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Inspection on 26/08/05 for Boxtree Cottage

Also see our care home review for Boxtree Cottage for more information

This inspection was carried out on 26th August 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Boxtree Cottage continues to offer a good quality service to those living in the home and provides specialist care and support in a homely and comfortable environment. Service users spoken to during the inspection were complimentary about the services and care they received.

What has improved since the last inspection?

A new snack area, with a sink, fridge and work surface adjacent to the main kitchen, is nearing completion. This will give service users access to snacks e.g. biscuits and other individually packaged foods and drinks throughout the day with assistance from staff when necessary. Locks have been installed to cupboards in the locked room where medication is stored to provide further security.

What the care home could do better:

The kitchen is due to be totally renovated within the next three months to provide more up to date equipment, appliances and storage.

CARE HOMES FOR OLDER PEOPLE Boxtree Cottage Way Lane Waterbeach Cambridgeshire CB5 9NQ Lead Inspector Andy Green Unannounced 26 August 2005 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 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Boxtree Cottage Address Way Lane, Waterbeach, Cambridgeshire, CB5 9NQ 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) 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. Individuals in the category of Mental Disorder (MD) should not be under 40 years of age. Date of last inspection 10/2/05 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. 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulation Inspector, Andy Green undertook this unannounced inspection on 26th August 2005. The inspector met with the manager, staff and service users to gather views regarding the services offered in the home. A number of records were inspected including care plans, training records and staff files. 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: 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 7 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 standard(s) 1,2,5 Service users have access to good information, and can make an informed choice regarding the home’s services. EVIDENCE: The home has a statement of purpose and service users guide, which meet the requirements of the relevant standards. The manager stated that there had not been any changes made since the last inspection but that these documents will be reviewed in the forthcoming months to ensure that they remain up to date and accurately reflect the services that are provided. Information gathered prior to admission indicated that an appropriate assessment of service users’ needs is carried out in order to ensure that the home is suitable to meet the needs of the person concerned. A number of visits are arranged prior to admission to ensure that prospective users can be integrated into the home. The registered 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 8 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 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 are in place to ensure each service user receives appropriate health care. Care plans indicated that service users healthcare needs are met and any changes are recorded on a regular basis and updated as required. Personal care is given in a manner that maintains individuals’ dignity. The importance of respecting service users’ privacy and dignity is highlighted in the home’s Statement of Purpose and Service Users Guide and included in the staff induction. Staff were observed to knock and wait before entering service users’ bedrooms. All personal care is given in service users bedrooms. 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. Recording is also in place to show the receipt of medication. Training is given to staff before they are allowed to administer medication and members of staff who are delegated to monitor the administration of medication also be attending advanced medication training. Locks have been Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 9 installed to cupboards in the locked room where medication is stored to provide further security. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 10 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 standard(s) 12,13,14,15 Staff provide appropriate support to ensure that service users have access to activities appropriate to their needs. EVIDENCE: Ranges of activities for service users are provided including musical entertainment, quizzes, shopping trips and visits to the local pubs. Day trips to local towns and coastal resorts are also planned throughout the year. Service users are encouraged to maintain contacts with family and friends and with the local village community. Service users spoken to confirmed that they were able to see their visitors at any time. The home has a summer and winter menu and meal choices are discussed on a regular basis. On the day of inspection a member of staff was meeting with a group of service users to plan meals for the forthcoming week. Special diets for four diabetic service users are also provided in the home. Service users spoken to expressed their satisfaction with the food provided. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 11 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 standard(s) 16,17,18 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, and the manager stated that he proactively deals with any issues of concern that are raised. The home has an adult protection policy to guide staff in dealing with allegations of abuse. This is included in the home’s policy on whistle blowing to encourage staff to voice any concerns they may have. Two members of staff are undertaking in depth training in Adult Protection Procedures, which they will then cascade to care staff in the home to ensure they receive annual updates. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 12 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 standard(s) 19,20,24,25,26 The environment is suitable for the needs of those living in the home. EVIDENCE: The building is well maintained and had a homely and pleasant atmosphere with a good standard of décor. The gardens were accessible to people with reduced mobility and were well kept. Furnishings and fittings in the home are of good quality and rooms are well lit, bright and airy service users have access to safe, comfortable and homely communal facilities, which meet their requirements. The home has three sitting rooms, three dining rooms and a dedicated area for smokers. One of the bedrooms has recently been redecorated. Further refurbishments and decorations are now being planned throughout the home during the forthcoming year. A new snack area, with a sink, fridge and work surface adjacent to the main kitchen, is nearing completion. This will give service users access to snacks e.g. biscuits and other individually packaged foods and drinks throughout the day with assistance from staff when necessary. This will also aid food hygiene in the main kitchen as some of the service users have unhygienically handled food for main meals, which has caused concerned Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 13 at times in the home. The manager stated that the kitchen is also due to be totally renovated within the next three months to provide more up to date equipment, appliances and storage. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 The home’s recruitment policy and processes makes sure that service users are protected from harm. 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. Ancillary are employed, waking night staff are on duty overnight and an on call system is in place for management support when needed. Staff were courteous, welcoming and helpful and observations confirmed that service users have a friendly and sociable relationship with staff who are employed at the home. The registered manager stated that there were currently two vacancies for carers and it was anticipated that at least one new carer would be appointed following an adequate POVA/CRB check Three staff files were inspected and two written references, a contract of employment, job description setting out their responsibilities and duties were found. CRB checks have been carried out and a photograph of each staff member is also held on file. All staff are over 21 years of age. There is a training programme in place to ensure that staff receive mandatory health & safety and client related training with updates and refreshers. Staff spoken to on the day of inspection confirmed that they had received training in moving and handling, food hygiene, first aid, continence and adult protection. NVQ training is also in place for all care staff. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,36,37,38 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. EVIDENCE: The manager has successfully managed the home for more than 20 years. He has undertaken periodic training to update his knowledge, skills and competence, and discussions indicated that he had a clear understanding of his responsibilities. Quality assurance systems have been developed, including a questionnaire, which is given to service users on a monthly basis to audit all aspects of the services provided. Monthly staff meeting also take place o raise any concerns or make suggestions. Staff receive regular recorded supervision meetings on at least six occasions during the year to ensure that their practice is regularly monitored and appraised. Staff spoken to during the inspection confirmed this to be the case. Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 16 The manager undertakes 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 x 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 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 x x x 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 3 3 3 3 x x x 3 3 3 Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 18 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 none 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 none Good Practice Recommendations Boxtree Cottage I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 19 Commission for Social Care Inspection 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 I53 I03 15090 BOXTREE COTTAGE V234638 280605 STAGE 4.doc Version 1.30 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!