Inspection on 18/11/05 for Botchill House

This inspection was carried out on 18th 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Botchill House 19/04/06

Botchill House 24/05/05

Botchill House 01/12/04

Botchill House 04/05/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Botchill House Hennesford Lane Dawlish Devon EX7 0QX Lead Inspector Mark Sharman Unannounced Inspection 18th November 2005 12:00 Botchill House DS0000003658.V267194.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 Botchill House DS0000003658.V267194.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. Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Botchill House Address Hennesford Lane Dawlish Devon EX7 0QX 01626 863047 01626 863047 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) Havencare (Plymouth) Mrs Victoria Hales Care Home 15 Category(ies) of Learning disability (15), Physical disability (15) registration, with number of places Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24/5/05 Brief Description of the Service: Botchill House is registered to provide accommodation with personal care to adults 18 to 65 years of age with learning disabilities and/or physical disabilities. Although the home may accommodate up to 15 residents it is not envisaged that occupancy will exceed the present number of 12. The age range of the current residents is from around 40 to 53 years. Accommodation is over two floors and all residents have a single bedroom, one bedroom being on the ground floor. Communal areas include two lounges, a dining room and a large activities room. There is no lift. The building itself is a large detached property standing in its own extensive grounds, which include a sensory garden, patio area, large orchard and car parking area. It is located in an attractive rural position about two miles from Dawlish. Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and about four and a half hours were spent at the home. Most of the twelve residents were spoken to, although it was not possible to communicate with all. The manager was away and time was spent with the deputy manager, and three other staff were also consulted. A sample of the home’s records was inspected and all of the communal rooms and bedrooms were seen. What the service does well: What has improved since the last inspection? No requirements or recommendations were made at the last inspection. Full use is now being made of the activities room which was built quite recently as part of an extension to the home. This is a large purpose-built room equipped for craft work etc., and fitted with kitchen equipment for use in teaching residents cooking and other life skills. It has proved to be of great benefit to them, especially in view of the closure of a local day centre which they used to attend. Botchill House DS0000003658.V267194.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. Botchill House DS0000003658.V267194.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 Botchill House DS0000003658.V267194.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): None of these Standards was assessed on this occasion. No new resident has been admitted to the home since the last inspection. EVIDENCE: Botchill House DS0000003658.V267194.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 9. Care planning is systematic and thorough and care plans are updated to reflect changing needs. Residents are helped and encouraged to take part in a range of activities some of which involve an element of risk. EVIDENCE: There is a care plan for each resident, and a small sample of these was inspected. They had been reviewed six monthly, and the reviews were followed by a written action plan. These action plans covered their health care and personal needs and their social needs. An annual review is also held to which relatives and care managers are normally invited (if residents wish). The residents’ individual files contained a number of risk assessments relating to activities which they take part in. Residents have free access into and around the home and they moved freely about the building and the immediate vicinity. Although assessment has shown that none can go out unaccompanied for any significant distance, some do regularly access the grounds and orchard. Activities which they take part in involving an element of risk include swimming and horse riding, both activities taking place each week. Botchill House DS0000003658.V267194.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): 12, 14 and 17. The residents have opportunities to pursue their particular interests and to engage in activities in the local community, including educational opportunities. The catering arrangements are satisfactory and they are encouraged to eat healthily. EVIDENCE: There is a budget for activities and one of the staff is designated as the activities co-ordinator. There was quite a busy atmosphere in the home with most residents involved in some activity. Three of them were out with staff on a regular weekly shopping trip for the home’s provisions, and one was attending an art therapy course in Exeter. The home has a modern, well equipped crafts/activities room where some residents were involved in painting and craft work at various times through the day. A weekly professional pottery class is held in this room. Three residents went for a walk and a drink at a pub in the afternoon, and three have a swim at the local leisure centre every Friday. Educational courses are available at the Community College and currently two residents attend a craft class there. Menus are planned on a four weekly basis, with a snack meal at midday and the main meal in the early evening (fish and chips etc. on the day of this inspection). The lunch was popular with the residents, who clearly enjoy their Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 11 food. Several of them have a weekly individual session with staff preparing their own meal as part of life skills training. Botchill House DS0000003658.V267194.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): 18 and 20. Personal support is provided by staff in a respectful way and with encouragement and support to residents to do what they can for themselves. There is a satisfactory medication system. EVIDENCE: Throughout the inspection the staff were seen to be treating the residents with respect and with due regard for their dignity. Help is provided where necessary with personal hygiene and choice of clothing, and the residents were appropriately dressed. A key worker system is in use, with allowance being made for the resident’s own preferences for certain staff. None of the current residents has any significant mobility problem and there is no need for any specific disability equipment. None of the residents is assessed as being able to self-medicate reliably. There is a good quality medication cupboard, and a sample of medication administration recording sheets were inspected and were satisfactory. The staff who administer medication have received medication training (either from Boots or at the Havencare head office). Botchill House DS0000003658.V267194.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): 22 There is a satisfactory complaint system which takes into account the special needs of the residents. EVIDENCE: The home’s complaint procedure was displayed, supplemented with diagrams to make it more comprehensible to the residents. Some residents have very limited verbal communication, but staff said that they generally know when they are discontented (via their body language or behaviour). It was evident during the inspection that the staff have developed the ability to communicate effectively with the residents most of the time. Residents can make a complaint one to one with a staff member of their choice. No complaint has been made to the Commission for Social Care Inspection since the last inspection. Botchill House DS0000003658.V267194.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, 25 and 30. The home is comfortable, spacious and safe and was found to be warm and clean. EVIDENCE: The standard of accommodation is commendable. Residents benefit from a lot of communal areas including two large lounges, a dining room and a large well-equipped activities room. All have a single bedroom and these are spacious and comfortably furnished. The building was clean and there is an excellent laundry room equipped with two commercial washers and two dryers. There are policies and procedures for infection control, and special (dissolvable) bags are used for washing soiled laundry. Botchill House DS0000003658.V267194.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): 32, 33 and 34. Staffing arrangements are satisfactory and staff morale is high. There is a good staff training programme, although the NVQ target has not yet been met. Staff recruitment practice is satisfactory. EVIDENCE: There was an adequate number of staff on duty at the time of this inspection. The staffing rota was inspected. The staffing levels during the day are sufficient to enable staff to give time to small groups or to individual residents, and consequently residents are able to take part in a wide variety of activities throughout the week. It is not always possible to offer activities outside the home during evenings, but most residents have a fairly active day. The staff reported that the organisation offers good training opportunities, and a new staff member said confirmed that she is to undergo an accredited induction programme. Several staff have achieved NVQ level 3, although the 50 NVQ target has not yet been achieved. Botchill House DS0000003658.V267194.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): 37 The home is well managed by an experienced manager with support and supervision from head office staff. EVIDENCE: The registered manager has been a qualified learning disability nurse since 1992. She has been in a managerial role within a range of learning disability services for the past 18 years. She is currently undertaking the NVQ registered manager award, and this Standard will be fully met when this is completed. Staff meetings are held regularly, and the minutes of the last meeting (November) were available. A monthly inspection of the home is made by head office staff as required by the Regulations, and a report sent to the Commission for Social Care Inspection. Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 3 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Botchill House Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x x x DS0000003658.V267194.R01.S.doc Version 5.0 Page 18 x Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 19 No. Are there any outstanding requirements from the last inspection? 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 YA41 Regulation 17 Requirement A written record of all visitors to the home must be kept. Timescale for action 30/11/05 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 Botchill House DS0000003658.V267194.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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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