Care Home: Gordena Care Homes

Similar services:

• 2 Perhaver Park
• The Vicarage
• St George`s
• 5 Seafield Road
• Radfords
• Honeybourne House
• 32 Beaumont Way

What the care home does well The home was found clean, warm, well lit and free from unpleasant odours. The atmosphere of the home was noted to be relaxed; individuals living in the home looked well cared for in their homely environment. Staff were interacting with the residents in an informal, respectful, personalised and dignified manner. The home stated in the Annual Quality Assurance Assessment that the philosophy of the home is to create a warm, friendly, secure environment where individuals can develop new skills. Individuals planning to move in to the home have detailed needs assessment using a variety of tools before admission to the Home to ensure that the home is able to meet the individual`s need and that they are compatible with existing residents. Evidence from the `Guest book` shows that families, friends, relatives and other visitors are encouraged to visit the home to ensure that regular contact is maintained. Residents we spoke with stated that they were satisfied with the care provided for them, that staff are kind and that their relatives are able to visit the home at any time without restrictions. There are ongoing training courses to enable staff to meet individual service users needs and to ensure that staff are aware of how to protect individuals from harm and abuse. Individuals living in the home are enabled to complain through a robust complaints procedure and the home would ensure that all complaints are thoroughly investigated and all required action (if any) implemented. The home told us in the Annual Quality Assurance Assessment (AQAA) that residents are encouraged to take part in all aspects of daily life and are assissted where appropriate in daily living. The home works well with other organisations to offer training, support and development that can assist residents with practical aspects of working. For example the home told us that two individuals working at a cafe nearby have gained greater independence, earning power, increased self esteem and self confidence and have made friends at work. The home has robust policies and procedures in place to support staff in meeting the needs of the individuals living in the home. What has improved since the last inspection? It was pleasing to note that the home had made considerable efforts to ensure that that the requirements have been met and considerations had been given to the recomendations made at the last inspection. The home stated in the AQAA that it had devised a highly informative Health Action Plan which is colour coded and easy to read. This document is completed by the resident with support from staff members. We noted this document in the care file of the individual reviewed. What the care home could do better: To ensure that prospective residents and their families receive accurate information before making a decision to move into the home, it would be better if all the information required in Schedule one of the Care Homes Regulations 2001 are included in the Statement of Purpose and Sevice Users Guide. The Care Quality Commission has received information that the documents have been updated with the required information before this report was completed. The home must ensure that all hand written medication entries on the Medication Administration Record Sheets are signed and dated by the person making the entry. All medication adminstered must be signed for and a reason given if a medication has not been given. This is so that risk of drug error is eliminated. In order to protect the residents it would be better if attention is given to the shower room on the ground floor and the shower head is replaced and cleaned regularly. Whilst the storage of residents monies and valuables seem adequate, it is recommended that a safe drilled to the wall is installed to enhance security of the monies and reduce the risk of theft at the home. Key inspection report Care homes for adults (18-65 years) Name: Address: Gordena Care Homes 16 Overnhill Road Downend South Glos BS16 5DN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home 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 full review a ‘key’ inspection. Lead inspector: Grace Agu     Date: 2 8 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 31 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Gordena Care Homes 16 Overnhill Road Downend South Glos BS16 5DN 01179569473 01179569473 enquiries@gordenacarehome.co.uk&sarah@gor denacarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr Simon Gordon Parker,Mrs Sarah Louise Howick care home 9 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is 9 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 category: Learning disability (Code LD) Date of last inspection Brief description of the care home Gordena Homes was registered with the Commission for Social Care Inspection in July 2005. The home provides personal care and accommodation to nine people with a learning disability aged 19 years and over. In addition the registration includes two named person who have dementia in addition to their learning disability. Gordena Homes is a large semi-detached Victorian property that is situated in a well-established residential area. The road links with Staple Hill and Downend, both areas being within walking distance. Both areas have good public facilities and a regular bus service into Bristol. The communal areas of the home are located on the first and top floors. This home would therefore only be suitable for individuals who are reasonably mobile and Care Homes for Adults (18-65 years) Page 4 of 31 Over 65 0 9 Brief description of the care home can use stairs. The kitchen, dining room, one