Care Home: St Teath Site

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What the care home does well The registered manager is assisting the parent organisation at another service, but under normal circumstances would be in day-to-day charge at St Teath. The home has a stable management and staff team that provides continuity and security for the people that live there. There are regular reviews of care involving other professionals, and the home enables people living there to see their relatives regularly. Residents have an active lifestyle and are engaged in regular activities. What has improved since the last inspection? The registered manager and staff have continued to work with other agencies to improve the quality of life for individual residents and for the group as a whole. What the care home could do better: Home Farm Trust could do more to ensure that all required records are available for inspection, and need to consider future arrangements if the registered manager is not available at the inspection. CARE HOME ADULTS 18-65 St Teath Site Trehannick Road St Teath Bodmin Cornwall PL30 3LQ Lead Inspector Alan Pitts Unannounced Inspection 1st April 2008 08:15 St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service St Teath Site Address Trehannick Road St Teath Bodmin Cornwall PL30 3LQ 01208 851462 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.hft.org.uk Home Farm Trust Mrs Christine Arlette Tucker Care Home 10 Category(ies) of Learning disability (10) registration, with number of places St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 5 adults aged 18 - 64 with a Learning Disability (LD) to be accommodated in Valley View. Service users to include up to 5 adults aged 18 - 64 with a Learning Disability (LD) to be accommodated in Rendle House.. Total number of service users not to exceed a maximum of 10 Date of last inspection 24th July 2006 Brief Description of the Service: The Home Farm Trust are registered to provide accommodation and personal care for a maximum of 10 adults with learning disability, in the age range of 18 to 64 years. Service users have complex needs falling within the Autistic Spectrum. The St.Teath Site comprises of two buildings, each providing the full range of services for 5 service users. The original Valley View home remains but has been refurbished to provide less accommodation with improved facilities and Rendle House is a purpose built home. The homes are close together on a safe, enclosed site with extensive views of the surrounding countryside. The 8 acre site is situated on the outskirts of the village of St. Teath, which provides community facilities. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out over a period of approximately 5 hours on 1st April 2008. The registered manager was not available for the inspection. We looked at records, toured the premises, and met with staff and residents. We also took into account comments made by residents and relatives in Commission for Social Care Inspection quality assurance surveys. Overall, this is an established home with a stable, skilled staff team. All the residents have lived at the home for a number of years and enjoy settled relationships with staff and each other. The home is clearly managed with the residents’ best interests at heart. What the service does well: What has improved since the last inspection? What they could do better: Home Farm Trust could do more to ensure that all required records are available for inspection, and need to consider future arrangements if the registered manager is not available at the inspection. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home has a statement of purpose and service users guide that provides information about the home in an appropriate format. A thorough assessment is carried out for all prospective residents. EVIDENCE: There is a Statement of Purpose and Service User Guide in appropriate formats available and provided to residents or their families. There have not been any admissions since the previous inspection, though Home Farm Trust are fully aware of the need for a comprehensive assessment of care needs and capabilities of potential residents prior to admission. Residents’ comments confirm that they had the opportunity to meet staff, visit the home and their room before moving in. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of residents, who are involved to the best of their capabilities in decision-making and self-determination. EVIDENCE: The staff demonstrated a detailed understanding of the complex range of needs that are presented by residents and the records inspected detailed how the relevant support is provided. The plans of care involved health care issues residents’ aims and aspirations in educational or social interactions. The residents have key staff to assist them in creating ‘Who am I’ information, attend reviews of care, and the monitoring and updating of their care plan. Care needs are the subject of annual multi-disciplinary review, but the care records inspected show that the home do not review the care plans in the intervening period. Appropriate daily records are kept. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 10 The staff were able to describe a number of everyday situations where residents would be assisted to make informed choices, and the care records also show that residents participate in decision making. Risk assessments are completed for various aspects of residents needs, capabilities, and activities. Community, leisure and holiday activities are supported. A new computerised care documentation system (SPARS) is due to be introduced in 2008. The system is backed-up, and protected by antivirus software. The system is also password protected, allowing different levels of access according to responsibilities. This system is yet to be fully implemented. Computer training is currently being rolled out to staff. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A range of social and recreational opportunity is provided in keeping with known preferences and capabilities. Residents engage with the local community, and all have appropriate contact with people important to them. Residents’ rights and capacity as adults is recognised. A balanced diet is provided. EVIDENCE: The residents, relatives, staff, and care records confirm that residents are involved in a range of appropriate leisure activities and maintain contact with people important to them. The residents attend a variety of activities that are clearly aimed at the enjoyment of the resident or meeting their individual goals. The residents access a range of community activities such as swimming, horse riding, walking, sensory room, and hydrotherapy. Most of the residents have very frequent contact with family members. Social/recreational activities and work opportunities are recorded in individual plans and the Home Farm St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 12 Trust provides a specifically appointed staff member to coordinate these activities. Menus evidence a good choice of meals. The record of food provided shows that alternative meals are provided when it is perceived that a resident does not want the main option. The staff said that all the residents have some capacity to express choice. Nutritional needs and weight are monitored. All staff have a responsibility for meal preparation and have undertaken relevant training. The kitchen in the two units is domestic, well equipped, and clean. The adjacent dining areas are clean, bright and pleasant. Comments from residents confirm that there is a variety of activities available and that they can choose whether or not to participate. