Inspection on 24/11/05 for Appledown

This inspection was carried out on 24th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Appledown 19/02/09

Appledown 09/03/07

Appledown 23/02/06

Appledown 23/02/05

Appledown 24/08/04

Appledown 18/03/04

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 08/07/2008.

CARE HOME ADULTS 18-65 Appledown Heather Lane Canons Town Hayle Cornwall TR27 6NG Lead Inspector Diana Penrose Unannounced Inspection 24th November 2005 01:30 Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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.V268513.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 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.V268513.R01.S.doc Version 5.0 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.V268513.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 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 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.V268513.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector visited Appledown Care Home on the 24 November 2005 and spent three and three quarter hours 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 23.02.05. In addition the inspector focused on the following key areas of care: choice of home, assessment and care planning, medicines, adult protection, some of the environment, recruitment and health and safety. On the day of inspection 2 residents were resident in the home and one receives respite care once a week. The methods used to undertake the inspection were to meet with one of the residents and 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: What has improved since the last inspection? The upstairs bedroom has been completed and is now in use. The water temperature to baths and showers has been regulated to 43ºC for resident’s safety. The policies and procedures have been reviewed. Risk assessments have been undertaken for residents and the environment. The statement of purpose and service users guide have been reviewed and now include the required information. The care plan documentation has been updated and the daily records improved. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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.V268513.R01.S.doc Version 5.0 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): 1 and 2 Prospective residents are given information about the home enabling them to make an informed decision. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide adequate care. EVIDENCE: There is a suitable statement of purpose and service users guide in use and available in the home. The registered provider said this is given to the relatives of prospective residents. The registered provider visits prospective residents prior to admission. She makes sure she has a Social Services assessment for prospective residents and gets information from family and other health professionals prior to deciding to accommodate anyone. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 Individual care plans are generated for each resident that inform and direct care provision. Residents make decisions about their lives; assistance and support is given where necessary. EVIDENCE: Each resident has an individual care plan that is reviewed every 4 months or more frequently if necessary. The care plans need to be signed as agreed or a reason stated as to why they are not signed. The residents have a review with their keyworker at the learning centre as well. Relevant risk assessments are undertaken. Daily records are maintained in separate diaries and are informative. The registered provider said that resident’s rights are respected and they are assisted with decision-making. There is a list of goals in the care plan documentation. The registered provider said that goals and targets are also discussed at the day centre. There is a reward system in place. One resident has an advocate who is in close communication with her. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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): 15 and 17 Residents have appropriate contact with family and friends; they are supported to develop relationships according to their wishes. Dietary needs of residents are well catered for with a varied selection of food available to meet their taste and preference. EVIDENCE: Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 11 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. Both residents have boyfriends and one resident talked about seeing her boyfriend at the day centre. The registered provider said the residents have access to the home telephone and one resident has a mobile phone. The registered provider said that residents have a variety of meals at the day centre each week and this had to be considered when organising the menu.She has a copy of the menu from the daycentre. There is a two week menu on the notice board with choices available. The registered provider said this is very flexible. Food records are maintained. A resident and the registered provider told the inspector of a recent birthday party at the home. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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): 20 There is a suitable system and policy in place for dealing with resident’s medicines that assures their safety. EVIDENCE: One resident requires medication which is administered by the registered provider. Medicines are stored securely in a locked wall cupboard. Appropriate records are maintained. There is a medication policy that has been reviewed. The registered provider should undertake appropriate medications training. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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): 23 Arrangements are in place to protect residents from possible risk of harm or abuse, improvements to the policy must take place to ensure these are robust. EVIDENCE: The home has a written Adult Protection and whistle-blowing policy. There is also a copy of the Cornwall Partnership Trust leaflets on abuse and the Adult Protection training video. The adult protection policy requires expansion to include the local inter agency policy. The registered provider said she would do this when she has attended the no secrets training which is imminent. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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. The home is clean and free from offensive odours making it a pleasant place to live in. EVIDENCE: The home provides a warm, comfortable, homely environment. It 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 at the home. There is a book for general repairs. The upstairs bedroom has been completed and is in use. 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.V268513.R01.S.doc Version 5.0 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): 34 EVIDENCE: There are no staff employed at present. The last member of staff was a close friend of the registered provider and there were records missing from her file as stated in the last report. As the registered provider intends to employ staff in the future she is required to produce and implement a thorough recruitment policy. She must undertake the relevant employment checks for prospective employees. No staff are to commence work without a POVA check and two references. Staff awaiting their CRB disclosure must work under supervision at all times. The recruitment records required by legislation must be maintained. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 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): 39 and 42 The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place, reporting to the Commission will ensure that regulatory requirements are met. The registered providers promote the safety the residents and appropriate checks are undertaken to ensure the health, safety and welfare of residents and visitors. EVIDENCE: Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 17 The registered provider has developed a suitable quality monitoring system for the home. She said the day centre also undertakes a questionnaire with the residents based on their goals. The registered provider said she has regular contact with the resident’s relatives as well. The registered provider must send an annual report of her quality assurance findings to the Commission. The environmental risk assessments have been undertaken. The fire risk assessment has also been completed and fire drills take place regularly. Hazardous substances are stored safely and data sheets are available for COSHH purposes. There is also a COSHH policy. There have been no accidents in the home. The registered provider has achieved the Basic Food Hygiene Certificate and is booked on a first aid course in December 2005. It is recommended that she undertake infection control training. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Appledown Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000008953.V268513.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? Yes 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 2 3 Standard YA23 YA34 YA34 Regulation 13 (6) 19 17 (2) Sch 2 & 4 19 18 (a) 19 24 (2) Requirement The adult protection policy must include the local inter agency policy The Registered Provider must produce a recruitment policy The recruitment records required by legislation must be maintained when staff are employed Staff must not commence work without a POVA check and two references. Staff awaiting their CRB disclosure must work under supervision at all times. An annual report of the quality assurance findings must be sent to the Commission. Timescale for action 26/01/06 26/01/06 24/11/05 4 5 6 YA34 YA34 YA39 24/11/05 24/11/05 26/01/06 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 Refer to Standard YA20 Good Practice Recommendations The registered provider should undertake appropriate DS0000008953.V268513.R01.S.doc Version 5.0 Page 20 Appledown 2 YA42 medications training. The registered provider would benefit by undertaking infection control training. Appledown DS0000008953.V268513.R01.S.doc Version 5.0 Page 21 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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