bathroom and the homes office are situated on the top floor. The middle floor has one lounge, a further three bedrooms and a bathroom. The laundry, shower room and five bedrooms are situated on the ground floor. There is a conservatory and a garden at the rear of the property. Gordena Homes is a family business owned by Mr Parker and Mrs Howick. The registered manager is Mrs. J Parker. The current fees for this service range from £525.00 to £739.00 per week, depending on the support needs for each resident. Care Homes for Adults (18-65 years) Page 5 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced inspection which took place over eight hours and was undertaken to review the requirements made at the last inspection and to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. At the last inspection three requirements were made, it was pleasing to note that the home had made efforts to ensure that the requirements were met. The home had taken into consideration the recommendations made The residents looked relaxed and staff were noted interacting with the residents in a dignified and respectful manner. We met with the registered manager and registered provider Judith Parker and Sara Howick. Whilst touring the building, we spoke with six service users; three staff Care Homes for Adults (18-65 years) Page 6 of 31 members and a number of records were viewed. Care Homes for Adults (18-65 years) Page 7 of 31 What the care home does well: What has improved since the last inspection? It was pleasing to note that the home had made considerable efforts to ensure that that the requirements have been met and considerations had been given to the recomendations made at the last inspection. The home stated in the AQAA that it had devised a highly informative Health Action Plan which is colour coded and easy to read. This document is completed by the resident with support from staff members. We noted this document in the care file of the individual reviewed. Care Homes for Adults (18-65 years) Page 8 of 31 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 31 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Information given to residents to enable them to make an informed choice is lacking in the Statement of Purpose and the Service Users Guide is incomplete. This needs to be remedied to so that the home meets the regulation. Evidence: The homes Statement of Purpose and Service User Guide, require some additions to ensure that it complies with the legislation. Areas that need to be included include are the homes complaints procedure, terms of conditions of service, fees charged and the range of needs that the home intended to meet along with the process and criteria for admissions to the home. Although the Service Users Guide placed a lot of emphasis on the environment and was available in an accessible format with photographs included to make the information more understandable for the prospective residents, their relatives and members of the public, it should be expanded to include the facilities and the services that individuals can expect. Care Homes for Adults (18-65 years) Page 11 of 31 Evidence: The registered provider told us that they would ensure that all relevant information is included in both documents in order to meet the legislation. The Commission has recieved an updated copy of the documents with all the required information before the report was completed. We noted that the most recent admission was pre assessed by the registered provider with the involvement of two residents at the home before the individual was admitted to ensure that they were compatible. The registered provider stated that the procedure followed recently was not part of the home admission policy however the decision was made to ensure that the persons need s could be met. The Manager also told us that all the professionals involved with the persons care were in agreement with the admission process. We noted that the individual had terms and conditions of stay in their care file. Care Homes for Adults (18-65 years) Page 12 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individualised care plans are provided for the residents to reflect their assessed needs and residents are supported to participate in the running of the home. Required support with risk assessments are provided for the residents to live independent lives with the assurance that information about them will be kept confidential. Evidence: One care files of an individual recently admitted to the home was reviewed and the care file contained an individuals plan of care on how the needs were being met. Information noted on the care file includes Person Centred Plan, Adult Care Plan and Enhanced Level Care Plan which provided detailed information about the residents likes and dislikes, important things in their life and things people need to know about supporting the resident. The care plans are developed by the key workers with the residents involvement and the individuals needs were regularly reviewed. The individuals person centred planning information included risk assessment and how identified risks were being managed by staff. Comprehensive details were noted Care Homes for Adults (18-65 years) Page 13 of 31 Evidence: on the care files on how the residents challenging behavior is being managed. The manager stated that after several reviews of the residents care plan is was decided in consultation with the resident and the family and health professional the strategies put in place are meeting the persons needs. Whilst we were unable to speak to the person our observation suggests the person looked well care for and was very calm on the day. Residents spoken with told us that they are supported to participate in running of the home. One resident stated that they make their own bed; goes out