Inspection on 09/03/07 for Appledown

This inspection was carried out on 9th March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Appledown 19/02/09

Appledown 23/02/06

Appledown 24/11/05

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 Key Unannounced Inspection 9th March 2007 13:30 Appledown DS0000008953.V333044.R01.S.doc Version 5.2 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.V333044.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 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.V333044.R01.S.doc Version 5.2 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.V333044.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 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 upstairs bedroom has an ensuite bathroom. The home is 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. Information about the home is available in the form of a statement of purpose / residents’ guide, which can be supplied to enquirers on request. A copy of the most recent inspection report is available in the home. Fees range from £325.00 to £640.00 per week; this information was supplied to the Commission in the pre-inspection questionnaire received on 16/01/07. Additional charges are made in respect of private healthcare provision, hairdressing and personal items such as confectionary and toiletries Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An Inspector visited Appledown Care Home on the 09 March 2007 and spent four hours at the home. This was a key inspection and an unannounced visit. The purpose of the inspection was to ensure that residents’ needs are properly met, in accordance with good care practices and the laws regulating care homes. The focus was on ensuring that residents’ placements in the home result in good outcomes for them. It was also to gain an update on the progress of compliance to the requirements identified in the last inspection report dated 23 February 2006. All of the key standards were inspected. On the day of inspection three residents were living in the home. The methods used to undertake the inspection were to meet with the residents and the registered provider to gain their views on the services offered by the home. Records, policies and procedures were examined and the inspector toured the building. This report summarises the findings of this inspection. The registered provider has complied with the requirements set at the last inspection. Residents expressed satisfaction with the care and services provided at the home and were treated with kindness and respect. Overall the home is providing a good quality of care to the residents placed there. What the service does well: The home provides a warm, clean, homely environment for residents where they live as part of a family. There is ongoing maintenance and risk assessments have been undertaken to ensure it is a safe place to live in. Residents were observed interacting well together and with the registered provider in a very relaxed atmosphere. Residents have excellent contact with their family and friends. They go out with them or stay with them when they wish, they can visit at anytime or they can be contacted by telephone. Residents showed the inspector photographs of their family and friends including their boyfriends. They talked about their outings, weekends with family and holidays. Residents are encouraged to take responsible risks and written risk assessments are in place. One resident said she goes out on the local bus and has a mobile phone to contact the registered provider. Personal safety is paramount and training for residents is ongoing. Activities take place in the home and the registered provider takes the residents out for walks and shopping trips and so on. The residents attend appropriate day centres where assistance is given with educational needs and they also attend a local college. Participation with household tasks is encouraged and the registered providers promote independence. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 6 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, Ms Wright delivers all the care and personal support to the residents in accordance with their written care plans. Healthcare needs are met and specialist workers are involved when 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. 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. The summary of this inspection report can be made available in other formats on request. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 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.V333044.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are only admitted to the home following an assessment of their needs to ensure the home can provide suitable care. However this assessment needs to be recorded and any assessment s from other agencies maintained on file. EVIDENCE: Evidence was provided in the form of documentation and talking with the registered provider. The registered provider stated that she went to see the newest resident several times prior to admission. She said the resident and her sister visited Appledown and the resident came for an overnight stay prior to any decision being made for her to move in. She said the Social Worker had provided a care plan, which was not up to date, a copy has not been retained in the home, and a CPN was also involved. The registered provider has written a care plan from the information gathered but had not compiled a written assessment for the prospective resident. The registered provider must evidence that prospective residents needs have been assessed prior to admission. This was discussed and the registered provider who agreed to ensure documentation is on file in future. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 9 Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Individual care plans are generated for each resident that are informative as to their needs. They will need to be more directive if staff are to be employed. Residents make decisions about their lives; assistance and support is given where necessary. Risks are assessed and appropriate support is given to enable residents to lead an independent lifestyle. EVIDENCE: Evidence was provided in the form of documentation, records, case tracking, interviews with residents, staff and registered provider. Each resident has an individual care plan that is drawn up with the residents and their family, they will need to be more detailed if staff are employed to direct the care provision. The care plans are reviewed at least every six months, more frequently if necessary. The registered provider said that the DASC are not very forthcoming to attend resident reviews. The residents do have a review with their key-worker at the learning centre as well. Relevant Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 11 risk assessments are undertaken. Daily records are maintained in separate diaries and are informative. The registered provider is going to attend a training course on person centred planning in June 2007. The registered provider said that resident’s rights are respected and they are assisted with decision-making. The registered provider said that goals and targets are set in the home and at the day centre. There is a reward system in place. The quality assurance questionnaires sometimes inform decision-making The registered provider was helping the residents decide what to do over the weekend when routines are flexible. The current residents are unable to manage their finances, however they have pocket money. One resident had been to the pub for lunch she had taken money with her and brought back the change. 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 and road safety training is ongoing. One resident now goes out alone on public transport she has a mobile phone to communicate with the registered provider. The home has a written procedure in respect of the action to be taken if a resident should go missing from the home. A home alone policy is being compiled for one resident. