Care Home: St Erme

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What the care home does well The person said they liked where they live, and the accommodation is as they want it. Care planning and risk assessment documentation is generally satisfactory. Staff seem caring towards the person, and understand his needs. A `Best Interest` meeting has been held. The professionals involved concluded that the service met the person`s needs, and to move the person would not be in the person`s interests. This service is primarily designed for people with complex needs. The people living there all have autistic spectrum disorders. They can challenge ordinary services, and therefore need specialist input. The organisation which runs the home employs staff and a psychologist which are trained to work with people with these specialist needs. What the care home could do better: In brief: (1) The full reasons for any restrictions should be documented and regularly reviewed to check these are in line with current best practice. There should be evidence that alternative strategies are regularly explored to minimise restrictive practices. (2) Care plan review documents need to be available for inspection. For one person the last care plan review document that was made available to us was dated September 2009. (3) External review of behavioural modification techniques for individuals should occur (e.g. particularly where people have complex needs, and where restrictions are placed on individuals). In such cases it is essential that local authority representatives attend care planning review meetings. We understand from the provider that representatives are always invited. It is imperative, where there are restrictions in place on the person, the local authority makes every effort to attend such meetings. It is also imperative that the registered persons make every effort to consult with local authorities regarding major decisions about the person, significant changes, and any restrictive practices. (4) There should be clear documented plans to regularly refurbish buildings. The frequency of refurbishments should be higher where damage occurs regularly /there is increased wear and tear. Where furniture, and fixtures and fittings are damaged, the registered persons need to have better systems to ensure these are repaired or replaced. (5) Although staffing levels are satisfactory, they should always be in line with what the provider is contracted to provide. We have written to the chairperson of the adult safeguarding panel with our full reasoning for these requirements and recommendations. This has been copied to the local authority which pays for the person`s care, and to the registered provider. Random inspection report Care homes for adults (18-65 years) Name: Address: St Erme Trispen Truro Cornwall TR4 9BW 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: Ian Wright Date: 3 0 0 3 2 0 1 0 Information about the care home Name of care home: Address: St Erme Trispen Truro Cornwall TR4 9BW 01872263355 Telephone number: Fax number: Email address: Provider web address: Mail@dcact.org Name of registered provider(s): Name of registered manager (if applicable) Miss Siobhan Helen Sinnott Type of registration: Number of places registered: Conditions of registration: Category(ies) : Spectrum care home 20 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 20 St Erme House - up to 10 adults with a Learning Disability (LD) St Michaels - up to 3 adults with a Learning Disability (LD) The Lodge - up to 9 adults with a Learning Disability (LD) Total number of service users not to exceed a maximum of 20 Date of last inspection Brief description of the care home St. Erme is a care home providing accommodation and personal care for up to 20 adults with a learning disability. The registered provider is Spectrum, which manages a number of homes providing care for people with autism. The service comprises of three separate, self-contained units St. Erme House provides accommodation currently for Care Homes for Adults (18-65 years) Page 2 of 10 Brief description of the care home up to five adults. People have their own bedrooms, some of which are en suite and their own lounge. There is also a communal lounge, dining area and kitchen. There is a secure garden. There is a self contained flat, for one person, attached to the house. The Lodge currently accommodates four people. People have their own bedrooms. There are shared bathroom, lounge, dining, and kitchen facilities. There is a garden. St. Michaels can accommodate up to three people. People have their own bedroom, and share lounge, dining, and kitchen and bathroom facilities. One of the people accommodated has their own self-contained flat within the home. There is a separate administrative block on the site. St Erme is set in its own extensive grounds, in the village of Trispen, which is close to the city of Truro. At the time of the last key inspection in November 2009 the fees ranged from £930 per week to £4266. There are variable additional charges to individuals for personal items such as hairdressing, newspapers, confectionery, private chiropody and off-site entertainment. Care Homes for Adults (18-65 years) Page 3 of 10 What we found: We carried out this inspection as part of a safeguarding investigation. The registered persons alerted the local authority as they were concerned that another local authoritywho pays for the care for one person-had terminated the contract and subsequently the person was going to be forced to move back to the local authority area, where they had not lived for a number of years. The registered persons said they did not think there was satisfactory consultation with the person themselves, and to move the person would be detrimental to the person. The local authority which pays for the persons care subsequently raised concerns about the care provided to the person. They said they have assessed the care the person is provided with and think it is unsatisfactory. We decided to carry out an inspection to look at the allegations made. We were concerned that if the allegations were correct, the person may be receiving poor