Inspection on 06/02/07 for Appledale Cottage Residential Home

This inspection was carried out on 6th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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... 05/03/06

Appledale Cottage Residential... 01/12/04

Appledale Cottage Residential... 11/06/04

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Inspirations

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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 Key Unannounced Inspection 6th February 2007 09:15 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.V313821.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 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.V313821.R01.S.doc Version 5.2 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 *** Post Vacant *** Care Home 9 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (9) of places Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The bedroom served by the `Velux` type ceiling window, must only be 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. Mr and Mrs Hodgson have confirmed written agreement to the above conditions. Date of last inspection 5th March 2006 Brief Description of the Service: Appledale Cottage is a small residential Care Home, recently approved to provide care for 9 older persons requiring ‘Residential’ care, including a number requiring ‘dementia’ care. 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 in a quiet, rural area, near to 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, the Home offers accommodation comprising 9 en-suite bedrooms, a large combined lounge/dining room, which benefits from the addition of a ‘sun-lounge’ at one end. Residents also enjoy the added interest and stimulation from the Proprietors’ small menagerie, including dogs, cats, a pony, a donkey, peacocks and chickens. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This ‘Key’ Unannounced Inspection commenced at 9.15am, concluded at 1.00pm (a duration of 3.75 hours), and was conducted by Mr Keith Salmon. The main objective of this Inspection was to review all of the ‘Key’ Standards, as set out on the National Minimum Standards for Care Homes for Older People. Present throughout the Inspection, were Mrs Pauline Hodgson and Mr Adrian Douglas Hodgson Joint Registered Providers. This Report is a product of observations made during a tour of the Home, a review of care related documentation, staff duty rotas and staff files, plus a range of documents/ records reflecting the general operation of the Home. The Inspector also held discussions with Staff and 9 Residents, 4 of whom were ‘case tracked’, and one Visitor. Weekly fees range from £400.00 to £700.00. What the service does well: What has improved since the last inspection? What they could do better: The Home has received a Report from the Fire Safety Inspecting Officer following a visit to the Home on 8 January 2007 listing areas requiring attention. Action is already in hand to address the areas identified. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 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.V313821.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes to ensure appropriate and thorough care needs assessment, prior to admission, are effectively applied. The findings are applied to ensure appropriate placement. EVIDENCE: Review of care plans, and related documentation, provided evidence that appropriate and thorough care needs assessment is undertaken by the Registered Manager, prior to admission. Information gathered is utilised in enabling an informed decision regarding the Home’s capability of meeting the individual care needs of each prospective Resident. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 & 10. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The model of Care Plan utilised by the Home is comprehensive, easy to follow and up-to-date. Care provided by the Home is very effective in meeting the Residents’ assessed care needs, and is delivered considerately. Residents are treated with respect, their privacy and dignity upheld. The storage, administration, and disposal of medicines are in accordance with accepted good practice. 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. The high level of detail included in Care Plans, which relate to Residents’ individual needs, together with clear statements of care to be provided, are commendable. These ensure Carers are enabled to fully meet those needs. Evidence was seen confirming regular care needs review by the Manager on at least a monthly basis. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 10 Individual discussions held with Residents, together with ‘Comment Cards’ completed by Residents and Relatives, confirmed Residents’ 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.V313821.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, & 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are involved in every aspect of day-to-day ‘family life’ as much as possible. The ‘Appledale team’ work 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 sized 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 from observation, and discussion with Residents, of their involvement and influence, 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. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 12 Residents enjoy opportunities to travel with the Owners and 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.V313821.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. A review of relevant documentation demonstrated 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, confirmation of which was forthcoming through 1:1 discussions with Staff, and from Staff Records. The Home has not received a formal complaint since being Registered as a Care Home. Accident Records were reviewed and found to be current, presenting no areas for concern. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 & 26. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Home continues to provide a high quality, comfortable and safe environment for those in residence. 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, bathrooms/showers, and specialist equipment, comfortably meets the needs of Residents, and the demands of tasks carried out by Care Staff. The standard of cleanliness in the Home is excellent. EVIDENCE: A tour of the property demonstrated Residents are accommodated in generously sized single bedrooms, all of which offer the benefit of en-suite toilets and wash-hand basins. The extended communal space, which had just been completed at the time of the previous Inspection, is now in full use. