Care Home: Gypsy Corner

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What the care home does well The service has a motivated and established staff team that are provide good quality care and support. The home has well equipped facilities such as overhead tracking and specialist bathrooms. The home has a good care planning system in place which is person centered and ensures that needs are regularly reviewed. What has improved since the last inspection? The home have extended the communal area by building a conservatory onto the lounge area which provides additional space for activities. The home has registered its manager and provided good supervision and support for staff. What the care home could do better: There are limitations placed upon the service users in terms of accessing the kitchen and laundry areas. These are both very small and not suitable for either wheelchair users or for instructing and supporting people to develop independence skills. Greater privacy could be provided in the bathrooms with the provision of blinds or curtains and accessing the garden from the individual bedrooms could be made easier if there was not a step down from the doors. The quality assurance system could be better implemented to provide clearer feedback about the service to the manager and the staff team. Key inspection report Care homes for adults (18-65 years) Name: Address: Gypsy Corner Badgeworth Lane Badgeworth Cheltenham Gloucester GL51 4UH     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: Simon Massey     Date: 1 0 1 2 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 24 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 24 Information about the care home Name of care home: Address: Gypsy Corner Badgeworth Lane Badgeworth Cheltenham Gloucester GL51 4UH 01242861375 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): gypsy@kentwoodsupport.com Lifeways Community Care (Gloucester) Ltd Name of registered manager (if applicable) Mrs Donna Wright Type of registration: Number of places registered: care home 5 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 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 category: Learning Disability (Code LD) Date of last inspection Brief description of the care home Gypsy Corner is a registered home for adults with Learning Disabilities that has also been equipped to meet the needs of physical disibilities. All the bedrooms have ensuite facilities and also external doors to the garden. The bedrooms are equipped with overhead tracking systems and specialised beds and the ensuite bathrooms contain appropriate bathing facilities. There is also an additional bathroom for communal use that has specialised adaptations in place. All accommodation is arranged on one level, Care Homes for Adults (18-65 years) Page 4 of 24 Over 65 0 5 3 0 0 1 2 0 0 9 Brief description of the care home the home being a converted residential bungalow. The home is close to local amenities and is a short drive from the town centre of Cheltenham. The Registered Provider is Kentwood Care, which is owned and run by Lifeways Community care. Care Homes for Adults (18-65 years) Page 5 of 24 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 inspection took place on 10/12/09 and lasted for approximately 6 hours. The Inspector met with care staff and the registered manager and also observed staff working with the two people living in the home. A number of surveys were circulated prior to this visit and the majority of these were returned to the Commission. Records relating to care planning, staff training and recruitment, health and safety and medication administration and storage were examined. An inspection of the environment was also carried out. Care Homes for Adults (18-65 years) Page 6 of 24 What the care home does well: What has improved since the last inspection? 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 7 of 24 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 8 of 24 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The admission procedure ensures that peoples needs and aspirations are assessed prior to prospective residents moving into the home The Statement of Purpose provides accurate and accessible information to service users and prospective admissions to the home. Evidence: The home has had no new admissions since the last inspection. There is an admissions policy that complies with the regulations and the manager explained how people had been shown around the home and supplied with information about the service that was offered and the facilities available. The service has made the changes to its Statement of Purpose that were required following the last inspection. Care Homes for Adults (18-65 years) Page 9 of 24 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. Detailed care plans ensure that the service users needs are documented and guidance is available to staff. The home takes action to encourage service users to make choices and supports them to take appropriate risks. Evidence: Both the current people living in the home had detailed care plans in place that had been appropriately reviewed and updated where necessary. Due to the needs of the people they have limited input into their care plans but staff gave examples how they support people to make choices over everyday routines as far as possible. The plans give information to staff about preferences and routines. Feedback from relatives and outosde professional was positive about the quality of personal care and support that is delivered by the staff. Activities and care routines have been correctly risk assessed and reviewed at appropriate intervals. Care Homes for Adults (18-65 years) Page 10 of 24 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. The home support people to have a lifestyle that meets their needs and encourage choice as far as peoples abilities allow. Evidence: The people living in the home have weekly routines which combine attending a day centre and activities that are run in the home. This includes craft work, watching videos and television and listening to music. People are also taken out into the community. People are also supported to enjoy time in their rooms which are personalized and comfortable. Due to individual abilities and the limited size of the kitchen people living in the home have no involvement in food preparation but are supported to make choices over meals, and staff demonstrated their understanding of the individual preferences. Some food preparation is undertaken in the living/dining room room so that people Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: living in the home can be more involved. The menus show that a healthy diet is promoted. The kitchen was well stocked with fresh and packaged produce and all items were correctly stored and labeled. Care Homes for Adults (18-65 years) Page 12 of 24 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. People living in the home have their personal care needs met and guidance and practice ensure they are treated with dignity and respect. Evidence: The care plans provide guidance for staff on the delivery of personal care and support and the home is equipped with specialized baths, hoists and beds to ensure that needs can be met. Feedback from surveys was positive about the personal care provided. People who live in the home have specialist input where required and guidance from this input is clearly recorded. All medical appointments are recorded and the records showed that people have regular checkups and that there health needs are closely