CARE HOME ADULTS 18-65
Appledown Heather Lane Canons Town Hayle Cornwall TR27 6NG Lead Inspector
Diana Penrose Unannounced Inspection 23rd February 2006 02:30 Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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 Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Appledown Address Heather Lane Canons Town Hayle Cornwall TR27 6NG 01736 740552 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) Ms Amanda Jane Wright Mr Nicholas Peter Dowden Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 24th November 2005 Brief Description of the Service: Appledown is a detached house situated in a quiet cul de sac in the village of Canon’s Town, just off the main road between Penzance and Hayle. The home is registered for 3 residents with a learning disability. The Registered Providers are Ms Amanda Jane Wright and Mr Nicholas Peter Dowden. Ms Wright is the sole care provider, there are no staff employed. The resident’s accommodation comprises of three single bedrooms, one of which is upstairs. There is a ground floor bathroom, a lounge and a kitchen / diner, shared with the Registered Providers. The home is very clean, tidy, well furbished and maintained throughout. The residents currently living in the home attend weekday activities assessed for and provided by Cornwall Social Services Department. The residents are given ample opportunities for socialising and visitors are openly encouraged. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspector visited Appledown Care Home on the 23 February 2006 and spent the afternoon at the home. This was an unannounced visit. The purpose of the inspection was to gain an update on the progress of compliance to the requirements that were identified in the last inspection report dated 24.11.05. In addition the inspector focused on the following key areas of care: risk assessment, activities, community and family contact, personal support and healthcare, complaints, some of the environment, recruitment and management On the day of inspection 2 residents were resident in the home and one is receiving respite care once a week. One resident was staying with her parent’s overnight as it was half term week and the other went out with her family just after the inspector arrived. She was very happy and excited and her family are very happy with the care provided by the home. The methods used to undertake the inspection were to meet with the registered provider to gain a view on the services that Appledown offers. Appledown’s records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. What the service does well:
The home provides a warm, clean, homely environment for residents that is relaxed and friendly. There is ongoing maintenance and risk assessments have been undertaken to ensure it is a safe place to live. Residents have contact with their family and friends as they wish by visits or by telephone. Residents are encouraged to take responsible risks and written risk assessments are in place. Personal safety is paramount and training for residents is ongoing. The registered provider takes the residents out and road safety is always reiterated. Activities take place in the home and the residents attend appropriate day centres where assistance is given with educational needs. Participation with household tasks is encouraged and independence is promoted. There is an appropriate complaints procedure in place that residents and their relatives are aware of. The home has had no complaints. There are no staff employed, the registered provider delivers all care and personal support to the residents in accordance with their written care plans. Healthcare needs are met and specialist workers are involved as required. The registered provider is experienced and competent to run the home; she has achieved the Registered Managers’ Award and keeps herself up to date on current care issues.
Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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 Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not inspected on this occasion. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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): 9 Risks are assessed and appropriate support is given to enable residents to lead an independent lifestyle. EVIDENCE: Residents are encouraged to take responsible risks and written risk assessments are in place. These cover the activities of daily living, electrical appliances, the environment including outside. Personal safety training takes place as required, road safety training is ongoing and one resident has been having independence training to enable her to go out with a friend. An appropriate reward system is used. The home has a written procedure in respect of the action to be taken if a resident should go missing from the home. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 10 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, 15 and 16 Service users take part in appropriate activities and are assisted with training and education to encourage their independence and individuality. Links with the local community are good and allow service users the opportunity to socialise. Residents have appropriate contact with family and friends; they are supported to develop relationships according to their wishes. There is a programme with house rules but service users rights and individual choice are respected. EVIDENCE: Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 11 Residents are encouraged to continue their education, undertake training and join in activities as they wish. They both attend day centres and progress reports are issued each term. Certificates are given for achievements made. They enjoy activities such as cooking, dancing, sports and shopping. Residents are encouraged to maximise their independence and make use of local community resources. They go out with the day centre staff and they have an annual holiday. The registered provider takes them out shopping, walking or for meals and so on. One resident goes out with a friend in accordance with her care plan and risk assessment. The registered provider said that residents have contact with their families as they wish. The records show that contacts are made and that visits take place. One resident was staying overnight with her parents at the time of the inspection and the other went out for the afternoon with her family. The registered provider said the residents have access to the home telephone and one resident has a mobile phone. Residents participate with the household tasks and the daily routines promote independence. Restrictions are in accordance with the resident’s care plan and risk assessments. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 12 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 and 19 Personal support is given to residents according to their needs ensuring their individual preference is respected. Service users have access to health care services as necessary to ensure their physical and emotional needs are met. EVIDENCE: The registered provider said she ensures that appropriate personal support, care and encouragement are provided in such a way as to respect resident’s privacy and dignity. The details are stipulated in the care plans. The daily routines are flexible and individual choice is respected. Both residents are registered with a GP and specialist health care workers are consulted as necessary, for example speech therapists, occupational therapists, dentists and doctors. Nutritional screening takes place and a healthy diet is provided and residents weight is monitored. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 13 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 The home has a satisfactory complaints procedure that ensures that residents are listened to and action is taken as necessary. EVIDENCE: The home has a written complaints procedure that includes suitable time scales for the process. The procedure has been acknowledged and signed by both residents as part of the service users guide. The registered provider said the relatives are aware of the procedure. There have been no complaints. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 14 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 The home and grounds are well maintained providing a safe environment for residents, staff and visitors. EVIDENCE: The home provides a warm, comfortable, homely environment. It is very clean, well furbished and free from odours. There is adequate heating, lighting and ventilation. The residents can easily access the garden, which is well maintained and equipped with garden furniture. The registered provider said there is an ongoing maintenance programme for the decoration and renewal of fabric in the home. Resident’s rooms are personalised with their own possessions. There are suitable laundry facilities situated in a utility room. Protective clothing is provided for infection control purposes. The registered provider is aware of infection control issues. It is recommended that the registered provider attend infection control training. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 15 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): There are no staff employed at present, the residents are well cared for by the registered provider EVIDENCE: Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 16 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 The manager is competent and experienced and residents benefit from a well run home. EVIDENCE: The registered provider is competent and experienced to run the home and has achieved the Registered Managers’ Award. She said she keeps up to date by attending relevant study days and reading care publications. She is attending first aid and fire fighting training in March 2006 and adult protection training in June 2006. She hopes to gain a place on a moving and handling course next term. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 17 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 X 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 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X X X X X X Appledown DS0000008953.V284629.R01.S.doc Version 5.1 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. 1. Standard YA23 Regulation 13 (6) Requirement The registered provider must obtain a copy of the local inter agency policy for the protection of vulnerable adults to accompany her adult protection policy Timescale for action 11/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA20 YA42 Good Practice Recommendations The registered provider should undertake appropriate medications training. The registered provider would benefit from undertaking infection control training. Appledown DS0000008953.V284629.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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