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents 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 residents the opportunity to socialise. Residents have appropriate contact with family and friends; they are supported to develop relationships according to their wishes. Residents participate with household tasks according to their individual risk assessment, their rights and individual choices and preferences are respected. Dietary needs of residents are well catered for with a varied selection of food available to meet their taste and preference. EVIDENCE: Evidence was provided in the form of documentation, records, observation, talking with residents and the registered provider. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 13 Residents are encouraged to continue their education, undertake training and join in activities as they wish. They all 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. They all attend college as well on a vocational key skills course. One resident is hoping to do animal care at a local centre. Literacy and numeracy skills are taught at the day centres and encouraged by the registered provider. She said that residents write shopping lists and are encouraged to copy typed notes in their personal files. They are all helped to manage their money. 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 and for meals and so on. One resident goes out alone in accordance with her care plan and risk assessment. The registered provider said that all of the residents have contact with their families as they wish. The records show that contacts are made and that visits take place. One residents said she stays with her sister every Sunday and sees her when she wishes during the week. One showed the inspector photographs of herself with her family. Friends and family visit the home. Residents said they have boyfriends who can visit the home and they meet them at the Gateway Club. The registered provider said 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. The registered provider said that residents open their own mail and are addressed by their preferred name. The registered provider said that residents have a variety of meals at the day centre each week and this has to be considered when organising the menu.She has a copy of the menu from the daycentre. There is a weekly menu on the notice board with choices available. The registered provider said this is very flexible and the residents help to compile the menu. Fresh fruit and vegetables are included. Food records are maintained. Residents talked about their lunch at the day centres and of what they would like for tea. They help to make drinks and are involved with the preparation of cold meals. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal support is given to residents according to their needs, ensuring their individual preference is respected. Residents have access to health care services as necessary to ensure their physical and emotional needs are met. There is a suitable system and policy in place for dealing with resident’s medicines that assures their safety. EVIDENCE: Evidence was provided in the form of documentation, records, and observation, talking to the registered provider. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 15 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. One resident had a bath during the inspection and her privacy was respected, the registered provider only assisted with her hair washing. The daily routines are flexible and individual choice is respected. All 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. A bereavement counsellor visited one resident during the inspection. There is a suitable medication policy. Medicines are stored securely in a locked wall cupboard. A monitored dose system is in use and appropriate records are maintained, new MAR charts have been implemented. Medicines received need to be entered on the charts and this was discussed with the registered provider. Patient information leaflets are kept and the registered provider has a copy of the royal pharmaceutical guidelines for care homes. The registered provider has undertaken appropriate medications training since the last inspection. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a suitable complaints procedure that ensures complaints will be listened to and acted upon. Arrangements are in place for the protection of residents safeguarding them from harm or abuse. EVIDENCE: Evidence was provided in the form of documentation, observation and talking to the registered provider There is a suitable complaints procedure in place that is available to the residents and their relatives. The residents were relaxed in the home and aired their views openly. There have been no complaints to the home or the Commission. 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 registered provider has attended the ‘No Secrets’ training and has a copy of the local inter agency procedures. There is a safe system for the management of resident’s money. Records are maintained of each transaction and receipts for expenditure are kept. The registered provider is appointee for the residents and deals with their money. Each resident has a lockable cash tin for the storage of money. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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: Evidence was provided in the form of a tour of the building, observation and discussion with the registered provider. The home provides a warm, comfortable, homely environment. It is 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. Some new furnishings have been purchased since the last inspection and an en-suite bathroom has been added to the upstairs bedroom. Resident’s rooms are personalised with their own possessions. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 18 There are suitable laundry facilities situated in a utility room. Protective clothing is provided for infection control purposes. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): These standards are not applicable as no staff are employed. EVIDENCE: There are no staff employed at present, the residents are well cared for by the registered provider. There is a recruitment policy that will be implemented if staff should be employed in the future. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager is competent and experienced and residents benefit from a well run home. The home is run in the best interest of the residents and they benefit from the Quality Assurance systems in place. The registered providers promote the safety of the residents and appropriate checks are undertaken to ensure the health, safety and welfare of residents and visitors to the home. EVIDENCE: Evidence was provided in the form of documentation, records and talking with residents and the registered provider. The registered provider is competent and experienced to run the home. She has achieved the Registered Managers’ Award and said she keeps up to date by attending relevant study days and reading care publications. She has Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 21 attended adult protection training and medication training since the last inspection. She has a good rapport with the residents and they interact well with her. Residents said the registered provider looks after them well. The registered provider has developed a suitable quality monitoring system for the home that includes six monthly surveys with the residents and their family and friends. Results have been positive. 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 and they are involved in the running of the home. There are environmental risk assessments for the home. 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 attended a first aid course. It is recommended that she undertake infection control training. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 22 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 2 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 N/A 35 N/A 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 23 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. 1. Refer to Standard YA42 Good Practice Recommendations The registered provider would benefit from undertaking infection control training. Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Appledown DS0000008953.V333044.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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