Inspection on 24/05/05 for Botchill House

This inspection was carried out on 24th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Botchill House 19/04/06

Botchill House 18/11/05

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 Announced 24/05/05 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 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 Stationary 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 D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Botchill House Address Hennesford Lane, Dawlish, Devon, EX7 0QX Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01626 863047 01626 863047 Botchill@havencare.com Havencare (Plymouth) Mrs Victoria Hales Care Home 15 Category(ies) of Learning disability (15), Physical disability (15) registration, with number of places Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 1/12/04 Brief Description of the Service: Botchill House is registered to provide accommodation with personal care to adults (aged between 18 to 65 years) with learning disabilities and/or physical disabilities. Although the home may accommodate up to 15 service users it is not envisaged that occupancy will exceed the present number of 12. The age range of the current service users is from around 40 to 53 years. A recently completed extension has improved the home’s facilities, and all service users now have single bedrooms. There is one bedroom on the ground floor. The extension has also provided a new laundry room, staff sleeping-in room and a large activities room. The home has two lounges and a dining 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, orchard and car parking area. It is located in an attractive rural position about two miles from Dawlish. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and took place over about seven and a half hours. A completed pre-inspection questionnaire was received from the manager before the inspection, and five comment cards were received from residents and four cards from relatives. All of the residents were spoken to (apart from two away on holiday) and six of the staff. A tour of the whole building took place. What the service does well: What has improved since the last inspection? No requirements were made at the last inspection. The recommendations which were made have been dealt with, relating to the redecoration of one bedroom and the replacing of the carpet in another. Further redecoration has also taken place, resulting in a pleasant, bright environment for the residents. One of the main benefits of the new extension has been the creation of a large activities room, which is now enabling the staff to offer more activities “inhouse” to the residents. Also one of the staff has recently been appointed as Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 6 the activities co-ordinator, which should help to ensure that this new room is well used. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 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 standard(s) 2. A prospective new resident’s needs would be assessed prior to his/her admission to the home. EVIDENCE: There has been no new admission to the home for many years. However there is a robust admissions procedure in place which requires the management to carry out a pre-admission assessment in the prospective resident’s own environment. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 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 standard(s) 6, 7 and 9. Residents are encouraged and supported to make decisions for themselves, which includes the taking of sensible and assessed risks. This is reflected in their individual care plans and in the range of activities that they take part in. EVIDENCE: Due to the nature of the residents’ disabilities they were unable to express a considered opinion on their lifestyle in the home. However it was apparent from conversations with the staff that they are encouraged to make decisions for themselves, with due regard to safety issues. For example one resident had decided that morning that she did not wish to join in the swimming group, which was respected by the staff. The building is not a secure environment and residents moved freely about the building and the immediate vicinity. Although assessment has shown that none can go out unaccompanied for any great distance, two or three are able to walk around the neighbouring orchard together. Activities which they take part in involving an element of risk include swimming and horse riding. There is a risk assessment in each of their individual files. There is a care plan for each resident, and a sample of these was inspected. The care plans had been assessed six monthly, followed by a written action plan. The action plans covered their health care and personal needs and their social needs. It was Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 10 noted that an independent advocate (Vocal) had been appointed in respect of one particular resident. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 11 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 standard(s) 12, 13, 15 and 16. The residents have opportunities to follow their particular interests and to engage in activities in the local community, including educational opportunities. They are able to have appropriate personal relationships with relatives and friends outside the home. EVIDENCE: On the day of the inspection several residents took part in activities within the local community (the home has a minibus and a car for the residents’ use). Some went swimming at the local swimming pool, one went out for his regular pub lunch, two went to an art group in Exeter, and two were to attend a social club that evening. Two residents were away for the week on holiday with two of the staff. Some attend courses at the local community college such as cookery, art, literacy and numeracy. A few regularly help staff to do the weekly food shopping. The staff ensure that residents are able to maintain contact with their families, and the majority have relatives who are concerned with their welfare. One resident was on holiday with his parents at the time of the inspection. Another Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 12 is regularly taken to see his parents, who live a considerable distance away and are now elderly. Some relatives are picked up by staff to visit the home. