Inspection on 11/01/06 for Boxtree Cottage

This inspection was carried out on 11th January 2006.

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

Boxtree Cottage 12/04/07

Boxtree Cottage 26/08/05

Boxtree Cottage 08/02/05

Boxtree Cottage 24/08/04

Boxtree Cottage 22/03/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOMES FOR OLDER PEOPLE Boxtree Cottage Way Lane Waterbeach Cambridgeshire CB5 9NQ Lead Inspector Andy Green Unannounced Inspection 17th January 2006 11.45 X10015.doc Version 1.40 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 Boxtree Cottage DS0000015090.V260206.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 Older People. 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. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Boxtree Cottage Address Way Lane Waterbeach Cambridgeshire CB5 9NQ 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) 01223 860859 01223 441861 Mr Jeffrey Robert Lloyd Mrs Agnes Catherine Lloyd Mr Jeffrey Robert Lloyd Care Home 14 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number disorder, excluding learning disability or of places dementia (14), Mental Disorder, excluding learning disability or dementia - over 65 years of age (14) Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Individuals in the category of Mental Disorder (MD) should not be under 40 years of age 26th August 2005 Date of last inspection Brief Description of the Service: Boxtree Cottage aims to provide a comfortable private care home for 14 people over the age of forty who are diagnosed as mentally ill or have suffered organic impairment such as dementia. The cottage is approximately four hundred years old, and has been renovated and extended. There are three sitting rooms, three dining rooms and a room specifically for smokers. There is also a snack area available to service users.Twelve of the 14 bedrooms are for single occupancy and 4 have ensuite facilities. There is level access to the attractive cottage garden, which has a range of outdoor furniture and numerous flowering shrubs and planted tubs. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulation Inspector, Andy Green undertook this unannounced inspection on 17th January 2006. The inspector met with the manager, acting deputy, one of the providers and service users to gather views regarding the services offered in the home. A number of records were inspected including care plans, training records, staff files, medication records and fire testing records. A tour of the building and grounds was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that CRB checks are in place prior to staff commencing employment in the home. Recorded supervision for all staff needs to be increased to ensure that adequate monitoring regarding performance and development is in place. The provider needs to undertake monthly visits to the home to ensure that the services provided are monitored. Copies of reports regarding the visits need to be forwarded to CSCI with a copy retained in the home. It is recommended that the storage of staff files and training files is reviewed to aid accessibility and lessen duplication. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 6 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. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 9 There have not been any changes made to the statement of purpose and service users guide since the last inspection. The manager stated that these documents will be reviewed during the year to ensure that they remain up to date and accurately reflect the services that are provided. The home receives a variety of information prior to admission to assist in making an appropriate assessment of service users’ needs and to ensure that the home is suitable to meet the person’s needs. Prospective service users continue to make a number of visits prior to admission to ensuring that they can make an informed decision about whether they wish to live in the home. The inspector met with a prospective service user who was visiting the home and she indicated that she is looking forward to moving in to the home in the near future. The manager continues to liaise with health care professionals including district nurses, GPs, and psychiatric services. Aids and adaptations are in place to meet residents’ needs. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Service users receive appropriate health and personal care to meet their assessed needs. Medication is administered and recorded accurately. EVIDENCE: Arrangements continue to be in place ensuring that each service user receives appropriate health care. During the day a number of service users had appointments with a chiropodist who was visiting the home. Two care plans were inspected and they indicated that support and healthcare needs are met with regular reviews in place. Any changes in care are recorded on a monthly basis and updated as required. Service users spoken to indicated that personal care is given in a way that meets their needs. All personal care is given in service users bedrooms. The home is committed to ensuring service users’ privacy and dignity is respected at all times. This is highlighted in the home’s Statement of Purpose and Service Users Guide and is also included in the staff induction. Staff were observed to speak to service users in a sensitive and friendly manner. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 11 The home uses a monitored dosage system for the recording and administration and there is a medication policy in place. The records of the home were inspected and found to be accurate. Staff receive training from a local pharmacist regarding the administration of medication. A local CPN also gives training regarding medication used for psychiatric conditions. One of the care staff continues to have the delegated task of monitoring the administration of medication in the home. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Staff provide appropriate support to ensure that service users have access to activities appropriate to their needs. EVIDENCE: Ranges of activities continue to be offered to service users including musical entertainment, quizzes, shopping trips and visits to the local pubs. On the day of inspection a member of staff was involved in a quiz with a number of service users in the lounge. Day trips to local towns and coastal resorts are also regularly undertaken throughout the year. Service users are encouraged to maintain contacts with family and friends and with the local village community. The home has a planned menu and meal choices are discussed at weekly meetings with service users. Alternative choices can be offered when required. Special diets for diabetic service users, and low fat diets, are also provided in the home Service users spoken to expressed their satisfaction with the food provided. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16.18 The home has a complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. EVIDENCE: The home had a clear complaints procedure, which is included in the service users guide. The home has received no complaints since the last inspection. CSCI has not received any concerns or complaints since the last inspection. The home has an adult protection policy to guide staff in dealing with allegations of abuse. Two members of staff are undertaking a three-day in depth training in Adult Protection issues, which they will then cascade as part of the in house training programme for all staff. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,25 The environment is suitable for the needs of those living in the home. EVIDENCE: The premises and gardens continue to be well maintained and communal areas and bedrooms are presented in a comfortable and homely manner. Furnishings and fittings in the home are of good quality and rooms are bright and airy. Service users continue to have access to safe communal facilities including a dedicated area for smokers, which meets their requirements. Further refurbishments and decorations are now being planned for the home during the forthcoming months. The main kitchen has been totally refurbished to a high standard with easily cleaned wall surfaces, new storage cupboards and work surfaces. New fridges, and cookers have also been installed. The snack area has also been completed. This gives service users more independence in making there own snacks and drinks throughout the day with assistance from staff when necessary. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 15 This has improved hygiene in the main kitchen as some of the service users had unhygienically handled food in the fridges which had caused concerned at times in the home. Service users do not have unsupervised access to the main kitchen. The manager stated that an outside storage area is being added, adjacent to the kitchen to re-house the freezers and provide more dry food storage. The area outside the kitchen has been refurbished with a new hard surface along with a new surface in the car parking area. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,29,30 The home’s recruitment policy and processes makes sure that service users are protected from harm. However improvements are need regarding CRB checks. Training is provided to make sure that care staff are competent to deliver care to the service users they support. EVIDENCE: Sufficient numbers of staff were on duty during the inspection to meet the needs of the service users present. Waking night staff are on duty overnight and an on call system is in place for on site management support when required. The acting deputy manager stated that there was currently one vacancy for a care post and it was anticipated that this would be recruited to soon following an adequate POVA/CRB check Two staff files were inspected and included two written references, a contract of employment, CRB checks and job description. The newly appointed part time cook’s CRB had not yet been returned and the manager was reminded that all non-care staff should have a satisfactory CRB in place prior to the commencement of their employment. There is a training programme in place to ensure that staff receive mandatory health & safety training including fire, moving & handling with updates and refreshers. Client related training is also arranged including mental health awareness and medication administration. NVQ training is also in place for all care staff. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,36,37,38 The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive a god standard of care. However, improvements are needed regarding staff supervision and required monitoring visits from the provider. EVIDENCE: The manager has successfully managed the home for more than 20 years and he undertakes periodic training to update his knowledge. Quality assurance systems continue to be in place including a questionnaire, which is given to service users on a regular basis to audit all aspects of the services provided. One of the providers of the home is now available, following a long-term illness, to undertake monthly monitoring of the service. She will send a copy of her report to CSCI with a copy retained in the home. Staff meetings also take place where staff are encouraged to raise any concerns or make suggestions regarding the services provided. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 18 Staff receive ongoing supervision and support from the management team in the home. However, staff files indicated that supervision meetings had been infrequent in the last six months. This area needs to be improved to ensure that all staff receive six sessions, as outlined in the standards to monitor individual performance and development needs. It is also recommended that the storage of staff files and training files be improved to provide a more accessible format so that required information/documents can be easily viewed. Health and safety checks and service contracts are in place to check equipment in the home. Fire records inspected were found to be accurate and up to date. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X X X 3 X STAFFING Standard No Score 27 3 28 X 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X X 2 2 3 Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 20 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 OP29 Regulation 19(5)(d) (i) Requirement Timescale for action 17/01/06 2 3 OP31 OP36 26 18(2) The registered person must ensure that adequate CRB checks are made before staff commence employment in the home. The provider must make monthly 28/02/06 visits to the home with a copy of their report sent to CSCI. The registered person must 31/03/06 ensure that staff receive regular recorded supervision. 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 37 Good Practice Recommendations It is recommended that staff files and training files are stored in a more accessible manner. Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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. Extracts may not be used or reproduced without the express permission of CSCI Boxtree Cottage DS0000015090.V260206.R01.S.doc Version 5.0 Page 22 - 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. 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