with Jane for shopping and another resident said they help out in the kitchen and does their own laundry. Residents were seen going in and out of the kitchen and one individual was noted making their sandwiches, independently and others others were noted accessing areas around the home without restriction. A staff member spoken with demonstrated a clear understanding of the importance of keeping information about residents confidential. The bedrooms of residents attending day-centre or out of the home for any reason were noted to be locked. The home has a confidentiality policy. Care Homes for Adults (18-65 years) Page 14 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have opportunities for personal development and are supported to maintain links with the community, family and friends. Their individual rights are respected . Theya re provided with healthy diets at their chosen times. Evidence: Based upon the needs of the residents the home ensures that residents engage in leisure activities outside and within the home based on individual risk assessments and capabilities. Review of the activity records and discussion with the registered provider and staff showed that residents are encouraged to live an active life based on their choices. Some residents attend day centerers and some participate in activities with their key workers on the days they stay at home, to foster relationships. Care Homes for Adults (18-65 years) Page 15 of 31 Evidence: One resident described their weekly activities and stated that she works in a cafe on Tuesdays and Fridays and I enjoy it very much. The individual told us in the comment card returned to the Commission Sometimes I get a bit bored, I mean tired because I get involved in so many things. But I would not change this because I like working there for the experience and I have made lots of friends. One Individual stated that they had been on holiday to France and is looking forward to going back next year. The manager told us that six other residents went to Burnam On Sea holiday Park with Caravans. Daily events are recorded by the key workers. Other activities provided at the home and displayed on the notice board included music therapy, cooking, ,shopping, games, Bingo, pub, club, cinema and other social events chosen by the residents. One of the day staff was noted interacting with residents and supporting them to participate in activities at the home. The AQAA told us that the home has created its own day care system which scales an assortment of daily activities which has been designed with the residents involvement. For example residents have had input into designing their own personal space including choosing color schemes and personal artefacts to have in their rooms. The manager also stated that the home has access to recreational and educational activities through Filton and Soundwell colleges. As stated in the Annual Quality Assurance Assessment (AQAA) college courses are presented and made available to those residents who express a wish to attend. This is discussed with the manager, key worker, family and college tutor to make sure all opportunities available are being utilized. One resident confirmed that they attend College to study Computers and Arts and Craft. The individual told us that the have been accepted to start another course at the college in September. We noted the persons certificates in the folder. Two other individuals go to Soundwell College to study English Literature, Communication and Local history. Evidence show that residents are supported with managing friendships, personal relationships and contact with families to ensure that communication is promoted at all times. For example one individual told us the she went on a day trip with her boyfriend and they had curry and that the day was very enjoyable. The manager confirmed that this resident is well supported to maintain this relationship. Another individual told us that he goes to see his brother every other Sunday and goes home to see his sister on Wednesdays. Care Homes for Adults (18-65 years) Page 16 of 31 Evidence: The manager stated that one individual had recently graduated from a travel buddy scheme, which allows the person to travel to and from thier day care placement on their own using their bus pass. This has raised the persons self worth as well as promoted their right to independence. Residents are provided with a healthy and balanced diet which is designed in consultation with the residents to enhance their quality of life. Two staff members met on the day stated that residents were involved in the planning of the menu. A twoweek menu viewed contained nutritious meals. The manager and staff confirmed that all residents devise the menu and that special diets are accommodated for example, for people with diabetes. This was noted on the menu displayed in the kitchen. Residents interviewed told us that they liked their food and that they are able to choose what they like. The homes- kitchen was found to be clean and tidy. The foods in the fridge were in date. The freezer temperatures in the kitchen had daily recording to ensure that the food is fit for consumption and reduce the risk of food poisoning to the residents staff and visitors. We noted that the home was visited by Environmental Services of the South Gloucestershire Council in March 2009 and was awarded a five star rating. The laundry area was found satisfactory with two industrial driers and a washing machine with sluicing facilities. One resident told us that they are supported to do their own laundry. Care Homes for Adults (18-65 years) Page 17 of 31 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive preferred personal support as required. Their emotional and physical health needs are met, also respect is given to their wishes in the