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 15 Provided through the removal of 3 original bedrooms, and replacement of the old conservatory, the additional area it affords is of good size, with furnishings and decoration being of a high order. There was clear evidence of personalisation of bedrooms, with Residents having brought their own possessions into the Home. The large gardens, which surround the property, have recently been landscaped and offer a safe environment with the added interest of a family of peacocks, a pony, and a donkey. The laundry, which was previously rather cramped, has been successfully relocated from the centre of the building to a small extension adjacent to the rear entrance providing more space and subsequently improving health and safety for Staff and Residents. Specialist equipment, e.g. hoists, wheelchairs, stand-aids, were observed thus facilitating provision of care. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective and well-supported staff group with the skills and knowledge to ensure Residents enjoy a quality of life, which meets their individual requirements and aspirations. 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 commendable. EVIDENCE: A review of duty rosters, and discussion with Staff confirmed that Staffing numbers, though small, enable a service provision, which meets the care needs of the Service Users. Specifically, throughout ’day-time’ hours, there is always a minimum of two staff members on duty. Staff cover at night compromises one `waking` carer with back-up from a `non-waking’ carer, who is located in the `private` accommodation above the Home, and linked via a direct alarm call system. This person is normally one of the Owners, who share this duty. In their absence cover is provided by another suitably trained, and approved, carer. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 17 Staff were observed to carry out their duties in an enthusiastic and professional manner. Residents informed the Inspector they were …”Very fond of the Staff. They work extremely hard and are very caring towards us.” Records demonstrated all Care Staff have now attained NVQ Level 2. In addition, one member of Staff has achieved Level 3 and one is currently undertaking Level 3, with two Staff due to commence Level 3 in the near future. Staff are subject to a thorough, and relevant, orientation/induction programme with evidence of on-going training. The Inspector considers that for such a relatively small Care Home the commitment and attention to staff training is to be commended. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 36, & 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Operationally, the Home is generally very well organised, with the central purpose being ‘the best interests of Residents’. All Staff are subject to effective support with regular supervision by the Manager and appear involved and happy in their work. The systems for consultation with Residents are good. The safety and welfare of the Residents is well protected. EVIDENCE: The Home has excellent leadership from the Owner/Manager who, due to living ‘on-site’, is virtually always available to support Staff. Also, the Manager has attained the Manager’s Award and has commenced NVQ Level 4 with an expected completion during Summer 2007. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 19 Operationally, the Home is very well organised with the central purpose being ‘the best interests of Residents’ and lines of accountability are clearly defined and observed. The ambience of the Home is warm, friendly, and inclusive. Questionnaires, completed by Residents prior to the Inspection, all presented without exception ticks in the ‘positive’ boxes, and included comments such as …“I go on trips and we play ball a lot”; …“I am very happy”. All Staff are subject to regular supervision, and appeared involved and happy in their work. The manner in which the Manager organises the ‘supervision’ process is commendable and exemplified in being focussed on ‘day to day’ care provision activities with resultant outcomes fully documented in considerable detail. Health and Safety Policies/Procedures/Practices were satisfactory as are COSHH requirements, with maintenance and servicing of equipment regularly undertaken, and appropriately documented. Records are maintained for hot water supply to baths, and water temperatures tested during the Inspection were found to be satisfactory. COSHH data sheets were found to be current. The Home has received a Report from the Fire Safety Officer, following a visit to the Home on 8 January 2007, identifying three areas, which the Home is advised to address, i.e. Consideration be given to changing the format of the ‘fire risk assessment’ to record more detailed information. Obtain a copy of the Annual Test Certificate for automatic fire alarm and emergency lighting systems as undertaken by the Maintenance Engineer. To ensure development of individual Staff Training Records to reflect in more specific detail training in respect of fire safety. Evidence was observed that the Registered Persons have begun implementing the appropriate action required to rectify the issues raised in the Report, e.g. written evidence relating to the engagement of an external Fire Safety Assessment/Training Agency. It is expected their involvement will commence over the coming weeks. Given the immediate positive response by the Owners the Inspector is satisfied with progress made by the Home to date, and is assured the Home will have fully addressed this issue before the intended follow-up Fire Safety Inspection scheduled for 3 April 2007, and, as such, existing ‘Fire Safety’ practices are in accordance with the ‘Outcome’ statement for this section. The Home does not manage Residents’ personal monies. Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 20 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 13 14 15 4 X X X X 3 3 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 4 3 4 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 4 3 X N/A 4 X 3 Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 21 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.V313821.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Appledale Cottage Residential Home DS0000020754.V313821.R01.S.doc Version 5.2 Page 23 - 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. 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