmed this. Although there was no evidence that the person had agreed the care plan, where they were able. This also did not appear to be dated or signed by the initiator of the care plan. The care plan appears to be carried over from each stay/visit and used again, but there was no evidence that it had been looked at (reassessed) or updated.
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 10 One person on the unit at the present time requires total care and assistance on a ‘one to one’ basis for everything, but is able to make decisions about most aspects of day-to-day life. One person spoken with was able to confirm the reason for their admission and what their needs were and the aim of the admission. But this was not confirmed in the documentation available at the inspection. The inspector was unable to assess whether they were receiving appropriate care or how they were being assisted. The care staff spoken with also could not find this information during the visit. Basic information was available for this person only. This must be addressed. Risk assessments were documented for two of the three people staying at the home and were specific to the individual persons needs. People staying indicated that they are provided with information to make decisions about their day-to-day lives during their stay. They said that staff support if you should need it and they use the call system to access staff. Assistance is given with personal care, going out, help with preparing meals or shopping. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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): 11, 12, 14 & 16 People staying at the unit are enabled to live a fully inclusive lifestyle accessing a range of local community facilities and activities. Contact with family and friends are supported and specific care /support for individuals continues whilst they stay at the unit. The rights and responsibilities of people staying on the unit are respected enabling them to be self-determining about activities of daily living. EVIDENCE: People staying at the unit are supported to continue to attend work, educational, social and leisure activities that they would be doing whilst living at home. People spoken with indicated that they are supported to take part in social activities if they wish. Two activity co-ordinators provide a range of activities for people to participate in whilst staying at the unit. They work their hours around the needs of the people staying at the unit and the supported living bedsits. They liaise with the people prior to admission and when they come in to provide them with
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 12 opportunities for leisure activities. Individual social/leisure interests were not recorded in the care files seen during the inspection. Documented evidence must be available to evidence peoples interests and how these are met by staff, all be it that many social and age appropriate activities are occurring each day; Such as pub lunches, cinema, sailing, comedy evenings and one to one activities such as facials, nails etc. Information is provided about functions taking place locally such as concerts, films and free bus trips etc. On the day of the inspection one person had gone to work via taxi. One person was going out to do the shopping and one person was remaining at the home today to listen to music. As people are largely responsible for their own meal preparation, meals are not recorded. It was evident that the dietary needs of people staying there are however being monitored. People’s choice is also facilitated especially when they cannot cook it themselves. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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 The way in which the people staying at the home would like to be supported is clearly recorded. EVIDENCE: The way in which people using the service would like to be supported is clearly identified in their records. One case record was not available to confirm this. People spoken to who were staying at the unit indicated that they receive support from staff as and when they require it. One person requires total support and this was clearly being given. Staff appeared to have a good understanding of the persons needs and dealt with them appropriately. One person has a personal assistant (from LIGS) and domiciliary care whilst staying at the unit. These were services they had at home and continue whilst they stay at the unit, to ensure continuity by people the person is totally familiar with and to continue their social activities. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not examined at this inspection. EVIDENCE: People staying at the home indicated that if they had concerns they would speak to the manager whom they felt would immediately address any issues. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 People live in a homely and comfortably furnished environment, which benefits from an ongoing maintenance programme ensuring that the home continues to meet the needs of the people living there. EVIDENCE: Wheatridge Court is well maintained with an ongoing programme of decoration and replacement of furniture. All the required furnishings are supplied in the unit. Each person staying on the unit has their own room with en-suite facilities and access to nearby bath and shower rooms. A range of specialist adaptations and equipment can be provided for people staying at the home and people are encouraged to bring any specialist equipment they may need from home in with them. Each person has cupboard and fridge/freezer space in the kitchen area, so that they can be as independent as possible. This has high/low surfaces enabling access to people who use wheelchairs. The unit has a lounge and small dining area. There is also a central communal lounge/relaxation area that people can use. Cleanliness was good and no infection control issues were identified. The laundry was not examined on this occasion.
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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): 32 & 34 Staff have access to a training programme enabling them to gain competence and skills necessary to support people using the home. The procedure for the recruitment of staff needs slight improvements to ensure the system is robust and protects the people living at the home. EVIDENCE: Three new members of staff have been appointed since the last inspection. Their files were examined. Two of these contained the required information but the third file raised a concern. The third file had a CRB check available but this was dated November 2003, when POVA was not part of the CRB process. This person started a permanent job with the home in November 2005 (she was on relief and working elsewhere). The County Council should have redone the CRB with POVA before she started or done a POVAFirst whilst they waited for a new CRB/POVA. The Manager told the inspector that one had been applied for recently as it as now considered out of date and they are waiting for its return. When the County Council are employing their own staff (internal applicants or relief staff) they must ensure that they follow the CSA Regulation 19 recruitment guidance and ensure that no member of staff starts any care job without the necessary CRB / POVA check in place.
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 17 The registered manager confirmed that the application form requests a full employment history but the reference request form still does not request the written reason for leaving from referees. The County Councils Human Resource department must ensure that the reference request form request this information. This was a requirement at the last inspection and whilst the Registered Manager is writing letters to try to get this information, the County Council has a duty to address this Corporately. Staff have access to Gloucestershire County Council’s training programme, which begins with induction, attendance at mandatory training courses and a NVQ Programme. Individual training needs are identified at the supervision sessions that are undertaken every four weeks. Evidence of supervision sessions was seen on personnel files. Many of the staff have a National Vocational Qualification (NVQ) award. Discussion with a member of staff confirmed that they had the knowledge, skills and experience necessary to support the people residing in the home at the inspection. Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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): 38 There is good leadership, guidance and direction to staff. This ensures residents receive consistent quality care and results in practice that promotes and safeguards the health, safety and welfare of the people using the service and staff. EVIDENCE: Staff appear to get good support and leadership from the Manager and the ethos for the home is to provide the best quality care and lifestyle for the people on respite. The staff team is small and staff meetings take place regularly and evidence was seen of the next scheduled meeting. Staff appear extremely motivated and appear to enjoy their work and working environment. Certificates of insurance and registration were displayed correctly at the time of the inspection. The Registered Manager showed a willingness to work with the Commission meeting with requirements issued at the previous inspection and sharing information and evidence at this inspection. The Registered Manager was open and transparent.
Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 X 14 2 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X X 3 X X X X X Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 14 & 15 Requirement Timescale for action 2. YA6 14 & 15 Assessment information and care plans for individuals must be 01/04/06 available in the home for the inspection. The following care record 01/04/06 amendments need addressing:• Assessments, Care plans and Risk Assessments must be evidence that they have been reassessed and updated on each admission. • Assessment and Care record details must be dated and signed by the initiator of these. • Evidence that the person has agreed their care plan must be available where possible. • Care assessment must ensure that social and leisure preferences for the individual are recorded. Documented evidence for individuals on how their leisure/social needs are met must be recorded. 01/04/06 3. YA14 16(2m) • Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 21 4. 5. YA34 YA34 19 Sch 2 19 Sch 2.4 No member of staff should start any care job without an up-todate CRB/POVA check. The Registered persons must amend the reference request from to ensure written verification of the reason a person left a previous position is obtained . 01/04/06 01/04/06 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 Wheatridge Court DS0000036389.V277849.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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