Care Home: Forest Green

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What the care home does well People are supported by long standing staff team who assist them in all aspects of their lives.A varied and balanced menu is offered which takes account of people`s needs and choices. The environment is clean, welcoming, spacious and homely place where people are encouraged to express their views. What the care home could do better: A number of requirements have been made as a result of the inspection. To make available the recent Statement of Purpose so that people are given sufficient information which would help in their decision making in regards to their place of residence. To make sure that all care plans are consistently completed so that the staff team have accurate information to meet people needs Regular team and residents meetings must happen this is to ensure any information is shared on a consistent basis and that residents are able to voice their opinions. Random inspection report Care homes for adults (18-65 years) Name: Address: Forest Green 46 Park Road Berry Hill Coleford Gloucestershire GL16 7AG two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Kath Houson Date: 2 8 0 5 2 0 1 0 Information about the care home Name of care home: Address: Forest Green 46 Park Road Berry Hill Coleford Gloucestershire GL16 7AG 01594836866 Telephone number: Fax number: Email address: Provider web address: www.brandontrust.org Name of registered provider(s): Name of registered manager (if applicable) Mr Charles Patrick Bunn Type of registration: Number of places registered: Conditions of registration: Category(ies) : The Brandon Trust care home 5 Number of places (if applicable): Under 65 Over 65 0 0 learning disability sensory impairment Conditions of registration: 5 5 The maximum number of service users who can be accommodated is 5. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: Learning disability- Code LD Sensory impairment- Code SI Date of last inspection Brief description of the care home Forest Green is a large detached house which provides personal care and accommodation for 5 people with learning disabilities, some of whom may have Care Homes for Adults (18-65 years) Page 2 of 12 Brief description of the care home physical disabilities and sensory impairment. The home can be found in Coleford in Gloucestershire. The property is a three storey building which has a basement, ground floor and first floor. There is a large garden at the front which continues round to the rear of the property with a good size pond at the front to the house. The rooms are furnished to a good standard and are comfortable and homely. The local amenities are close by and people can enjoy short walks to their local day centres. The home is staffed 24 hours a day. The Brandon Trust manages the home. The fees at the time of publishing this report range from £72-£110 per week people also have to pay towards the transport which range from £12.50-£36.00 this is based on the Disability Living Allowance (DLA) people maybe given. Care Homes for Adults (18-65 years) Page 3 of 12 What we found: This was an unannounced random visit as part of the inspection process. The purpose of this visit was to review the requirements and the recommendations from the previous visit in August 2007 and to monitor the quality of the service provided to the people living at Forest Green Care Home. The Care Quality Commission has not received any complaints in the last 12 months. We looked at the information received such as the residents surveys and the homes recent Annual Quality Assurance Assessment (AQAA). The visit was made on the 27th and 28th of May 2010. During the visit we talked with the people who use the service and the staff team. The manager was unavailable on both occasions. We looked at information about the people who use the service and how well their needs are being met. We were unable to look at other documents to check that the staff had the qualification and skill to meet the needs of people who use the service. A tour of the premises took place to make sure it was clean safe and comfortable. We checked what improvements had been made since the last inspection. There were a number of recommendations made as a result of the previous inspection what appears to have been met thus far is the implementation of the residents health action plan the development of activities personal inventory of peoples belongings has been developed. However other recommendations were not assessed due to the relevant documents not being available. What we found for each of the following outcomes can be seen in the following text. Choice of Home Potential admissions have their individual needs assessed, this was evident in the care plans which shows to have an assessment from the placing authority and from the staff who are confident that the provision of the service can meet the assessed needs of the potential resident. A number of people said in their surveys that they were not asked if they wanted to move into this home and they additionally responded in their survey that they did not receive enough information about the home before they had moved in order to make a decision about if the home was the right one for them. Others said that they were not asked if they wished to move into the home but had received sufficient information about the home to help with the decision on whether the home was the right place for them. It is important that people are given sufficient information about a probable place of residence this is to ensure that people have been involved in the process of making their own decision about their place of residence and that the service is a good fit for peoples individual needs and aspirations. Individual needs and Choices A selected number of care plans were looked at and found Care Homes for Adults (18-65 years) Page 4 of 12 to contain, health action plans, choice and equality, information on mental capacity, daily records, person centered plans and risk assessments. There were some inconsistencies found in some of the residents care plans. The care plans contain a traffic light system to arrange residents information according with the coulor code, when using the traffic light system some of the care plans was found to be incomplete. It would be beneficial for all the residents if their information to be kept up to date and consistent which would help the staff team to support peoples needs based on information that is accurate and assessable. One care plan showed how the traffic light system is supposed to be used for instance, red is for information that is vital such as contact details, GPs, next of kin. The amber is for information that is new or ongoing and any new information and the green is information that has been agreed and ongoing in regards to the residents wishes being met. Some of the folders are organised and health action plans are being developed and agreed with other health professionals. The care plans seen show consistent involvement from the Community Learning Disabilities Team (CLDT). Residents have their health needs assessed and this is reflected in their care plans. Residents are involved in developing their care files as some signatures can be seen. Residents spoken with said I get good help from my support worker. Peoples responses in their surveys show that they make decisions about what they do each day. People who lack the capacity to make their own decisions are supported by the staff team CLDT and advocates. However the survey responses highlighted that there is a lack of resources to expand people with limited communication skills. People who have the ability to voice their opinion are supported with their decision making about how they wish to spend their daily life and take risks. Lifestyle People who use the service each have an activities plan which is personalised to their needs and are supported to take part in their own personal development. For instance, there are individuals that take part in cookery, sewing and other life skills so that they can entertain their guests in another part of the home independently with staff support being provided from a distance. Other activities residents take part in are regular visits to the local centre where they have the