Inspection on 08/12/08 for 63 West Park Road

This inspection was carried out on 8th December 2008.

CSCI found this care home to be providing an Good service.

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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

63 West Park Road 08/12/06

63 West Park Road 02/02/06

63 West Park Road 09/09/05

63 West Park Road 14/02/05

63 West Park Road 05/07/04

63 West Park Road 11/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 27/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 63 West Park Road 63 West Park Road Corsham Wiltshire SN13 9LW     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sally Walker     Date: 0 8 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: 63 West Park Road 63 West Park Road Corsham Wiltshire SN13 9LW 01249712425 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Jean Cottle Type of registration: Number of places registered: Mrs Jean Cottle care home 1 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 63 West Park Road is a private domestic home, registered to provide care and accommodation for one service user. The registered provider and manager is Mrs Jean Cottle. She and her husband are the sole carers. The home is close to Corsham town centre and there are good transport links nearby. The service user has a bedroom on the first floor, with an adjacent toilet. There is a ground floor shower and toilet and a first floor bathroom. Communal space on the ground floor includes a sitting room and a large kitchen with table and chairs. The home also has areas of garden at both the front and back. Fees charged for care and accommodation are paid by the local authority which funds the placement. The service user also makes a weekly contribution from their own income. Information is available about the service. A brief Statement of Purpose has been compiled which explains the nature of the care provided. A copy of the most recent CSCI inspection report is also kept in the home. 1 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 26 Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This announced Key inspection took place on 8th December 2008 between 9.20am and 12.50pm. The inspection was announced due to the nature of the service. We spoke with the person who uses the service and Mrs Cottle. We looked at the care plan, the daily report, risk assessments, medication and Mrs Cottles training records. We made a tour of the communal rooms. As part of the inspection process we sent survey forms to the home for the person who uses the service and healthcare professionals to tell us about the service. Mrs Cottle had completed the forms. We asked Mrs Cottle to send us her AQAA (Annual Quality Assurance Assessment). It Care Homes for Adults (18-65 years) Page 6 of 26 was filled out and returned on time. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has provided care and support for just one person for nearly fifteen years. Mrs Cottle does not intend to offer a place to anyone else. Evidence: The home provides care and support for only one person. It is not Mrs Cottles intention to offer places to anyone else. The person has lived with Mrs Cottle and her husband for nearly 15 years. In the past there have been discussions about registering with the Adult Placement Scheme (now described as Shared Lives by the National Association of Adult Placement Schemes). We said that the relevant standards may be better suited to this service than those for care homes. Mrs Cottle told us that she may now pursue this avenue. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The persons care and support needs are set out in their care plan, which is regularly reviewed. The person is supported to make their own decisions. Risk assessment does not prevent the person from experiencing an independent lifestyle. Evidence: The persons care and support needs are set out in a plan of care. The care plan identifies communication and social care needs as well as risk assessments. The person has signed their care plan. In a survey form the person told us all my needs met, support when I need it. I can make my own choices when possible. Action has been taken to address the good practice recommendation we made that all elements of the persons care plan should be reviewed and updated. The daily report showed good evidence of how Mrs Cottle supports the person to be independent in their personal care. In the AQAA Mrs Cottle told us The service user is cared for in every way that we possibly can, washing, cooking, keeping everything clean, neat and tidy, and also making sure that the service user has everything [they need]. We make sure Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: that the service user makes [their] own choices when possible. There were risk assessments with regard to the persons independence, both at the home and in the locality. There is a missing persons procedure in place. The person is encouraged to make their own decisions with support as necessary. The daily diary records what the person has been involved with each day, any support with personal care, who they have been in contact with, where they have been and family contact. Mrs Cottle supports the person in regular contact with their care manager. Regular reviews are held with them. Action has been taken to address the good practice recommendation we made about the arrangements for supporting the person in managing their money. We said that the information should be updated and contain greater detail about the overall approach. Mrs Cottle told us that the person manages their own finances with very little in put. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person enjoys a range of activities both at the home and in the locality. The person is supported to maintain regular contact with family. The persons rights are upheld and their welfare safeguarded. The person enjoys a healthy diet. Evidence: The person is supported to be independent in their daily life. The person told us about their part time employment and what it entailed. They told us they liked to go shopping either locally or to Bath and Bristol. They said they used public transport. They told us they regularly visited family who lived locally. Mrs Cottle told us she will sometimes drive the person to visit their family and on shopping trips. The person told us that they were looking forward to going to stay with family abroad for an extended holiday. They told us that they liked to watch their extensive collection of films and listen to music. Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: The person regularly goes out for meals with their family who live locally. The person also regularly goes to stay with other family members in another part of the country. Mr and Mrs Cottle have included the person in two of their family holidays this year. Further holidays are planed so that the person has new experiences. The person is well known locally and regularly accesses the locality. The person attends the religious meetings with Mrs Cottle and her husband. Mrs Cottle is a qualified cook and supports the person to plan and shop for the ingredients needed to prepare their meals. A record is kept of daily meals eaten and refreshments. Mrs Cottle told us that the person prepared most of their own meals, depending on how they were feeling. She went on to say that she cooked a roast meal twice a week, which the person enjoys. The person has separate storage areas in the kitchen. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. All the persons medical and healthcare needs are identified in their care plan. The person has good access to healthcare professionals. There is a safe system to ensure the person is supported to regularly take their prescribed medication. Evidence: The persons care and support needs are set out in their care plan. They are independent in most aspects of their personal care. Mrs Cottle provides prompts and reminders. There is information about supporting the person with a medical condition. Mrs Cottle supports the person to keep appointments with their GP and neurologist. There is an agreement with the person and their care manager that Mrs Cottle supports them with their mail, so that any appointments are not missed. She attends any medical appointments at the persons request, in order to help them understand and remember any advice given. Monitoring is ongoing and Mrs Cottle keeps family members updated about the persons current health. The persons family attend hospital appointments with the person. Mrs Cottle is familiar with supporting the person to manage specific healthcare needs. Records are kept of any interventions. The person has an SOS badge with some information available if they are unwell away Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: from the home. Mrs Cottle makes daily entries in the daily report on her monitoring of the persons health and welfare. Mrs Cottle manages the persons medication, which is kept securely and administered according to prescribing instructions. A record is kept of medication which has been ordered and when it is received, together with when medication had been administered. Mrs Cottle has received recent training on medication through her other employment. This employer assesses Mrs Cottles continued competence in administering medication. Mrs Cottle told us that she finds the training supports her role in administering and managing the persons medication. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems are in place so that the person who uses the service and their representatives can complain about the service. Safeguarding procedures are in place to protect the person from abuse. Evidence: Mrs Cottle has a complaints procedure, a copy of which has been given to the person who uses the service and their relatives. Mrs Cottle has set up a log, but as yet no complaints have been received by the service. In the AQAA Mrs Cottle told us The service user has never had any complaints. [They are] always happy with the service we provide, and so is the service users family. Action has been taken to address the good practice recommendation we made that the homes complaints information should be updated to include the correct information about the CSCI. Action has been taken to address the requirement we made that a record must be kept of all money received from or returned to the person who uses the service. We said that the record must show the purpose for which the money was used. Mrs Cottle is not involved with the persons finances. The person has their own bank account which they manage themselves. The person pays their part of the fee to Mrs Cottle each week. Records are kept of this payment in the persons daily record and rent book. She told us that she would only access the account if the person was ill and could not go to the bank themselves. Mrs Cottle has given the person the contact details for the Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: local advocacy service. Mrs Cottle keeps contact details of the local safeguarding vulnerable people policy and procedure. She is aware of, and confident in reporting any allegations of abuse to the process. She has received training from her other employment in recognising and reporting abuse. