Care Home: Coates Garden House

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What the care home does well The needs of people living in Coates Garden House are assessed before they move in to make sure it is right for them. Staff involve people living in the home in planning their care and support and making decisions and choices about their lives. People living in the home are treated with dignity and respect by staff that help with their health and support needs. People living in the home are able to take part in a lifestyle that meets their wishes. Staff are well trained and properly recruited to make sure people living in the home are kept safe. Staff listen carefully to any concerns people may have and the home is warm, comfortable and well maintained. What has improved since the last inspection? New staff have been checked before they start work to make sure they are safe to work with people living in the home. Checks have been made to makesure staff have the skills needed to do their jobs and progress has been achieved in delivering further training to them. What the care home could do better: Social activities should be developed so that people living in the home have more choices about what they can do in the evenings. An annual holiday abroad should be considered to enable people living in the home widen their life experiences. Management Systems for checking the quality of the service should be improved, so it is possible to develop plans from suggestions and ideas about it from people who know the service well. Thought should be given to displaying the staff rota with their photographs attached, so people living in the home can be better informed about who will be on duty. CARE HOME ADULTS 18-65 Coates Garden House High Street Patrington Hull East Riding Of Yorks HU12 0RE Lead Inspector Rob Padwick Key Unannounced Inspection 29th November 2007 01:15 DS0000019660.V355809.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 DS0000019660.V355809.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. DS0000019660.V355809.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Coates Garden House Address High Street Patrington Hull East Riding Of Yorks HU12 0RE 01964 630716 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) steve.turley@bleakhouse.org Bleak House Limited Mr Steven Turley Mrs Sheila Margaret Turley Care Home 8 Category(ies) of Learning disability (8) registration, with number of places DS0000019660.V355809.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th January 2007 Brief Description of the Service: Coates Garden House is a registered care home for up to 8 adults of either gender, with learning disabilities. The home is located in the village of Patrington and is close to local amenities, including shops and the post office. Residents gain access to public transport via a short walk to the main road. The home consists of a detached property, which is well maintained and provides comfortable and homely accommodation. All bedrooms are single and are not en-suite. There is not a stair lift. The home has a small parking area/garden at the front of the property and a rear garden. Support is provided with the personal and health care needs of people living in the home with access to other professionals, for example, the GP as necessary. Coates Garden House is privately owned and run by Bleak House Ltd. The standard fee charged by the home is £450 with additional charges made for hairdressing, chiropody, toiletries etc. DS0000019660.V355809.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home on 9th January 2007, including information gathered during a site visit to the home. A questionnaire asking for information about the service was sent to the home manager before the inspection visit and information from this was included as part of the inspection process. Other information used, included feedback from questionnaires sent out to people living in the home, their relatives and professional staff who know them well, together with official notifications received by the Commission for Social Care Inspection about the home. The inspection visit for this service lasted for 5.25 hours and during this period, time was spent talking with people living in the home and observing their daily lives. Other time involved inspecting the building and looking at care plans and other records and talking to staff. In order to improve the way the Commission for Social Care Inspection involves and engages with people who use services, someone with experience of receiving similar services known as an “Expert by Experience” assisted with this inspection visit. This person, Lee Fiskel, spoke to people living in the home and helped to look round the home as well as speaking to staff. Lee was able to give feedback to one of the home’s managers at the end of his visit and information collected by him has helped us make judgements about the service provided at Coates Garden House. What the service does well: What has improved since the last inspection? New staff have been checked before they start work to make sure they are safe to work with people living in the home. Checks have been made to make DS0000019660.V355809.R01.S.doc Version 5.2 Page 6 sure staff have the skills needed to do their jobs and progress has been achieved in delivering further training to them. 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. DS0000019660.V355809.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 DS0000019660.V355809.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): 2 People who use this service experience good outcomes in this area. The needs of people living in the home are assessed as part of the process of moving into it to ensure the service is able to meet them satisfactorily. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home who we spoke to indicated they had been involved in decisions about moving into Coates Garden House and the case files inspected confirmed this process had included an assessment of their needs, to ensure it was suitable for them. The Provider/ Manager indicated two people had been admitted as emergencies since the last inspection visit, but that one of these was no longer living there, following a decision it would not make an appropriate long term placement and review involving Social Services. The case files of the most recently admitted person contained a Local Authority Care Plan and other information obtained from professional staff who knew her well, that staff in the home had based their own assessment of needs. DS0000019660.V355809.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 and 9 People who use this service experience excellent outcomes in this area. People living in the home are involved in making decisions about their lives, and staff help them with planning their care and support to ensure it is appropriate to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home that we spoke to indicated they were involved in making decisions about their lives and staff were observed actively involving them in planning their care and support. Information provided by the manager indicated the home specialises in “providing and promoting individuality” where independence is promoted with staff encouraging a normal lifestyle, in order to “capture a sense of living a real life”. Positive comments were received from Social Services Staff about this with one commenting staff had an “excellent knowledge of the service users needs….they have encouraged independence as far as (the) person’s abilities allow safely”. Whist another stated the home “provides a “homely” environment….