Inspection on 05/03/06 for Appledale Cottage Residential Home

This inspection was carried out on 5th March 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 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

Appledale Cottage Residential... 06/02/07

Appledale Cottage Residential... 01/12/04

Appledale Cottage Residential... 11/06/04

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

CARE HOMES FOR OLDER PEOPLE Appledale Cottage Residential Home Bagley Marsh Ellesmere Shropshire SY12 9BP Lead Inspector Keith Salmon Unannounced Inspection 11:30 5 March 2006 th X10015.doc Version 1.40 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 Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 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 Older People. 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. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Appledale Cottage Residential Home Address Bagley Marsh Ellesmere Shropshire SY12 9BP 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) 01939 270374 01939 270374 Mr Adrian Douglas Hodgson Mrs Pauline Hodgson Care Home 9 Category(ies) of Old age, not falling within any other category registration, with number (9) Which may include (4) four persons with of places Dementia Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1 The bedroom served by the `Velux` type ceiling window, must be only occupied following signed agreement by the resident and/or his/her Relative or Advocate. Staff cover at night must compromise a minimum of: One `waking` carer. One `non-waking` carer who will be located in the `private` accommodation above the home and linked by a direct alarm call system. This person will normally be one or other of the owners. In their absence this provision may be by another suitably trained and approved carer. 24th May 2005 2 Date of last inspection Brief Description of the Service: Appledale Cottage is a small residential Care Home, recently approved to providing care for 9 older persons requiring ‘Residential’ care, up-to 4 of whom may have dementia. Care is provided within the family home of the Proprietors, Mr and Mrs Hodgson, who are both involved as full-time carers, and are supported by generous levels of staffing. The Home is situated near the centre of the Village of Bagley Marsh, approximately five miles from the Town of Ellesmere in North Shropshire. Set in attractive, extensive and accessible grounds and gardens, Residents also enjoy the added interest, and stimulation, from the Proprietors’ small menagerie, which includes dogs, cats, pony, donkey, peacocks and chickens. Accommodation comprises 9 ensuite bedrooms and a large combined lounge/dining room which at one end offers a recently added sun-lounge’ facility. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection involved an initial ‘Announced’ Inspection held in December 2005, plus a number of subsequent visits, by the same Inspector, culminating in a final ‘Unannounced’ Inspection on 5 March, 2006. The purpose of undertaking this series of visits was to cover the period during which building work was brought to completion to increase accommodation from 3 to 9 bedrooms. Total time covered by these Inspection visits was 8.5 hours, and this Report is based on observation during those visits, a review of care related documentation, including staff recruitment/deployment records, a range of documents/records reflecting the general operation of the Home. In addition to observations made during several tours of the Home, discussions with the Proprietor, Registered Manager, Staff, all current Residents and two Visitors. High standards of direct care provision, and overall management are provided in a friendly and open atmosphere. This is strongly reflected in written and verbal comments made by Residents and Relatives and included…”Very good facility…”, “Very knowledgeable about care of people with Alzheimer’s...”, “Friendly, informal atmosphere in a well equipped environment…”, “My Wife has been well, and affectionately, cared for…”, “My Family and myself are really pleased that I have been able to come here – it is really homely and friendly…”, “...We are treated with respect and dignity…”, “The Owners and other Staff are always available and appear to make great efforts to make it nice for us...”. What the service does well: What has improved since the last inspection? Since the previous Inspection (May 2005) the Home has been extended to increase the number of places from 3 to 9. Residents are accommodated in generously sized single bedrooms, all off which offer the benefit of ensuite toilets and wash hand basins. Bathing facilities have also been improved to now include a shower. Communal space has been increased through removal Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 6 of the previous 3 bedrooms and replacement of the old conservatory. This area is not only of good size, but now provides vistas to both front and rear of the property. Statutory Requirements cited at the previous Inspection relating to emergency lighting, provision of a Visitors’ Book, and ‘Legionella’ risk management have all been met. 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. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5. Prior to taking up residency prospective Service Users, or their representatives/advocates are enabled to reach an informed choice, and to fully understand the service they can expect to receive. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are diligently and effectively applied. Staff are able to provide the type, and quality, of care required by Residents. EVIDENCE: The Home has a Statement of Purpose and User Guide. These documents have been revised to reflect the Home’s increase in the number of Residents, and are concise, easy to read, available in large print and meet the requirements of the Standard. Service Users are provided with a Statement of Terms and Conditions detailing the accommodation to be provided. A review of all Residents’ Care Plans, and discussions with Residents, confirmed the Registered Manager assesses all prospective Residents/Service Users prior to admission. Four of the Residents informed the Inspector that they and/or their Relatives had visited the Home prior to admission, following which they decided “this was the Home for them”. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. The model of Care Plan utilised by the Home is easy to follow and of effective design. It is diligently utilised in aiding the provision of care which meets Residents’ assessed care needs. Practices relating to the storage, administration and disposal of medicines are in accordance with accepted good practice. Staff relate to Residents in a friendly and respectful manner. EVIDENCE: Review of Residents’ care related documentation demonstrated evidence of full pre-admission assessment carried out by suitably qualified Staff. Care plans were well organised, easy to understand and up-to-date. Attention to detail in written plans, is commendable and helps ensure Carers, unfamiliar with a Resident’s needs, to fully meet those needs. Individual discussions held by the Inspector with Residents, together with ‘Comment Cards’ completed by Residents and Relatives, confirmed Resident’s needs are being met. Inspection of medicine storage provision and administration records demonstrated the Home’s practices meet the guidelines of the Royal Pharmaceutical Society. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above 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. Residents are involved in every day ‘family life’ as much as possible. The Appledale team works in close liaison with Residents, and their Relatives, to promote individual lifestyles and enable achievement, where possible, of personal preferences. The Home provides a daily choice of attractive and nutritious meals. EVIDENCE: A real strength of this relatively small size Home is in enabling a truly ‘family’ setting for Residents, and providing a strong feeling of ‘community’. Activities are in accordance with Residents wishes and abilities. There is clear evidence of active involvement and influence from Residents, including choice of colour schemes in their individual bedrooms and in the manner in which each prefers to conduct their ‘day’. A review of documentation, discussion with Residents/Staff and written comments received by the CSCI, demonstrated individuals are encouraged, and empowered as far as is practicable, to maximise their independence and to be involved in choices relating to daily activities within the Home. This is exemplified where Residents have been actively involved in the planning of changes incurred by the recent change process and the resultant new environment. Residents enjoy opportunities to travel with the Owners and Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 11 Staff when undertaking shopping trips, visits to garden centres and a range of other ‘leisure’ activities. Residents were very complimentary about the range, quality, and choice of food provided. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Service Users are protected from abuse by the Home’s policies and Procedures, which include systems to ensure concerns or complaints are dealt with promptly and effectively. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: Complaints procedure details are included in the Service User Guide and are displayed prominently for the benefit of visitors. There are policies and procedures in place intended to provide protection for vulnerable people. These fully meet the requirements of this Standard and the topic is covered at induction and through on-going staff training. The Home has not received a formal complaint since being Registered as a Care Home. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,23,24,25,26. The Home’s lounge/sitting and dining areas offer a good variety of size and outlook, with furnishings and decoration being of excellent order and presenting a ‘domestic’ ambience. Provision of toilets and bathrooms/showers, and provision of specialist equipment, comfortably meets the needs of Residents’, and with the demands of tasks carried out by Care Staff. The standard of cleanliness in the Home is excellent. EVIDENCE: Since the previous Inspection, held in May 2005, the Home has been extended to increase the number of bedrooms from 3 to 9. A tour of the property showed Residents are now accommodated in generously sized single bedrooms, all off which offer the benefit of en-suite toilets and wash hand basins. Bathing facilities have also been improved to now include a shower. Communal space has been increased through removal of the previous 3 bedrooms and replacement of the old conservatory. This area is not only of good size, with furnishings and decoration being of high order, but now provides vistas to both the front and rear of the property. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 14 Specialist equipment, e.g. hoists, wheelchairs, stand-aids, was seen to be available to facilitate provision of care. Evidence was seen of Residents having brought their own possessions into the Home. The large gardens, which surround the property, offer a safe environment and the added interest of a family of peacocks, a pony and a donkey. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Staff numbers on duty and skill-mix were sufficient to meet the assessed care needs of current Residents. Recruitment and employment practices are consistent with the safeguarding of Residents. The Home’s approach to providing training for Care Staff is exemplary. EVIDENCE: The Home has recently recruited several new members of Staff to match the increase in Residents. The Home has previously enjoyed a good reputation for affording Staff opportunities to undertake basic training and on-going personal development. Evidence was seen in Staff Files, and in future training plans, this approach will continue. Particularly pertinent are arrangements already in hand to enable Staff to undertake the 14-week Course in ‘Positive Dementia Care’ provided by Walford College. The Inspector considers the Home’s commitment to Staff training is commendable. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,36,37 & 38. The Home has excellent leadership from the Owner/Manager who, due to living ‘on-site’ is virtually always available to support Staff. The ambience of the Home is warm, friendly and inclusive. Operationally, the Home is very well organised with the central purpose being ‘the best interests of Residents’. Lines of accountability are clearly defined and observed. All Staff are subject to regular supervision, and appeared involved and happy in their work. Health and Safety Policies/Procedures/Practices were satisfactory. EVIDENCE: The Management Team comprises Mrs Pauline Hodgson, who is Registered Manager and Mr. Adrian Hodgson. Mr Hodgson undertakes the business/administrative responsibilities of the Home. It was evident from observations made during the Inspection there are clear lines of accountability established within the Home. Staff informed the Inspector that Staff Meetings are held regularly, involve all grades of Staff and they receive support and commitment from the Owners. The leadership provided by the Management Team is exemplary. Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 3 3 4 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 3 X 3 3 3 Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 Appledale Cottage Residential Home DS0000020754.V259839.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. 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