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The personal and health care needs of residents are met with evidence of promoting privacy, dignity and good multi-disciplinary working taking place. EVIDENCE: The care records, and discussion with the staff show that the residents’ waking day is flexible, within the parameters of their care plan. Residents are encouraged, or assisted where necessary, to make meaningful choices (e.g. clothes, room décor). The staff ensure that the residents receive health care services as required, and in accordance with the residents’ known preferences. The home maintains good links with other health care professionals. Residents are registered with General Practitioners at a local surgery. The key worker role is responsible for ensuring that the identified needs of residents are monitored and that services, equipment and support is provided as required. Residents do not currently self-medicate. Residents are assisted with their medication needs. The medication records, procedures and storage facilities St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 14 are appropriately maintained. Medicines were observed to be administered properly, the medicines being securely stored afterwards. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents were seen to interact with staff in a relaxed manner. Support staff have a clear understanding of ‘Adult Protection’ issues and procedures that will protect residents from abuse. EVIDENCE: The staff spoken with understood the appropriate procedures to report issues of concern regarding residents’ welfare. In-house training is provided for staff and the Home Farm Trust have appropriate policy and procedures to support senior staff. There is a complaints policy and procedure that is made available to residents and their families. Staff said that the complaints procedure is normally displayed, but this could not be found on the day of the inspection. The staff working at the home will also make ‘complaints’ as advocates for the residents on issues considered to be affecting the quality of life and safety issues for others living at the home. Advice regarding various forms of potential abusive situations and reporting procedures are available to staff and are raised during induction, training and staff meetings. The adult protection policy refers to ‘No Secrets‘ and the need to refer concerns to the Department for Adult Social Care. The parent organisation, Home Farm Trust, is fully aware of the requirements in respect of adult protection. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable, and safe environment that is suited to its stated purpose. EVIDENCE: The St Teath site consists of 2 separate houses in close proximity, each providing care and accommodation for 5 residents. Rendle House is a purpose built facility providing 3 bedrooms on the ground floor and 2 bedrooms on the first floor. The bedrooms, communal lounge areas, kitchen/dining, bathroom and w/c facilities are designed to provide a quality specification meeting the requirements of various agencies and providing a homely, spacious and comfortable home. Valley view has been refurbished to provide a large conservatory incorporating a new dining room and kitchen, bedroom, shower, bathroom and w/c facility. Bedroom accommodation is provided on the ground and first floors, appropriate communal space, bathroom and w/c facilities are provided. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 17 All the residents are provided with single rooms that are individually decorated and furnished with personal possessions and belongings. An appropriate range of furniture and fittings is provided to meet residents’ needs. The environment was clean, warm and organised to provide for the welfare of residents. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Quality in this outcome area is good. This judgement has been made using evidence from the last inspection of this service. The Home Farm Trust is providing competent support staff, in appropriate numbers to provide for the welfare of residents. EVIDENCE: Staff generally work the same shifts and this is reflected in the printed ‘draft’ duty rota. There is a current duty rota: the entries are made in pencil; the rota does not show staff surnames; the rota does not provide a key to the symbols used (e.g. *=sleep-in); the rota does not distinguish between staff cover for the two units on the site. On the day of the inspection there were 8 staff on duty. Staffing is organised to respond to peak times of activity, group living situations and individual needs. Previous inspections and the home’s Annual Quality Assurance Assessment show the Home Farm Trust has a commitment to providing a trained workforce at NVQ level 2 in care or above. Staff are provided with a range of training opportunities. Staff training records were not available at this inspection, as St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 19 the staff did not have access to the locked cupboard in the registered manager’s absence. Previous inspections and the home’s Annual Quality Assurance Assessment show that appropriate recruitment procedures exist and CRB checks and references are obtained for all staff. Staff confirmed that they are provided with job descriptions and induction training. Personnel records were not available at this inspection, as the staff did not have access to the locked cupboard in the registered manager’s absence. The home’s Annual Quality Assurance Assessment and previous inspections show that the registered manager and senior staff provide staff supervision at the required frequency. Supervision skills’ training has been provided to the senior staff to assist in this process. Supervision records were not available at this inspection, as the staff did not have access to the locked cupboard in the registered manager’s absence. Whilst the inspector does not have any concerns about Home Farm Trust’s adherence to regulations in respect of the above records that were not available for inspection, the organisation does need to consider how best to make required records available at inspection. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The registered persons are delivering appropriate services to provide for the welfare of service users. EVIDENCE: The registered manager has over 14 years in a management position with the Home Farm Trust and has consistently complied with the standards and regulations. The registered manager has achieved the Registered Managers Award. The registered manager was not available at this inspection. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 21 The home provides opportunities to receive feedback on the running of the home through external management reviews, staff consultation groups, supervision, grievance and complaints procedures, staff and residents’ meetings and the key worker role. Staff have a number of communication strategies to involve esidents with complex needs. Staff and the home’s Annual Quality Assurance Assessment confirmed that appropriate induction and training opportunities are provided in first aid, fire precautions, food/hygiene and moving and handling, though these records were not available at the time of the inspection. Four quality assurance questionnaires (distributed prior to this inspection) were returned completed by staff members on behalf of the residents, and whilst this is understandable a more valid return might have been achieved by family members answering the questions. Previous inspections show that risk assessments regarding the vehicles, security of the buildings and the site are completed and regular maintenance of the homes equipment and facilities are organised though these records were not available at the time of the inspection. Comments from staff confirm that the service is a pleasant, supportive, safe place to work in and that residents receive the care they need. Home Farm Trust are requested to forward copies of the most recent gas safety certificate and electrical system check. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA32 YA34 YA35 YA39 YA42 Regulation 17(3) Requirement The registered manager must ensure that records are available at all times for inspection. Timescale for action 01/05/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA33 Good Practice Recommendations The registered manager should ensure that care plans are reviewed at least 6-monthly in addition to the annual review. The registered manager should amend the duty rota so that it accurately shows the staff on duty at any given time, role or capacity, and so that it provides a historically accurate record. St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI St Teath Site DS0000009240.V361894.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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