(with) good key worker relationships/support”. The Care plans that we inspected were based on an DS0000019660.V355809.R01.S.doc Version 5.2 Page 10 assessment of the particular strengths, needs and abilities of the individuals concerned, to undertake a range of daily activities. Evidence within them confirmed that people living in the home had participated in the construction and development of these. Guidance for staff about the type of support needed to maximise and promote independence was included and discussion with staff confirmed they had a sound knowledge and understanding of the issues affecting people living in the home. Staffing levels were structured to enable good support, aimed at particularly busy times of day. Staff demonstrated good insight into enabling people to make informed choices that were consistent with their everyday lives and responsibilities. Assessments of risks to people living in the home were included in the care plans we inspected, together with guidance about the management strategies for these. A good standard of daily recording was contained in the case files with evidence of regular monitoring and reviews of the care plans, to ensure they continued to reflect identified needs. People living in the home confirmed they were able to participate in making decisions about the home and that regular resident led meetings were held, with staff invited to provide support with note taking. The Expert by Experience said “I think it is a good idea that the residents hold meeting(s) chaired by a resident. This is good because it involves residents making decisions about the home”. People living in the home told us they were able to make individual choices about what to eat and a group of them were observed collecting their personal food allowances, before going out shopping with staff to support them with budgeting and ensuring they maintained a healthy and nutritious diet. The Expert by Experience said “I like the fact that residents choose, buy and cook their own food as this also makes them responsible and independent.” DS0000019660.V355809.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, 15, 16 and 17 People who use this service experience good outcomes in this area. People living in the home are supported to participate in a lifestyle that meets their individual needs and wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed they were able to make choices about their lives and staff were observed supporting them to ensure their wishes and needs were met. Information provided by the manager indicated staff “encourage a traditional normal lifestyle ( with) access to external colleges, jobs, day services” and evidence of this was contained in the case files inspected and confirmed by direct observation and discussion with people living in the home. The Expert by Experience found that people living in the home were encouraged to go out and socialise independently wherever possible, and that they could have friends and relatives visit and go into their bedrooms if they wished, with staff making them feel very welcome. The Expert by Experience said, “I like the fact residents had friends and family DS0000019660.V355809.R01.S.doc Version 5.2 Page 12 visit” and that (they) “are invited to the parties” whilst a relative commented, “Communication is good…frequent phone calls, usually via my daughter’s carer… very happy with this”. People living in the home told us they sometimes went to the pub or a local club or watched TV and listened to music in the evenings. The Expert by Experience found that people living in the home had been on a caravan holiday to Mablethorpe for seven days this year and that they sometimes went to the theatre, but that this had not happened for a while. The Expert by Experience said, “although residents do activities, I think there should be regular trips out to the theatre and (things like) the cinema and bowling and I think maybe next year they should go on holiday abroad”. A recommendation is made about this. Routines in the home were kept flexible to enable personal freedom of choice and some of the people living in the home were out attending college courses in Hull, whilst others said they sometimes went into Bridlington on the bus to see friends or attend drop ins or clubs held there. A Social Services staff member stated, “The service provided is of excellent quality and reliability…the service user I review is happy and settled and enjoys a full and active lifestyle”. People living in the home told us that staff assisted them with things like cleaning, budgeting, shopping and making their own meals and the case files inspected documented good levels of individual support, aimed at developing their independent living skills. The Expert by Experience “I liked the fact the residents are able to go into the kitchen and that residents choose, buy and cook their own food as this also makes them responsible and independent”. Case files contained evidence that the nutrition of people living in the home was being monitored appropriately with regular entries for individual weight and food intake being recorded where needed. DS0000019660.V355809.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 People who use this service experience good outcomes in this area. Staff support people living in the home to ensure that that their health and personal care needs are met with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We spoke to people living in the home who confirmed they were happy with the way staff supported them and that their health and personal care needs were being met. The Expert by Experience said “I was really pleased the staff member did not show us into any of the residents’ bedrooms who were not there…this shows staff respect the residents’ privacy and own space”. People living in the home were largely independent in relation to personal care and discussion with them confirmed that staff prompted them about these when this was required. The care plans belonging to people living in the home contained information about their individual needs, together with a good standard of daily recording, which documented support provided and information concerning their behavioural moods. Evidence was seen of regular reviews of the support plans to ensure they continued to reflect current needs, together with close liaison with members of Professional staff in the Community. A member of Social Services staff commented “Garden House DS0000019660.V355809.R01.S.doc Version 5.2 Page 14 appears to maintain a good working relationship with the Community Nurses and GP’s”. Medication policies and procedures were available and discussion with staff and inspection of their files confirmed they had received training on this aspect of practice to ensure people living in the home were kept safe from harm. The random sample of medication records we inspected were in good order and confirmed that staff were maintaining them appropriately. DS0000019660.V355809.