event of death. However, some medication administration practices at the home fail to protect the residents. Evidence: The care file reviewed showed evidence of the level of support the individual resident needs and this is dependent on their specific assessed need. One resident we spoke with during the inspection told us that staff support them to do things that they are not able to do for themselves for example having a bath or shower. During a walk around the home, staff were noted knocking on the residents doors and waiting to be allowed in to assist the residents with personal care. One staff member, interviewed, was able to demonstrate how a particular resident is assisted in the morning and during the day if needed. The care file reviewed showed evidence of GP and Consultant medication reviews when necessary. The home accesses support from the Community Learning Difficulties Team for managing residents challenging behavior. Other health professionals visiting Care Homes for Adults (18-65 years) Page 18 of 31 Evidence: the home include the chiropodist and occupational therapist. The manager told us that residents are supported to attend out-patient appointments; for example one individual in a sexual relationship is supported to attend Sexual Health Clinic to ensure that adequate protection is in place. The home has a communication book which ensures that all staff are made constantly aware of any requirement of an individual. Staff are required to check this on arrival of their shift. There is also a shift handover check list and communication sheet which is completed by the sleep-in staff which gives details of any appointment for the day, any incidents which occur on the night shift and any other details that may be relevant to the next shift. As stated in the Annual Quality Assurance Assessment the care file reviewed had detailed health action plan which enables staff to have good knowledge of the residents health care needs. The health action plan is developed with the input from the resident and or their representative. Records noted in the action plan include weight chart, appointments for dentist, optician and continence nurse and challenging behavior monitoring. On reviewing medication at the home, we noted that there were discrepancies in relation to signing of medication when administered and recording a reason if medication was not administered. Some medication entrieswere hand written but were not signed for. This fails to ensure that the individual is protected from drug error. In addition the manager is required to ensure that any change in dose of a residents medication is signed by the person making the entry to avoid possible error. We have issued a requirement in relation to the above discrepancies to protect the residents. The home has a policy in relation to drug administration. Staff interviewed demonstrated knowledge of how to care for residents with terminal illness and the care files viewed had information in the event of death. The home has a death and dying policy. The manager stated that staff were able to care for the individual that died recently at the home. Care Homes for Adults (18-65 years) Page 19 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are supported and encouraged to complain with the confidence that their views will be listened to and acted upon. Staff have received training and information on how to protect residents. Systems and procedures are in place on how to protect resident sfrom harm and abuse. Evidence: The complaints book showed evidence of five recorded complaints between service users and how the complaints were successfully resolved. Each care file viewed had a complaint procedure in picture format, however it was agreed that the information about the Care Quality Commission be included in the procedure to enable the residents and representatives to contact the Commission if they are not satisfied with services provided at the home or about any complaint to the organisation. While touring the building we noted that each residents bedroom door had a sign making a complaint which describes the complaint process in a clear and easy to understand way. This is also available in Makaton format. The home has a policy and procedure on the Protection of Vulnerable Adults from Abuse. Staff spoken with demonstrated knowledge of how to report suspected abuse and where to access information. Staff records showed that staff have attended training in relation to abuse of residents. Care Homes for Adults (18-65 years) Page 20 of 31 Evidence: The AQAA told us that the home accommodates some individuals who may display behaviors that may be challenging, these varys from verbal aggression, self harm and property damage. The home was noted with policies in relation to dealing with violence and aggression, physical intervention and restraint where appropriate. Staff are provided with training in relation to why people present with challenging behavior and how staff should respond to support them. Social Services raised concerns last year in relation to managing residents monies. While this was resolved with a series of meetings between Social Services and the home, we reviewed all the residents monies at this inspection and noted that they were all correct with appropriate records. Although the monies and valuables were stored in a secured locked cupboard we believe that the monies are still vulnerable. We have made a recommendation for the home to install a safe which is secured to the wall in the cupboard to reduce the risk of theft of residents monies and valuables. Care Homes for Adults (18-65 years) Page 21 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents are provided with a good comfortable environment with suitable equipment. The home ensures that residents are safe and have a clean