use of a trampoline. Residents are also involved in music swimming farming and looking after livestock volunteering at the Salvation Army (SA) where some often lunch out with SA. At the time of the inspection some of the residents were preparing to go on their holiday. The homes AQAA states, that the service wishes to have more understanding of those with limited communication capacity and to seek, out more activities for those with specialist needs. In order to promote equality in the home it is important that those residents with specialist needs are catered for and that activities which would enhance their ability to communicate be investigated. Residents have regular contact with friends and family and some often go for regular home visits this was evident in their care plans. People are supported to attend and maintain their spiritual beliefs and often obtain assistance from the local church. Mealtimes are calm and unrushed. People have a choice of healthy options and those with specialist diets are given nutritious options. There was plenty of fresh fruit and vegetables Care Homes for Adults (18-65 years) Page 5 of 12 seen on the day of the inspection. Personal healthcare and Support Residents receive positive support in the manner they prefer the information is recorded and relates to their personal needs. The staff team are very supportive to the needs of the residents and the system for recording their wellbeing is available. For instance the recording of peoples health appointments were seen to be satisfactory. The home has an adequate medication procedure, all residents medication files were looked at and no omissions were seen. Any errors with medication are dealt with rapidly. Many have end of life plans which takes into account the wishes of individuals during death or serious illness. Concerns and Complaints The home has a communication book where concerns are written and the information is shared with the staff team. The staff team state that if the residents have any concerns it is usually dealt with quickly. Residents in some of their responses said that they did not know how to make a complaint. Other residents said that they did know where and how to make a complaint. It is important that issues of inequality be addressed so that all residents are equally able to make a complaint. Those residents who do not know how to make a complaint will require support which would enhance their independence. Documents that show staff that are trained in the protection of vulnerable adults were not available. All documents must be made available on request. The homes AQQA states that staff and residents and their relatives are aware of how to make a complaint and that all staff had POVA training. These documents were not available therefore it was difficult to find evidence to support comments made in the homes AQAA. Environment Forest green is a large detached house with domestic facilities which can be found in Coleford Gloucestershire. Each of the bedrooms varies in size with good fixtures and fittings. All the bedrooms are individualised and residents have been encouraged to bring their own personal belongings. The upper floor of the home has large living areas which there are plans to make in into self contained living area where residents can entertain their friends and relatives. The bathrooms are well equipped with specialised equipment for people who have difficulties with mobility. Hand rails were seen throughout the inside and outside of the home and a slope for wheelchair users to gain access into the home was also available. The damp patch in the first floor bathroom has been repaired and the doors can close easily. There are plans to have the floors in the hallway re-laid and recarpeted. The kitchen is of good size and was found to be clean, tidy and homely with well stocked Care Homes for Adults (18-65 years) Page 6 of 12 food cupboard. All foodstuffs were labelled with expiry date of opening. The dining area looked out onto a good size garden which is laid mainly to lawn. The outside of the property has a well kept garden where a good size pond can be found. The gardens are well maintained by a paid gardener. The home provides a physical environment that meets the specific needs of the people who use the service. The home was found to be comfortable, welcoming clean and tidy. This was confirmed by the residents responses in their surveys which state the home is always clean and fresh. There is however a musty smell from the basement of the house this part of the property is locked and secure. Staffing People are supported by long standing staff team and provide 24 hour care to people who use the service. The residents survey states that the staff team treat them well. It was also observed that the staff team are supportive to residents needs for instance staff team was seen to be attentive and assisted the residents with their requests. No staff files were seen on this occasion therefore it was difficult to find any evidence to support information provided in the homes AQAA. For instance, support staff to complete their NVQ level 3 in care, no evidence to examine the homes recruitment and selection procedures and to check that this coincide with the recommendations of the National Minimum Standards, which would ensure that people are being protected from abuse and physical harm. There was recent staff team meeting notes to see if information has was exchanged, the communication book was also seen. Conduct and Management of the Home The manager was unavailable on this occasion and the staff team appear to be left to their own devises. Its unusual for a manager not to be unavailable for both days during an inspection. Therefore no feedback about the findings of the inspection was shared with the manager of the service. The previous report made a number of observations about the leadership and management style of the service, for instance management presence and direction, the manger should undertake relevant development courses relating to management. None of these have been checked to see if these concerns have been met. The homes AQAA states that these issues have been met but no evidence was seen during the inspection to support the homes AQAA. Safety checks for the home were looked at and found to be in order, this shows that the home is a safe place for the residents. What the care home does well: People are supported by long standing staff team who assist them in all aspects of their lives. Care Homes for Adults (18-65 years) Page 7 of 12 A varied and balanced menu is offered which takes account of peoples needs and choices. The environment is clean, welcoming, spacious and homely place where people are encouraged to express their views. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 12 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 22 22 (7) The complaints procedure must include the name, address and telephone number of CQC. This is to ensure that people are given accurate information at all times. 19/07/2010 Care Homes for Adults (18-65 years) Page 9 of 12 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 1 4 The registered person shall compile in relation to the care home a written statement of the aims and objectives of the care home;a statement as to the facilities & service which are for the residents. This is to ensure that all residents receive before moving into the home 19/12/2010 2 12 34 All relevant documents relating to staff files and recruitment application are made available. This is to ensure that people are protected from harm and that good recruitment practices are being followed in line with the NMS. 30/07/2010 3 13 37 Mangers presence, direction and leadership,care teams This is to ensure that both the residents and the staff team are given additional 19/08/2010 Care Homes for Adults (18-65 years) Page 10 of 12 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action support and empowerment. 4 23 23 Documents must be available 23/07/2010 to support the evidence that staff have had their pova training. This is to ensure that people are kept free from potential harm Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 11 of 12 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. 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