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 People who use this service experience good outcomes in this area. People living in the home are safeguarded from abuse by staff that have been trained about this and who take their concerns seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home indicated they were happy with the service and policies and procedures were in place to ensure their concerns were taken seriously. Comments received from relatives and professionals associated with the home were supportive in nature. One relative stated, “Staff do the job and (their) actions are first class” whilst another commented, “Questions are always addressed appropriately”. A Social Services staff member said, “The home is very informative about my clients concerns/needs- it is always dealt with appropriately”. The Commission for Social Care Inspection had received no complaints about the home since the last visit to the service and the home’s complaints log indicated that none had been received by the home. Training relating to the protection of vulnerable adults had been provided to staff and policies and procedures were available to guide them on this aspect of practice. The Expert by Experience found that people living in the home could talk to the manager, key workers or staff if they did not feel safe or had any concerns and said that “It was clear from what I saw the staff and residents have a good relationship. I liked the way residents said they could talk to a member of staff or the manager if they wanted to. I think it is good that residents feel they can approach the manager”. A check of the records of money held on behalf of people living in the home confirmed satisfactory systems were in place to ensure that their financial interests were being safeguarded. Records DS0000019660.V355809.R01.S.doc Version 5.2 Page 16 documented signatures of two staff members for monies given out or received and a random check of these indicated they were being accurately maintained. DS0000019660.V355809.R01.S.doc Version 5.2 Page 17 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 and 30 People who use this service experience good outcomes in this area. People living in the home are provided with a warm and comfortable environment to ensure it can appropriately meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The service is provided in a normal domestic setting, which is well maintained and was warm and comfortable, clean and with a relaxing and welcoming atmosphere throughout. A Professional member of staff in the Community stated the service “Provides a “homely” environment with good key worker relationships / support” and the Expert by Experience said, “I found the home was welcoming and very neat and tidy”. The maintenance book contained evidence of regular entries for work carried out and information provided by the manager indicated relevant health and safety training had been delivered to staff to ensure people in the home were provided with a safe environment in which to live. DS0000019660.V355809.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 People who use this service experience good outcomes in this area. Staff are recruited properly to ensure they were safe to work with people living in the home and training is provided to them to ensure they can do their jobs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed staff were meeting their needs and observation on the day indicated very strong relationships existed between these two groups. Staff demonstrated a good understanding of the needs of people living in the home and inspection of staff files confirmed they had received appropriate induction to the service, with evidence of mandatory and foundation training, together with additional courses relating to the specialist needs of people living in the home. The mixed gender nature of the staff group and good levels of support, structured around particularly busy times of day, ensured appropriate person centred care could be provided. Staff spoken with indicated confidence in their abilities and motivation to doing their jobs. The service ensures staff receive NVQ training to equip them with the skills needed and information provided by the manager indicated that well over 50 had obtained this level of qualification at level 2 or above. Evidence within the DS0000019660.V355809.R01.S.doc Version 5.2 Page 19 files inspected confirmed staff were receiving regular supervision and appraisals of their work and career development. A recruitment policy and procedure was in place to ensure staff employed in the service were safe to work with people living in the home. Staff files inspected contained evidence that this was being appropriately followed, with copies of references obtained, together with checks of identity and with the Criminal Records Bureau. Protections of Vulnerable Adults list (POVA First) checks were now being carried out as previously required, for new staff before allowing them to start work in the home. The Expert by Experience said “I like the way residents like the staff as it makes a welcoming environment. I recommend there should be a rota for residents to see who is working with staff names and photographs”. A recommendation is made about this. DS0000019660.V355809.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 People who use this service experience good outcomes in this area. Although the home was being well run, more formalised systems for checking the quality of the service would help the manager demonstrate the effectiveness of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home to indicated the home was being well run. Comments received from relatives and professional associated with the service were very supportive of the home. The manager is suitably qualified to manage the service and staff indicated that he had an open style of management. Evidence was seen of home’s management commitment to involving both people living in the home and staff in decisions concerning them. Uncertainties concerning the future viability of the service had over the past year been raised and evidence was seen that these had now been DS0000019660.V355809.R01.S.doc Version 5.2 Page 21 resolved following consultation and involvement of all those with an interest in the service. A recommendation was made at the last inspection that the quality assurance systems for the home be developed in order to demonstrate the service was monitoring its success in achieving its aims and objectives. Regular checks of various aspects of the service were taking place about this, however a further recommendation is made that more formalised participatory systems are developed to ensure the service can evaluate and monitor its effectiveness from responses received about it. A random sample of the home’s maintenance records indicted that effective checks were being carried out to ensure the health and safety of people living in the home. DS0000019660.V355809.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X DS0000019660.V355809.R01.S.doc Version 5.2 Page 23 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. 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 YA14YA14 Good Practice Recommendations The registered person should ensure that people living in the home are able to have a choice of other leisure activities in the Community (e.g. cinema and bowling) and consider the possibility of a holiday abroad. The registered person should consider displaying the staff rota with pictures of them to ensure people living in the home are able to tell what staff are on duty and working in the home. The registered person should further develop the quality assurance systems for obtaining feedback about the service and audit responses from these at least annually. 2. YA31YA31 3. YA39YA39 DS0000019660.V355809.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 DS0000019660.V355809.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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