Inspection on 14/06/10 for Country Home Care

This is the latest available inspection report for this service, carried out on 14th June 2010.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Country Home Care 25/01/06

Country Home Care 30/09/05

Country Home Care 18/08/04

Country Home Care 26/04/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Random inspection report Care homes for adults (18-65 years) Name: Address: Country Home Care Brook Lane 2 Sedgebrook Cottage Plaxtol Sevenoaks Kent TN15 0QU three star excellent 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: Helen Martin Date: 1 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Country Home Care Brook Lane 2 Sedgebrook Cottage Plaxtol Sevenoaks Kent TN15 0QU 01732810821 Telephone number: Fax number: Email address: Provider web address: thepells@plaxtolkent15.freeserve.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Brian Pell Ms Lesley Pell Type of registration: Number of places registered: Conditions of registration: Category(ies) : Ms Lesley Pell,Mr Brian Pell care home 5 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 0 The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD). Date of last inspection Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home Country Home Care is a care home registered to provide personal care and accommodation for up to five younger adults, it is owned and run by Mr and Mrs Pell. The owners have many years of experience in caring for people with learning disabilities. Country Home Care is located on the outskirts of the rural village of Plaxtol. There is a post office, pub and a church in the village. The towns of Sevenoaks, Tonbridge and Maidstone are a short drive away, where there are all the usual facilities. The home is a semi detached two storey building that has been extended. All the bedrooms are single, two are upstairs and three are on the ground floor. Two of the bedrooms have an en suite bathroom and one bedroom has a shower. There is a stair lift to the first floor with two further bedrooms and separate living accommodation for the owner. There is an enclosed garden to the front and rear of the property with seating areas and a swimming.Jacuzzi pool. Fields surround the property and there is a driveway with some parking for vehicles. The residents are able to go on holiday for frequent short breaks using a private caravan in Whitstable. The accommodation and staff support are paid for by the home. Full details of the service provided and the fees charged are available from the owner. Care Homes for Adults (18-65 years) Page 3 of 11 What we found: This Random Inspection was undertaken on 28th June 2010. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This report should be read in conjunction with the previous Annual Service Review dated 9th June 2009 together with the last Key Inspection report of 12th June 2007, which looked at all core standards. We received a completed Annual Quality Assurance Assessment from the home on 9th March 2010. The focus of this Random Inspection is to assess how the home continues to provide an excellent quality service. This Random Inspection included a visit to the home on 28th June 2010, where the Registered Manager, the Deputy Manager were spoken with and time was spent with two Service Users. Some judgements about the quality of the service provided were taken from observation and conversation. Some records and documents were looked at together with the premises and facilities of the home. All of the above have been included within this inspection process and some of the gathered evidence is mentioned within this report where appropriate. During this Random Inspection of 28th June 2010 we found the following: Written information about Country Home Care is available for people who are thinking about moving in. There is a statement of purpose and service users guide about the service offered. Information about the home is also provided in a way that service users find easier to understand. Most service users have been living at Country Home Care for some time, whilst one person has moved in more recently. Before they move in, people are assessed by the home and the local authority to make sure that staff can meet their needs. Assessments are recorded and care plans for the support that people need are developed from these. Service users are given written contracts. Individual plans of care and support are developed for each service user. These aim to identify the action required from staff to meet peoples personal, social and health care needs. Two care plans were looked at. These are detailed, clear and easy to follow. Risk assessments are completed. Information is reviewed regularly. Daily notes are written by staff to reflect service users changing needs. These are usually written twice a day. The Registered Manager assured the inspector that should notes need to be written at night these would be done; currently service users do not have any problems at night. The Registered Manager also assured the inspector that from now onwards daily notes would state the time of the entry and be signed by the member of staff making the record. Service users are supported to take risks as part of maximising their independence. The Care Homes for Adults (18-65 years) Page 4 of 11 Registered Manager and Deputy Manager demonstrated a good understanding of these and the individual needs of service users. People are protected from increased harm in their daily living activities through risk assessment. Country Home Care is a small family orientated home. People who live there are encouraged to participate in the running of the house. They are supported to make individual choices and decisions and are encouraged to achieve as much independence as possible. People who live at Country Home Care are treated as individuals who have different interests and aspirations. They enjoy a full lifestyle with a variety of activities, which are agreed with them and appropriate to their interests and abilities. Service users activities include art and craft, sensory activities, fishing, gardening, tenpin bowling, involvement in the church, one to one time and day centre activities. People are supported to take part in social outings and events, such as trips out to places of interest and pub lunches. Service users benefit from being able to access community facilities. Service users can be involved in growing flowers, vegetables and herbs in the garden and greenhouse. A patio and barbeque area is available, which at the time of this inspection was decorated with various national flags inspired by the football world cup. Service users can also use the dip pool Jacuzzi and sauna in the grounds. Service users have the opportunity to go on holiday. Regular breaks are arranged at the homes caravan by the coast. At the time of this inspection three service users were on a fishing holiday, while the other two went out for the day. Contact between service users and their families and friends is encouraged and supported. Service users are encouraged towards independent living skills and supported with domestic tasks. They benefit from being supported with cooking and menu planning, choosing their own meals with the help of photographs. Service users can be supported with special diets. People who live in the home are well supported. They are given the personal assistance they need to maximise their independence, whilst at the same time respecting their dignity and privacy. A good rapport was observed between service users and staff, who were attentive and respectful during the visit. Service users have access to health and social care professionals, such as GP, optician and dentist. They are supported to consult specialists where necessary. A physiotherapist visits the home on a regular basis. All service users benefit from the support of staff regarding their medication, most of which is provided from the supplying pharmacy in an easily monitored dosage system. There is a system for administering medication on a when required basis. Medication is stored centrally within the home and kept in a wooden lockable facility. This is not a