place to live in. However the shower room on the ground floor needs attention in order to protect the residents. Evidence: Gordena Homes is a large semi-detached Victorian property that is situated in a well established residential area. The road links with Staple Hill and Downend, both areas being within walking distance. Both areas have good public facilities and a regular bus service into Bristol. Communal/shared areas in the home are located on the first and top floors. This home would be only suitable to individuals who are fully ambulant and can use stairs. The kitchen, dining room and one bathroom plus the managers office is situated on the top floor. The middle floor has one lounge, a further three bedrooms and a bathroom. The laundry, shower room and five bedrooms are situated on the ground floor. There is a conservatory, which is available for the smokers of the household. There is a small garden at the rear of the property mainly grassed with surrounding shrubs. Care Homes for Adults (18-65 years) Page 22 of 31 Evidence: The home remains suitable for its stated purpose and was found clean, tidy and free from unpleasant odours. The home was also found to be well maintained and in good decorative order. The corridor, staircase, bathrooms and toilets were fitted with hand and grab rails to assist with residents mobility. We agreed that the home should undertake a generic risk assessment of the the stairs to minimise the risk of falls to residents, staff and visitors. Each resident had a good sizeable room to accommodate their personal belongings. The rooms were found to be well furnished, clean and tidy and decorated to personal taste. The staff sleep in facility viewed was noted to be safe clean and adequate. The kitchen was noted to be clean and tidy; the fridge and freezer temperatures were regularly recorded. In terms of future development the home stated in the AQAA that the lay out of the kitchen needs to be rearranged and can only be completed when planning permission is obtained and the relevant health and safety checks completed. The plan is to move the kitchen downstairs so that the garden can be easily accessed and less mobile resident can use the dining area with ease. To ensure that residents are adequately protected the home has an electronic intercom system with a locking buzzer. There is a sign on the inside of the front door to warn the residents not to open the front door rather to contact a staff member to deal with visitors to the home. The home has a comprehensive policy on Infection Control to ensure that people living in the home, staff and visitors are protected. The laundry area was found clean tidy with good flooring and ventilation. One individual told us that staff help them to do their laundry by themselves. Staff spoken with were aware of safe practices necessary to prevent the spread of infection should it occur. We have issued a requirement in relation to the shower room on the ground floor filled with grime on the edges and the shower head that needs attention. Care Homes for Adults (18-65 years) Page 23 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy good warm relationships with skilled and competent staff and are protected by the Home through appropriate staff recruitment. It ensures that staff are offered regular supervision and identified relevant training courses. Evidence: On the day of the visit there were eight residents and one vacant bed. Review of staff duty rotas evidenced that the home is adequately staffed to meet the assessed needs of the residents living in the home. For example, there were two support staff working from 08am to 1600 and 0900 to 1600 excluding the manager and the registered provider who are at the home from 0900 to 1600 and 10.00 to 1600 respectively. The registered provider stated that both of them are hand on and would always cover for sickness and annual leave. In the afternoon there were two support staff from 1600 to 2200. On night duty there is one support staff on sleep-in duty from 2200pm to 0800. The support staff are provided with an alarm system that is triggered off in an emergency. The home is supported by an administrator and a maintenance person. The home told us in their AQAA that there is a varied staff team with varied abilities, skills and experiences to give to the residents living in the home. Staff have clear understanding Care Homes for Adults (18-65 years) Page 24 of 31 Evidence: of their roles within the team and their personal roles and accountability and responsibilities. One staff member spoken with stated that there is a good communication within the team. Evidence suggests that the last staff meeting was in June 2009 and all staff members attended. Issues discussed included holidays, shopping and rotas. All the residents were also discussed. There was evidence that staff are receiving supervision regularly to enable them to perform their duties effectively and to discuss any areas of difficulties. We noted from the files that each staff member has a supervision contract which confirms that they should be provided with a formal supervision every eight to ten weeks. The AQAA states that supervision is an integral part of staff support and professional development which in turn raises the standard of service delivered to the residents. Staff spoken with confirmed that they have received regular supervision and that this supports them in improving the care given to the residents. The home has a robust recruitment process to ensure that the residents are protected and receive high quality care. The care file of one staff member who recently joined the home showed that information required in Schedule 2 of The Care Homes Regulations 2001, in term of recruitment, were met. To further protect the residents the AQAA states all staff are issued