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 13 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 standard(s) 18, 19 and 20. Personal support is provided by staff in a way that maintains the dignity of the residents, while encouraging them to do what they can for themselves. The residents’ health is monitored carefully, and professional help is requested when felt necessary. There is a safe medication system. EVIDENCE: Throughout the inspection the staff were seen to be treating the residents with respect and with due regard to their dignity, and most of the residents appeared relaxed and contented. A key worker is assigned to each resident, bearing in mind the resident’s preferences and wishes. There is level access from the ground floor to the outside, although there is no need for any specific disability equipment for the current residents. All are registered with a local general practitioner, and have an annual health check. The key worker for one resident was concerned about a change in her behaviour and was in contact with the surgery about possible health problems. Each resident’s file contained an up to date health care plan. The residents have a six monthly dental check. None of the residents is assessed as able to self medicate. The medication cupboard and medication administration recording sheets were inspected and were satisfactory. The staff have received medication training (either from Boots or at the Havencare head office). Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 14 Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 15 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 standard(s) 22 and 23. There is a satisfactory complaint system, and arrangements for protecting residents from abuse are satisfactory. EVIDENCE: The home’s complaint procedure was displayed, and an attempt has been made to make it more comprehensible with the use of diagrams. Although some residents have very limited verbal communication the staff said that they generally know when they are discontented (from body language or behaviour). Most of the staff have worked at the home for several years and have come to understand the residents’ varying methods of communicating. One staff member has developed a book of pictures (which was seen) to help her communicate with the resident for whom she is key worker. The home has written policies on the protection of vulnerable adults, including a whistleblowing policy. The staff spoken to were aware of these policies and of where they are kept. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 16 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 standard(s) 24 and 30. Recent substantial investment has significantly improved the appearance and facilities of the home, which is a comfortable and safe environment for the residents. EVIDENCE: There is ample communal space comprising two lounges, a dining room and a new large activities room. This, together with spacious hallways, enables the residents to move about freely within the home, and to find a quiet place away from others if they wish. The staff are now also able to offer more activities within the home, and two staff ran a craft session with four residents during the afternoon. All bedrooms are single rooms, many of which have been personalised by their occupants. The home was clean and free from odour. There are policies and procedures for infection control. There is now a new laundry room, with two commercial washers and two dryers. Laundry is not carried through food areas. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 35. Staffing arrangements are satisfactory and staff morale is high, resulting in an enthusiastic workforce. The staff receive training appropriate to working with this client group. EVIDENCE: The staffing rota was inspected. The staff felt that the staffing levels enable them to give sufficient time to small groups or to individual residents, although it is not always possible to offer activities outside the home during evenings (when there are often only two staff on duty). Most of the staff have worked at the home for several years. There is not quite a full staff complement, and agency staff have had to be used regularly in the last few months. However, the manager said that the agency is usually able to supply people who know the home and the residents. There is a thorough staff recruitment procedure. A sample of references for new staff and Criminal Records Bureau disclosures was seen. The organisation offers staff good training opportunities. New staff are undertaking Learning Disability Award Framework accredited training. Two staff are doing NVQ level 3, the deputy manager is doing the NVQ assessor award, and the manager is doing the registered manager award. A variety of appropriate training is offered at the organisation’s head office. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 and 42. The home is run in the best interests of the residents, and arrangements to ensure their health and safety are satisfactory. EVIDENCE: A satisfaction questionnaire is used to gauge the views of relatives, and twice a year there is a “family and friends” day at the home for relatives and friends. The home is inspected monthly by staff from the organisation’s head office. Assessments of each resident are carried out in respect of their vulnerability. The fire log was inspected. All radiators accessible to residents have low surface temperature covers, and the hot water supply to the baths and washbasins is temperature regulated. These measures should prevent residents from suffering burns or scalds. Upstairs windows are restricted to prevent accidental falls. Staff carry out a monthly health and safety/fire safety check of the building. Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 Botchill House x 3 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 3 3 x Version 1.20 Page 20 D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc 16 17 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 3 x Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 21 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 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 Good Practice Recommendations Botchill House D54-D07 S3658 Botchill House V213655 240505 Stage 4.doc Version 1.20 Page 22 Commission for Social Care Inspection 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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