metal cabinet specifically designed to hold drugs. The Registered Manager stated that currently the home did not hold any medication that required refrigeration and assured the inspector that, should this be the case a designated medication fridge would be purchased. Most records for the administration of medication are completed appropriately, although two hand written entries seen were not signed as double checked by two members of staff. The Registered Manager stated that all staff who administer medication have undertaken a six week in depth training course and, although this was in 2005, have received refresher courses since then. It was said that these are undertaken Care Homes for Adults (18-65 years) Page 5 of 11 with a trained nurse together with the administration of specialist medication for people with epilepsy. Subsequent to this inspection the Registered manager stated that staff received refresher training for the administration of specialist medication for people with epilepsy on 12th July 2010 but that staff have not yet received their certificates; The Registered Manager is chasing these; The most recent two new members of staff have undertaken an induction course and have started their NVQ level 2 but currently are not undertaking administration of medication; They both undertook the specialist medication course in July 2010. The Deputy Manager stated that they would look at the systems in place for the administration of medication within the home in conjunction with the latest guidelines from the Royal Pharmaceutical Society. A requirement has been made that the Provider complete their stated intention to review the system for the administration of medication. The home has a written complaints procedure. This is also available for service users in a format that they can more easily understand. Written policies regarding safeguarding vulnerable adults are available for staff, which include the procedures for the local authority. The Registered Manager and Deputy Manager have a good understanding of safeguarding procedures. Staff are trained in the protection of vulnerable adults. Staff have undertaken training in the Mental Capacity Act and Deprivation of Liberty. Care plans contain assessments for service users capacity. Service users have access to an advocate. A system is in place to service users with their finance. Small amounts of cash are held securely on behalf of service users together with transaction records and receipts. Cash was not fully audited on this occasion. The home is clean and tidy. Communal areas in the house and service users rooms are attractively decorated, the latter being personalised, reflecting individuals interests, choice and taste. All the bedrooms are single, two are upstairs and three are on the ground floor. Two bedrooms have an en suite bathroom and one has a shower. There are two further bedrooms and separate living accommodation for the owner. There are attractive enclosed gardens to the front and rear of the property, which contain seating areas, a greenhouse, dip pool, Jacuzzi and sauna. There is a stair lift to the first floor. The Registered Manager stated that this did not cause any problems with service users accommodated on the first floor. There are some adaptations and specialist equipment provided according to service users needs, such as profile beds, a hoist and standing frame. One half of the garden is flat access from the road and there is a portable ramp for the front door. Currently there are steps to the top half of the garden and the Registered Manager described plans to improve access for people with mobility problems. Country Home Care is a family run home. The current staff team consists of five people including both owners.Registered Manager who live in the home, the Deputy Manager who has worked at the home for eight years and some staff who have been employed for some time. There is one domestic member of staff. Service users are treated as part of the family. Care Homes for Adults (18-65 years) Page 6 of 11 Service users benefit from the support of staff who are enthusiastic and committed to promoting their welfare. The Registered manager and Deputy Manager are clear about their roles and demonstrated a good knowledge and understanding of individual service users needs and wishes. A good rapport was observed between service users and staff, who were attentive and respectful during this visit. The home is fully staffed. Staffing numbers depend on the needs and wishes of service users. There is one member of staff sleeping in at night. There were sufficient staff on duty to meet service users needs at the time of this visit. Recruitment procedures are in place, which aim to protect service users and appoint suitable staff to meet their needs. Two staff files looked at showed appropriate pre employment checks for individuals who had been employed for some time; although the application form did not include a request for a full employment history. The Registered Manager assured the inspector that the application form would be amended to include this for any future staff applicants. Staff training records show courses such as the protection of vulnerable adults, moving and handling, fire and the mental capacity act. Planned training includes epilepsy, infection control and equality and diversity. The Deputy Manager is qualified to NVQ level 4. Both owners have undertaking training in sight impairment with the aim to meet the specific needs of service users. Staff are given appraisal and supervision and supported with their own personal development. People who live in the home benefit from the knowledge and experience of a well qualified Registered Manager and Deputy Manager. There is an open and friendly atmosphere in the home and service users seen were relaxed, spending time with the staff and manager. The Registered Manager described the system the home uses for quality assurance as including annual questionnaires and an audit of the National Minimum Standards. A range of risk assessments have been undertaken and recorded, including those for the environment and activities within the home. The last visit from the Environmental Health Officer was in December 2008 when no recommendations were made. An infection control visit was undertaken in December 2009, when several recommendations were made. The Registered Manager assured the inspector that all recommendations made had been addressed since then, with the exception of the replacement of the existing kitchen sink with one providing a separate hand washing facility. It was said that this was in the process of being addressed and would be installed shortly. Improvements made include the use of alcohol gel in the laundry room as there is no hand washing facilities available, the use of colour coded cleaning equipment and a blood spillage kit. The Registered Manager described the system for the maintenance of infection control within the laundry room. A clinical waste system is in place. The system in place for the prevention of fire was discussed. The Registered Manager assured the inspector that the system and procedures had been approved by the Fire Officer and are contained within the homes fire risk assessment. Care Homes for Adults (18-65 years) Page 7 of 11 What the care home does well: 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 set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 11 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 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 20 13 The registered person shall make arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home In order to enhance the protection of service users, the Provider must complete their stated intention to review the system for the administration of medication, in line with guidance from the Royal Pharmaceutical Society. This must include storage facilities and record keeping for administration and staff training. 06/09/2010 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 Care Homes for Adults (18-65 years) Page 10 of 11 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. 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