monitored by the staff. All staff must undertake accredited medication training before they can administer medication to the people living in the home. An examination of the medication storage and recording was undertaken and found to be order. There was evidence that medication is correctly reviewed and any change clearly recorded. A full medication Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: audit is undertaken every month. Care Homes for Adults (18-65 years) Page 14 of 24 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. Staff training and regular contact with the community and families help promote a safe environment in which people are protected and treated with respect. Evidence: The home has a complaints procedure in place that complies with the regulations and there have been no complaints made since the last inspection. The home has kept a record of a number of compliments it has received from outside agencies and relatives with regards to the care and support the staff have provided. Due to the needs of the present people living in the home it would be difficult for them to communicate a concern or make a complaint individually, but both are visited regularly by their families and also attend a day centre every week. Staff were aware of how to make a complaint or raise a concern and all had also undertaken training in safeguarding and adult protection. Care Homes for Adults (18-65 years) Page 15 of 24 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a home that is well maintained and decorated throughout and provides a comfortable homely environment. Limitations on the access to the kitchen and laundry areas affect the involvement in daily living skills. Service users are supported and encouraged to personalize their living space. Evidence: The home is a converted bungalow which has been equipped to a high standard to meet the needs of people with learning disabilities who also have physical disabilities. All bedrooms have overhead tracking lifting systems with en-suite facilities. There are also additional bathrooms which have specialized bathing equipment. Generally the home has been fitted and decorated to a high standard, but as mentioned at the last inspection, there are some limitations to the design and layout of the home. The kitchen is very small and is inaccessible to wheelchair users, as is the laundry area which is adjacent to the kitchen. Following a requirement made after the last inspection these limitations have now been accurately reflected in the homes Statement of Purpose. The bathrooms are well equipped but whilst there is frosted glass in place none of the bathrooms have blinds or curtains in place to promote privacy. Whilst each bedroom has an outside door which accesses the garden area, there is a step down from these Care Homes for Adults (18-65 years) Page 16 of 24 Evidence: doors which is not ideal for wheelchair users. The service has had an additional conservatory area built onto the living/ding room area which has greatly improved the communal space, and this room also provides easier access to the garden with a level exit having been installed. The previous inspection report recommended that the Provider considers how it can address some of the issues outlined and this is repeated in this report. The kitchen and laundry areas are not suitable for the supervision of anyone learning independence skills due to the size and the layout. The home was well maintained and clean and hygienic throughout at the time of this inspection. Care Homes for Adults (18-65 years) Page 17 of 24 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. Service user needs are met by a motivated and effective staff team who are provided with regular training, which helps ensure they have the necessary skills and knowledge to meet the needs of the service users. Evidence: There are currently two people living in the home and the staffing levels are sufficient to meet the needs of these people. Staff on duty were observed interacting appropriately with the people living in the home and supporting them to undertake craft activities on the day of the inspection. Staff spoken to and feedback from surveys confirmed that staff thought they worked well as a team and were supportive of one another. People also said they felt supported by the manager of the home and understood the philosophy of care and support that was being followed in the service. Staff records were examined and these contained the majority of information relating to the required checks and information. Some information on some recently recruited staff was still in the main office. However this system was checked when an Inspection was completed of another home run by the same Provider and was found to be effective and in order. There has been little staff turnover in the last twelve months and all staff are up to Care Homes for Adults (18-65 years) Page 18 of 24 Evidence: date with the required statutory training such as first aid, food hygiene and moving and handling. The majority of staff have completed NVQ to at least NVQ level 2 and also undertaken additional training in safeguarding and the administration of medicines. Staff undertake Equality and Diversity training during their induction. The Provider has recently appointed an external organization to oversee some of the training including the induction training. The manager thought this was a positive development. Staff have been receiving regular formal supervision and there have been regular staff meetings, with are well attended and minuted. Care Homes for Adults (18-65 years) Page 19 of 24 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. People living in the home and staff working there benefit from effective management and leadership Evidence: The home has been provided with leadership and direction by the Registered Manager and feedback from surveys, and interviews with staff, stated the manager was approachable and supportive. The home is well organized and efficiently and effectively managed with good systems in place and evidence of good record keeping being undertaken. The line manager for the service is on extended leave and the service has only been visited once in their absence by the person covering this post. Also it appeared that some regulation 26 inspections were being done by other registered managers from within the same organization. One of these had been completed by a manager who was not registered and was in an acting position. In the view of the Commission this this was inappropriate and more effective and consistent support should have been provided. Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: The home reported it had supplied information to the Provider organization as part of a quality assurance process but was yet to receive any feedback on this data. The manager has completed training on the Mental Capacity Act and the Deprivation of Liberty Act. All equipment and essential maintenance had been completed and recorded and fire safety testing had been undertaken and completed. Care Homes for Adults (18-65 years) Page 21 of 24 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 22 of 24 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 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 24 The home should consider how it can address the shortcomings outlined in the report with regards to the environment. Care Homes for Adults (18-65 years) Page 23 of 24 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 24 of 24 - 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!