Care Home: Trelawney

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 staff, registered manager, and Home Farm Trust have supported residents and each other well over a difficult period. Staff have continued to promote and expand opportunities for the residents, and since the last inspection have made progress with other professionals in meeting the health care needs of one of the residents. There are regular reviews of care and the home enables people living there to see their relatives or representatives regularly. The home has a trained and stable staff team that provides continuity and security for residents. Residents have an active lifestyle and are engaged in regular activities. The service puts the needs and best interests of the residents first. What has improved since the last inspection? The parent organisation, Home Farm Trust, have now purchased the rear garden from the local authority and there are plans to extend the home and improve the garden for the benefit of the residents. What the care home could do better: The home can do more to demonstrate that they adhere to a robust employment procedure in order to protect the people living at Trelawney. It is disappointing to note that this area has not improved since the last inspection. CARE HOME ADULTS 18-65 Trelawney 34 Brookside St Austell Cornwall PL25 4HL Lead Inspector Alan Pitts Unannounced Inspection 7th July 2008 09:30 Trelawney DS0000042698.V366530.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 Trelawney DS0000042698.V366530.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. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Trelawney Address 34 Brookside St Austell Cornwall PL25 4HL 01726 69735 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 Elizabeth Anne Scott Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home providing personal care only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability- Code LD- maximum of 6 places The maximum number of service users who can be accommodated is 6. Date of last inspection 8th January 2008 Brief Description of the Service: Trelawney is registered to provide accommodation and personal care for 6 adults with a learning disability. Home Farm Trust are providing a domestic style home and those currently living at Trelawney have been resident for a number of years. Each service user has their own bedroom and use of the communal lounge and family style kitchen. There is a small garden to the rear of the property, which overlooks the adjacent primary school. Trelawney is conveniently placed to allow the service users to participate in local activities, education opportunities and day care. The home has a mini bus for the range of activities and outings that are provided. Parking is available in the grounds of the home for staff and visitors. Home Farm Trust fees range from £213.25 to £1026.26 per week. Trelawney DS0000042698.V366530.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 was an unannounced inspection, which took place over approximately 4.5 hours. The inspector met with two residents, staff, and the registered manager. The inspection included a tour of the premises, discussion, and examination of relevant records. The previous inspection took place in January 2008. This inspection was brought forward from the scheduled plan in response to an unforeseen event that affected the health and welfare of one of the residents. The focus of this inspection was to ensure that the care plans met requirements and covered all aspects of residents care needs. Overall, this is an established home with a stable, skilled staff team. All the residents have lived at the home for approximately 15 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? The parent organisation, Home Farm Trust, have now purchased the rear garden from the local authority and there are plans to extend the home and improve the garden for the benefit of the residents. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 6 What they could do better: 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. Trelawney DS0000042698.V366530.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 Trelawney DS0000042698.V366530.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: The statement of purpose and service users guide has been completed. The home makes use of a variety of appropriate communication tools to assist residents. The registered manager and staff maintain good links with the families of residents. There have not been any new admissions since the last inspection. The registered manager is aware of the need for assessments of prospective residents prior to admission, and the existing residents were fully assessed prior to admission. Trelawney DS0000042698.V366530.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, 8, 9 - Quality in this outcome area is excellent. 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 registered manager 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. Appropriate daily records are kept. The registered manager and staff liaise with other professionals to ensure the rights of the residents are safeguarded, and their right to self-determination is not compromised. Confidentiality precludes any further detail, but the Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 10 registered manager and care records described the lengths undertaken recently to ensure the health care needs and rights of one resident were met. Risk assessments are completed for various aspects of residents’ needs, capabilities, and activities. Trelawney DS0000042698.V366530.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): 11, 12, 13, 14, 15, 16, 17 - Quality in this outcome area is excellent. 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, registered manager, and care records confirm that residents are involved in a range of appropriate leisure activities and maintain contact with people important to them. The care plans are informative of ongoing discussion and development in respect of individual goal planning. The registered manager and staff recognise the residents’ right to determine their own waking day within the parameters of meeting their health care needs. Residents are able to choose when to be alone or in company, and when not to join an activity. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 12 The residents attend a range of resources such as swimming, walking, pub meals and trips to places of interest. Some of the residents have college placements. Contact with family members is encouraged and assisted where necessary. Social/recreational activities and work opportunities are recorded in individual plans and the Home Farm Trust provides appropriate staff to support these activities. Two residents have had recent holidays. Staff supported one resident in taking a holiday on their own and participating in activities they chose. One resident re-established contact with family members whilst on holiday. Menus were not inspected at this time, but at the last inspection they evidenced a good choice of evening meals, most residents being out on activities during the day, Monday to Friday. All staff have a responsibility for meal preparation and have undertaken relevant training. The weekly menu is determined with input from the residents. The kitchen is domestic, well equipped and clean. Trelawney DS0000042698.V366530.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, 21 - 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 registered manager and staff show that the residents’ waking day is flexible, within the parameters of their care plan. Evidence of this was also directly observed at the time of the inspection. Residents are encouraged, or assisted where necessary, to make meaningful choices (e.g. clothes, room décor, health decisions). The registered manager and support staff ensure that the residents receive health care services as required, and in accordance with the residents’ known preferences. The registered manager and staff have gone to lengths to ensure that residents’ health care needs are met in the best way for the resident, including specialist support from other health care professionals. Residents are registered with General Practitioners at the local Practice. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 14 One observation for note by the registered manager is that the home is still using two systems (computer records (SPARS) and paper files) and this can mean that some information is in one system and not the other, and is not readily accessible. As discussed, the home should complete the transfer to one system only. Also, and possibly hindered by the use of two recording systems, recent changes in the physical care needs of one resident were not reflected in the care plan. Residents do not currently self-medicate. Residents are assisted with their medication needs and the registered person maintains records regarding the ordering and administration of prescribed medication. The medication records, procedures and storage facilities are appropriately maintained. Medicine Administration Records were not inspected at this time, but were seen to be in order at the last inspection. Medicines were observed to be administered appropriately to one resident. The registered manager and staff have ensured that residents and family wishes are handled with respect and as the individual would wish. Trelawney DS0000042698.V366530.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 registered manager understands 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. The homes’ policy and residents charter includes the complaints procedure and this is presented in a relevant format for residents and for those acting on their behalf. How to make a complaint or express a concern is discussed with residents and the home has effectively dealt with one internal complaint. The Commission for Social Care Inspection has not received any complaints since the last inspection. Advice regarding various forms of potential abusive situations and procedure are available to staff and are raised during induction training. The home and Home Farm Trust have cooperated fully in the past with safeguarding investigations, and are fully aware of the need for prompt reporting of any concerns. Trelawney DS0000042698.V366530.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. Quality in this outcome area is good. The Home Farm Trust continues to develop the environmental standards. The overall quality of furnishings and fittings is good and residents live in a safe, clean, and homely environment. EVIDENCE: An extension has been completed that provides a staff sleeping in room and office space. The registered manager discussed further plans to extend the ground floor area to provide additional communal space in conjunction with a small landscaped garden now that Home Farm Trust have purchased the land from the local authority. The furnishings and fittings are of good quality and residents live in a comfortable and homely environment. The home is in keeping with the local community and offers the people that live there access to local amenities. Toilets and bathrooms are provided in sufficient numbers and offer privacy to the residents. The kitchen is modern and clean. The home is maintained appropriately and residents’ rooms are individually decorated and personalised with various equipment and belongings. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 17 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, 34, 35 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home Farm Trust is providing skilled and experienced support staff to provide for the welfare of residents. Records did not show that the registered provider is adhering to a robust employment procedure. EVIDENCE: A stable staff team ensures continuity and a consistent approach to care, and though two staff have recently left these are to be replaced by three new staff as additional hours have been allocated to one client. Also new activities have been identified for one resident and staff will be made available to support the resident in these. The registered manager is undertaking the NVQ Level 4 in care training later this year, having already achieved the Registered Managers Award. The ratio of NVQ trained staff to non- trained was in excess of 50 at the last inspection in January 2008. There is never less than a 2:6 staff to resident ratio during the waking day, and this will increase as needs or activities dictate. There is provision for 1:1 staffing for one resident during specific hours. There is 1 sleep-in staff member Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 18 available on the premises at night. The residents generally have little in the way of nocturnal care support needs. The staff on duty were observed to exhibit appropriate skills and attitudes in their interactions with residents, and one resident at home at the time of the inspection clearly made choices in respect of the structure of their day. The inspector asked to see the personnel file of the staff member most recently employed at the home. The personnel file at the home did not provide the information necessary to demonstrate adherence to a robust employment procedure. This is of concern as this was a requirement at the previous inspection and in order for the Commission for Social Care Inspection to have continued confidence in the registered provider this requirement must be rectified. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 19 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 Home Farm Trust continues to provide for the safety and welfare of residents. Trelawney has a registered manager to provide for the welfare of residents with a stable and consistent approach. EVIDENCE: The registered manager has completed the Registered Managers Award and has worked at the home for approximately 18 months. The registered manager is going to commence further training later this year (NVQ Level 4 in care). There are clear staff responsibilities and hierarchy both within the home and HFT. The registered manager showed a commitment to resident focused care and lifestyle. There are internal quality assurance tools, such as team meetings, house meetings, and Home Farm Trust audits, and residents are consulted as part of Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 20 everyday normal practice. Quality assurance was not inspected at this time, but this will be followed up at the next inspection as a recommendation was made in January 2008 in this respect. A senior manager supports the registered manager and completes a monthly report on the conduct of the home. The Home Farm Trust provides other administrative and financial support functions to the registered manager, though in view of the requirement on Standard 34 it is perhaps pertinent to mention that responsibilities must be clear to ensure that essential checks are carried out. This will be followed up at the next inspection. Relevant maintenance and safety records are kept (e.g. fire equipment, insurance). Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 21 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 X 34 1 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 3 4 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 4 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 4 3 4 3 X 3 X X 3 X Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 22 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 YA34 Regulation 17 Requirement The registered manager must ensure that records required to be kept are available for inspection. In this instance records that demonstrate compliance with a robust employment procedure. This requirement was made at the previous inspection. Timescale for action 01/08/08 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. Refer to Standard YA18 Good Practice Recommendations The registered manager should ensure that the care documentation is promptly updated to reflect changes in care needs. Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 23 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 Trelawney DS0000042698.V366530.R01.S.doc Version 5.2 Page 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!