Inspection on 07/11/06 for 14 Cook Close

This inspection was carried out on 7th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

14 Cook Close 21/12/05

14 Cook Close 30/06/05

14 Cook Close 04/10/04

14 Cook Close 24/03/04

14 Cook Close 19/11/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 14 Cook Close Dovercourt Harwich Essex CO12 3UE Lead Inspector Neal Cranmer Key Unannounced Inspection 7th November 09:03 14 Cook Close DS0000017722.V290126.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 14 Cook Close DS0000017722.V290126.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. 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 14 Cook Close Address Dovercourt Harwich Essex CO12 3UE 01255 240095 01255 240095 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) The Brain Injury Rehabilitation Trust Mrs Suzette Anne Doherty Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) 21st December 2005 Date of last inspection Brief Description of the Service: Cook Close is a detached bungalow situated in a residential area of Dovercourt. The home has three single bedrooms. The home caters for the needs of three gentlemen who have cognitive, behavioural and functional deficits resulting from acquired brain injuries. The registered provider is The Brain Injury Rehabilitation Trust; a charitable organisation, which operates, registered homes nationally. The sister home to Cook Close is Myland House in Colchester, which is approximately 20 miles away. Fee’ for residing in the home are between £ 828.80 per week and £ 1080.87, an additional charge is made to service users who require one to one care of 162.20 per week. Further additional charges are made for the following items: • Hairdressing • Swimming lessons • Toiletries • Holiday’s. This information was provided in the pre-Inspection Questionnaire submitted to the Commission on the 12th October 2006, and a telephone conversation with the home’s registered manager on the 24th November 2006. 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection to the home that took place over one day in November 2006, lasting approximately 6.00 hours. The inspection process included discussion with all three service users, the registered manager, home manager and staff. Tour of the premises included observation of service users rooms, communal areas, and bathing and toilet facilities. Twenty-two of the forty-three standards were inspected, of which eighteen were met, three were partially met, and one was considered to be a major shortfall. What the service does well: What has improved since the last inspection? Service users care plans now contain evidence of being kept under review, and records relating to the care plan objectives were related. The home’s recruitment practice has been improved; files sampled reflected a robust recruitment process. Evidence was provided that indicated that service users are now being consulted with in relation to menu planning. 14 Cook Close DS0000017722.V290126.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. 14 Cook Close DS0000017722.V290126.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 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is (Adequate). This judgement has been made using available evidence including a visit to this service. There is no recent data to indicate pre-admission assessments but policies and procedures used by the home indicate that there is an appropriate assessment process. EVIDENCE: There have been no admissions to the home for a number of years, discussion with the registered manager indicated that there is a assessment screening tool that is used for all new admissions, which is currently held at the home’s sister home in Colchester, and therefore unavailable to be viewed, however knowledge of the practice of the home’s sister home lead the inspector to the view that future service users admitted to the home would be assessed appropriately, this will be assessed further during future inspections when the screening tool will be expected to be made available within the home. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect that their assessed and changing needs will be reflected in their individual plans of care. Service users can expect to be supported to make decisions about their everyday lives with assistance as required. Service users can expect to be supported to take risks as part of developing an independent lifestyle. EVIDENCE: All three service users files were sampled, a requirement was set at the previous inspection for these to be kept under review, and it was evident at this inspection that all three plans now evidenced that they were being kept under periodic review. 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 10 Discussion with service users showed that they are supported to make decisions about their every day lives; service users had initiated a meeting about a particular incident within the home about which they were not happy. Risk assessments continue to identify the nature of the risk, and provide clear and concise information to staff as to the actions to be followed to minimise the risk, there was evidence of service users having been involved in the risk assessment process, and review dates set. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15,16 and 17. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service Users can expect to be supported to take part in activities that are age and peer appropriate and supported to take an active part in their local communities. Service users can expect to be supported to take part and engage in leisure activities that are appropriate, and to maintain links with their families and friends. Service users cannot always be assured that staff will respect their privacy. Service users can expect to be provided with a healthy and nutritious diet, and to have opportunity to provide input into menu planning in the home. EVIDENCE: 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 12 None of the service users residing at the home have any paid or voluntary employment, or take part in any form of adult education, discussion with service users showed that this was their choice, further discussion evidenced that service users are continuing to take part in activities that they had prior to their injuries e.g. Sailing, swimming and attending the gym. Service users inclusion in the community included attending various clubs for people who have physical difficulties, attending the library, going banger racing, going for meals out, attending rock & roll evenings, and maintaining attendance at specific meeting groups attended prior to their injuries, related to specific areas of interest. One service user spoke of recently have been supported by the home to visit Scotland in an attempt to trace their ancestry. Discussion with service users indicated that they are supported to plan holidays of their choosing One service user who has a particular interest in rock & roll spoke of having been supported to arrange a holiday to Great Yarmouth for a rock & roll weekend Discussion with the service user confirmed that this went down very well. Another service user spoke of their holiday to Scotland, and the third spoke of planning holiday’s abroad each year, the last one being a break to Tenerife. The home has an open door policy on the receiving of visitors. Service users spoke of staff supporting them to maintains links with their families and friends through the sending of letters and cards, service users spoke of also staying in touch through the use of the telephone. At the previous two inspections to the home, service users have spoken of concerns about their privacy and dignity, in particular the occasional failure of staff to knock on their doors before entering, although service users indicated that this has improved considerably, there was still a view that one member of staff still fails to do so, this was discussed with both the registered manager and the home manager at the time of the inspection. Menus provided by the home were varied and nutritious, with three meals being provided daily, one of which was cooked. Discussion with service users indicated that there was better consultation with them now on the planning of the menu’s stating that discussion take place with them at the start of each week, service users then sign their agreement to the menu. Meals are provided flexibly to facilitate service users activities; the meal on the day of the inspection was taken in a relaxed and unrushed atmosphere. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in a way that is appropriate to their needs and wishes. Service users can expect that their physical and emotional needs will be met. The home’s medication practice is adequate and safe. EVIDENCE: Discussion with service users indicated that they are supported with their personal needs in a way that they find appropriate; their personal support needs being carried out in private. Times for getting up and going to bed are generally flexible, and service users spoke of being free to choose what they wish to wear. All service users are registered with a General Practitioner. Records relating to service users healthcare needs were maintained clearly and concisely and identified input from healthcare professionals, including a General practitioner, Dentist, Neurologist and Opthalmologist. 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 14 In addition service users have access to the organisations psychiatry and psychology professionals. The home’s medication practice was sampled and found to be in order All staff with the exception of one have received training in the administration of medicines, the registered manager stated that the member of staff not currently trained does not administer medicines, and is shortly scheduled to receive training. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect that their views will be listened to and acted upon. Service users can expect that the home’s policies, procedures and practice will protect them from the risk of harm and or abuse. EVIDENCE: The home has a Complaints Procedure that is corporately developed, which contains reference to the Commission for Social care Inspection. Since the previous inspection the home has received two complaints, which were appropriately investigated, the home maintains a log for the recording of any complaints received, both of the complaints that had been received in respect of the home had been logged. Discussion with all three of the service users evidenced that they were all aware of how to make a complaint, and to whom they should direct their complaint. As with the home’s Complaints procedure, the Adult Protection Procedure is also corporately developed, although the home follows the Essex County Councils Guidelines for the reporting of allegations of abuse. The registered manager stated that all staff have received training in this area, this was substantiated during the viewing of the home’s staff training records. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is (Adequate). This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in an environment that is generally homely, comfortable and safe. However they cannot be assured that unpleasant odours would be managed. EVIDENCE: The home has undergone some refurbishment since the previous inspection to the home.This has included one of the shower rooms being fully refurbished and Clear Perspex has been fitted to all of the lower areas of the communal walls to minimise damage caused by service users wheelchairs when mobilising around the home. The hallway, kitchen and lounge have all been redecorated. However during the tour of the premises it was noted that the carpet in the lounge was very badly stained, although discussion with the registered manager indicated that there were plans for its replacement in the near future, 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 17 it was noted that there was a particularly unpleasant odour emanating from the home’s second shower room. It was also noted that the hand grab rails in this room were in a poor state of repair, being badly corroded and rusted. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34 and 35. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to be protected by the home’s recruitment policies and practice. Service users can expect their needs to be met, by staff that are skilled and appropriately trained to meet their particular needs. EVIDENCE: Three members of staffs recruitment files were sampled and showed that the home has in place a robust recruitment practice which safeguards the needs of service users. All of the documentary evidence required under regulation was in place, including references, application forms, criminal record checks, supervision and induction. Staff records sampled evidenced a good level of training being provided which included: • Adult protection training • Recruitment and selection • Certificate in nutrition and health • Food hygiene 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 19 • Medication administration • Manual handling • Infection control • Managing challenging behaviour. Discussion with staff indicated that access to staff training provided by the home was good. 14 Cook Close DS0000017722.V290126.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is (Good). This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported through the ethos of a home that is well run and managed. Service users can expect that their views will be sought, as part of the home’s quality review process. Service users can expect that the home’s practice will protect and promote their health and safety. EVIDENCE: The registered manager has significant previous experience of working in a care setting and is qualified at N.V.Q level 4 in management and care, and has overall responsibility for the running of the service, the manager undertakes 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 21 periodic training to enable them to keep up to date, although due to personal circumstances the manager explained that this had been minimal since the previous inspection. The home’s quality assurance process is managed corporately, with representatives of the Brain Injury Trust carrying out annual audits; service users indicated that their views were sought during this process. In addition, monthly regulation 26 reports are provided to the commission. The home’s safe working practice was sampled through the viewing of the following safety certificates: Boiler safety declaration, Fire extinguisher certificate of inspection, Employers public liability insurance, Hoist service report, and reports relating to the home’s vehicle tail lift. 14 Cook Close DS0000017722.V290126.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 X 2 2 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 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 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 3 15 3 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 23 Yes 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 YA2 Regulation 14 Requirement The registered person must ensure that a procedure is in place for ensuring that no service users are admitted to the home without first having had their needs fully assessed. The registered person must ensure that the care home is conducted in a manner that respects the privacy and dignity of service users. This relates specifically to staff entering service user’s rooms without their permission. The previous two timescales set were not meet. The registered person must ensure that the home is maintained in a good state of repair, and that equipment provided in the home is maintained in good working order. Timescale for action 31/12/06 2. YA16 12 (4a) 31/12/06 3. YA24 YA30 23 (b, c & d) 31/12/06 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 24 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 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 14 Cook Close DS0000017722.V290126.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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