with lanyard photo identification cards, detailing their names and position/job roles within the home to ensure that residents have clarity of staff roles and responsibilities. The AQAA also told us that interviews of new employees are carried out with the assistance of a resident who is invited to sit on the latter part of the interview to gauge the opinion of the person being interviewed and ask questions such as why would you like to work at Gordena Care Homes. The opinion of the of the resident is considered when making a final decision for offer of an appointment. We reviewed staff training and evidence from the staff records suggest that staff have attended training to enable them to perform their duties effectively. Training records suggest that staff have attended training on the Protection of Vulnerable Adults from Abuse, Dementia, Mental Capacity Act, Supporting People who self Harm, Medication, Principles of Person Centred Planning and National Vocational Qualifications. Care Homes for Adults (18-65 years) Page 25 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a competent leader who safeguards the rights and interests of residents and also protects them through the application of policies, procedures and good recording keeping. Evidence: Gordena Care Homes is managed by an experienced and well-qualified home manager Mrs Judith Parker. Mrs Parker has managed the home for the past three years and is well experienced in the care of people with learning difficulties. The registered manager has attained National Vocational Qualification (NVQ) at level 2,3,4 and has completed theRegistered Managers Award. Throughout the inspection the registered provider Sarah Howick was more involved because the present manager is planning to hand over the management of the home to the registered provider who is also her daughter. The registered provider is also well experienced in the care of people with learning difficulties. Both the registered manager and provider have undertaken other courses to maintain their knowledge and obtain their skills and level of competencies to ensure Care Homes for Adults (18-65 years) Page 26 of 31 Evidence: that residents receive the best possible care. Staff spoken with on the day of inspection commented positively on the managers ability in relation to managing a care home for people with learning difficulties. Staff stated that the manager is caring, kind, approachable and will listen and act upon any concerns raised. Residents at the home were able to make send us comments about the manager and were clear that the manager had good positive relationships with the residents as was seen in her interaction with them on the day of inspection. The fire logbook was viewed and was found to be well maintained. Other Health and Safety checks seen included, portable appliance testing certificate (for electrical appliances). The manager stated that the Five Yearly Periodic Inspection of electrical installation will be undertaken and the certificate sent to the Care Quality Commission for verification. The home had a new boiler installed. The records and discussion with the staff members showed that staff have attended regular fire drills. Fire fighting equipment is regularly checked. Staff have received fire training at regular intervals. The liability insurance is in date. Other risk assessments in relation to residents safety were in place. Policies and procedures noted at the home to ensure that the residents are adequately protected include medication policy, manual handling, communication, accidents, health and safety, monies and financial matters and missing persons policy, complaints and whistle blowing. Accidents were recorded in each individual residents file and were, reviewed satisfactorily to enable staff to detect and deal with injuries promptly if and when they occur. It was also noted that guidelines were in place in relation to how to deal with a resident who had behavioural problems and was aggressive towards other residents. Residents money kept at the home was checked and the balance was correct and records were seen to be securely locked away. Recommendation in relation to extra security for the residents monies was discussed under Protection. Care Homes for Adults (18-65 years) Page 27 of 31 Are there any outstanding requirements from the last inspection? Yes £ No R 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, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 28 of 31 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, Care Homes 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 Ensure that the Statement of Purpose consists of the matters listed in Schedule I of The Care Homes Regulations 2001. To provide required information to prospective residents. residents. 10/09/2009 2 20 13 Ensure that all medication administered is signed for and indicate reason if not administered. All hand written medication must be signed and dated. Ensure that any change in the dose of a residents medication is signed by the person making the entry. To eliminate the risk of drug error. 17/08/2009 3 24 23 Ensure that the shower room on the ground floor is kept in a good state of 10/09/2009 Care Homes for Adults (18-65 years) Page 29 of 31 Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes 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 repair. The shower head must be cleaned regularly. To protect the residents. 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 1 23 We have made a recommendation for the home to install a safe which is secured to the wall in the cupboard to reduce the risk of theft of residents monies and valuables. Care Homes for Adults (18-65 years) Page 30 of 31 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. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!