care, and also others living at the service may also be receiving an unsatisfactory service. The allegations made are: (1) The service received is very risk averse- this creates a culture where the person cannot develop or experience new opportunities due to the perceived risks the person presents. (2) The accommodation provided is not satisfactory. (3) Staffing levels are not satisfactory, and actual staffing provided is not what the service is contracted to provide. The person is left for hours without support. (4) Food and clothing is locked away and not accessible to the person. Within this report we are not going to provide a detailed response to these concerns as they are in relation to one person, and this is a public document. We have written separately to the relevant parties involved in the Safeguarding investigation regarding these issues. This report will provide an overview of our findings. What the care home does well: What they could do better: Care Homes for Adults (18-65 years) Page 4 of 10 In brief: (1) The full reasons for any restrictions should be documented and regularly reviewed to check these are in line with current best practice. There should be evidence that alternative strategies are regularly explored to minimise restrictive practices. (2) Care plan review documents need to be available for inspection. For one person the last care plan review document that was made available to us was dated September 2009. (3) External review of behavioural modification techniques for individuals should occur (e.g. particularly where people have complex needs, and where restrictions are placed on individuals). In such cases it is essential that local authority representatives attend care planning review meetings. We understand from the provider that representatives are always invited. It is imperative, where there are restrictions in place on the person, the local authority makes every effort to attend such meetings. It is also imperative that the registered persons make every effort to consult with local authorities regarding major decisions about the person, significant changes, and any restrictive practices. (4) There should be clear documented plans to regularly refurbish buildings. The frequency of refurbishments should be higher where damage occurs regularly /there is increased wear and tear. Where furniture, and fixtures and fittings are damaged, the registered persons need to have better systems to ensure these are repaired or replaced. (5) Although staffing levels are satisfactory, they should always be in line with what the provider is contracted to provide. We have written to the chairperson of the adult safeguarding panel with our full reasoning for these requirements and recommendations. This has been copied to the local authority which pays for the persons care, and to the registered provider. 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 5 of 10 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 7 13 The registered persons need 01/01/2010 to ensure monies belonging to people using the service are managed to a satisfactory standard, and suitable records are kept. People using the service will subsequently be more assured that their monies are managed to a satisfactory standard. Improve records regarding when people using the service see medical practitioners such as a GP, dentist, optician, chiropodist etc. This will help to ensure there is a record of when a person last saw the relevant medical practitioner; and assist staff to monitor peoples health needs so the person concerned sees relevant practioners at regular intervals. 01/01/2010 2 19 12 3 35 18 All staff must receive training 01/04/2010 according to the law, and the needs of the people using the service (for example as outlined in the Staffing section of the report.) This will ensure that people using Page 6 of 10 Care Homes for Adults (18-65 years) 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 the service and their representatives can be assured that staff have suitable skills and knowledge to meet the needs of people using this service. 4 38 13 The registered persons must 01/02/2010 ensure there are satisfactory health and safety precautions at the service. For example there is evidence gas and oil fuelled appliances and /or heating has been serviced. Copies of relevant certificates need to be forwarded to the Commission. (Previous timescale of 01/03/2009 only partly met Second Notification). Matters listed under this 01/01/2010 regulation, such as injuries or untoward incidents, must be reported to the commission without delay. This will ensure that the commission is made aware of any matters, required by law, regarding any incidents adversely affecting people using the service. 5 41 37 Care Homes for Adults (18-65 years) Page 7 of 10 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 9 13 Care Plans and risk 01/05/2010 assessments must accurately reflect agreed practices This will ensure there is a clear record regarding agreed staff practices and any restrictions are clearly documented with a clear rationale why they are in place. 2 19 23 The care home needs to be 01/05/2010 kept in a good state of repair externally and internally. Maintenance and refurbishment plans should be recorded. Repairs to the building and fixtures and fittings, especially where there is higher levels of wear and tear should be carried out promptly. This will ensure people using the service live in a more homely environment Care Homes for Adults (18-65 years) Page 8 of 10 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 6 External professionals are more involved in drawing up, and reviewing any behavioural modification techniques that are in place for individual people using the service Except in emergencies, staffing levels should be maintained for individual service users at levels agreed with the sponsoring local authority. 2 33 Care Homes for Adults (18-65 years) Page 9 of 10 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. Care Homes for Adults (18-65 years) Page 10 of 10 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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