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person enjoys a well maintained, warm, homely environment which is cleaned to a good standard. Evidence: The person has their own single bedroom which they showed us. They told us they liked their bedroom. It is furnished and decorated to reflect their personality. They have has unrestricted access to all the communal areas of the home and the garden. There is a toilet next to their bedroom and they use the downstairs shower room. Mrs Cottle continues to make improvements to the environment, with regular redecoration and refurbishment. In the AQAA she told us We have improved the house over the last 12 months, by completely redecorating every room and putting new flooring down and light fittings. Mrs Cottle told us she intends to redecorate the sitting room when the person goes on holiday with family in the New Year. The home is well maintained, warm, clean and homely. The person is involved in some household chores, for example, changing their bed linen and bringing any clothing to the washing machine or emptying their rubbish bin, depending on how they are feeling. Care Homes for Adults (18-65 years) Page 19 of 26 Care Homes for Adults (18-65 years) Page 20 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person is supported by Mr and Mrs Cottle. Standards for recruitment and training are not applicable to this service. Evidence: No staff are employed. Mr and Mrs Cottle support the person day to day. They are never left alone in the house, even when Mrs Cottle is at her other employment. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The person benefits from a manager who is qualified, competent and experienced. The home is run in the best interests of the person who uses the service. Systems are in place so that the persons health, safety and welfare are safeguarded. Evidence: Mrs Cottle has run the home for nearly fifteen years. Mrs Cottle and her husband both provide care and support to the person who uses the service. Mr Cottle is available when Mrs Cottle works at her other employment. Mrs Cottle has attained NVQ Level 2 and expects to start NVQ Level 3 in January 2009. She continues to keep up to date with current good practice with training provided by her other employers. She has been working part time at a local care home for a number of years. Recent training has included: medication, dementia, mental health, Parkinsonism and diabetes. Mrs Cottle also receives regular updated training in first aid, moving and handling, infection control, fire prevention, health and safety and safeguarding vulnerable people. At the last inspection we made a requirement that a system must be established for Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: evaluating the quality of the service provided. At the time little information was available as to whether the regulation was applicable to this service. Mrs Cottle has completed and returned her AQAA. In the AQAA Mrs Cottle told us We are constantly checking with the service user that everything is to [their] satisfaction. We make sure that the service users views are always taken into account and listened to. We advised Mrs Cottle that in order to fully meet this requirement, as part of her review of her service, she should record the views of the person using the service. We also advised seeking the views of the persons representatives and other stakeholders. We said that this consultation could take the form of questionnaires on different aspects of the service. Any comments should then be taken into account when reporting on measures to improve the service. All cleaning fluids are kept locked away. Mrs Cottle keeps a record of regular testing of hot water temperatures and servicing of the central heating boiler. A record is kept of any accidents or incidents. Risk assessments, with regard to any tasks that the person who uses the service may undertake, for example, use of the kitchen appliances, are recorded in their care plan. A family member works for the Fire and Rescue Service and has provided Mrs Cottle with fire prevention advice. New smoke detectors have been fitted to the top of the stairs and in the persons bedroom. Mrs Cottle keeps a record of regular tests of the smoke alarms together with any replacing of the batteries. She also keeps records of regular fire drills and evacuations. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes R No £ Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action 1 39 24 The registered person must establish and maintain a system for evaluating the quality of the services provided. COMMENT: The registered person was previously advised that this standard was not applicable. This situation has now changed. The Commission agreed to give further advice and input on this topic when more information becomes available. 31/03/2007 Care Homes for Adults (18-65 years) Page 24 of 26 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, Care Homes 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 39 24 A system for evaluating the quality of the service must be established. So that comments from the person and their representatives can inform the quality report on the service. 06/03/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 39 As part of the homes quality audit, consideration should be given to seeking the views of people who are important to the person, for example, family, care manager and GP. This could take the form of a questionnaire. Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!