Inspection on 27/02/06 for Brickfields Cottage

This inspection was carried out on 27th February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Brickfields Cottage 02/05/07

Brickfields Cottage 03/05/06

Brickfields Cottage 05/04/05

Brickfields Cottage 07/10/04

Brickfields Cottage 14/04/04

Similar services:

Claremont House

Coopers Mill Ltd

Sun Court Nursing Home

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

15 Bramble Close

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

CARE HOME ADULTS 18-65 Brickfields Cottage Hare Street Road Buntingford Hertfordshire SG9 OAB Lead Inspector Bijayraj Ramkhelawon Unannounced Inspection 27th February 2006 12:10 Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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 Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Brickfields Cottage Address Hare Street Road Buntingford Hertfordshire SG9 OAB 01763 289 230 01763 289 012 robin.brandon@turningpoint.co.uk 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) Turning Point Southern Area Office Care Home 6 Category(ies) of Learning disability (6), Physical disability (1) registration, with number of places Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. This home may accommodate 6 people with learning disability. This home may accommodate up to 1 person with physical disability (when associated with learning disability). 5th April 2005 Date of last inspection Brief Description of the Service: Brickfields Cottage is a care home providing personal care and accommodation for 6 adults with a learning disability, three of whom may have associated physical disabilities. It is owned by Turning Point. The home is located two miles east of Buntingford and one mile to Hare Street village, which is in a rural area of Hertfordshire. The home has its own means of transportation. The home is a large detached two-storey house. It has six single bedrooms, three on each floor. The three ground floor bedrooms accommodate service users with physical disabilities. There are adequate bathing and toilet facilities on each floor. Communal space is provided on the ground floor and comprises of a large lounge, dining room and an activity room in addition to a well-equipped domestic style kitchen and a separate laundry room. The home has a large landscaped rear garden. The gate to access the home is mechanically controlled. The grounds are secure with fenced boundaries and a driveway has been constructed to provide safer access from the main road to the car park. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was generally a positive unannounced inspection, the feedback received mostly from staff was excellent and the standard of support and practices observed was good. The majority of the service users were in the home and other were attending day care centres and engaged in community activities. There was a pleasant and relaxed atmosphere in the home. Care plans were well documented and updated to reflect the changing needs of service users. The senior staff on duty and management of the home was noted to be planning and delivering care in a smooth and professional manner. However, the policies and procedures in relation to the management of medicines must be adhered to. Maintenance work must be carried out within a reasonable time and that the toilet seats must be fitted to the downstairs toilets. What the service does well: What has improved since the last inspection? Unfortunately, there has been very little change since the last inspection. The majority of the requirements and recommendations were not complied with. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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 Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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): 1-5 Service users’ needs were assessed and reviewed, enabling the service user and the staff to continuously review the individuals care package provided. Staff on duty was unable to locate the ‘Statement of Purpose’ (SoP) and the ‘Service User’s Guide’ (SUG). EVIDENCE: As both documents (SoP, SUG) were not available for inspection on this occasion, it was not possible to verify whether these were user friendly and contained the updated details as required in the last inspection. Full assessments of each service user’s needs and aspiration were carried out before the service user moved into the home. The admissions procedure to the home included trial visits for the service users to make an informed choice about where to live. A contract was then drawn between the home and the service user. The contract included the terms and conditions within the home and the rights of the service user. Due to the complex needs of the service users their contracts and Statement of Purpose must be formulated in a user-friendly format and signed by the manager of the home and the service user / representative. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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): 6,7,9 & 10 Individual needs and choices within the home were being promoted to encourage and empower service users. Service users individual records were not secured and did not meet with the homes own confidentiality policy, which is in breach of the rights of the service users. EVIDENCE: All service users have an individual care plan and an allocated key worker to support them in the home. These were comprehensive, detailed and reflect the changing needs of service users. Care plans were reviewed on a regular basis. Unfortunately, individual daily notes and guidelines for the service users were not securely held nor were the care plans which were held in the main office but not under lock and key so therefore confidentiality cannot be assured. An external advocacy agency works with a number of the service users to support them in making decisions in their lives. Risk assessments were completed within the home for necessary actions. Activities and outings enjoyed by the service users indicated that service users were supported to take risks as part of an independent life style. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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): 12,13,15,16 & 17 Service users were given the opportunity to engage in activities and choose their meals. Inclusion into the local community is encouraged enabling integration into community life. EVIDENCE: Service users were supported appropriately to take part in activities within the home. Individual needs, choices and preferences were considered and offered. A record of activities was maintained. Service users accessed the local community services frequently and visited the local area, enjoying going out for lunch and shopping. The home provided a four-week rolling seasonal menu, which was developed through service user choice and preference with specialist dietary advice. A record was maintained of foods eaten. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 11 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): 18,19 & 20 All personal and health care support was well maintained ensuring individual needs, choices and preferences were being met. Safe practices in the management of medicines must be developed and implemented. EVIDENCE: All care provided was individual and tailored to each person, with service users needs, choices and preferences being promoted. Service users were supported with all aspects of their physical and emotional health and received adequate, appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice was provided to all services users regarding general health issues. A policy and procedure is in place to support the administration, storage and receipt of medicines. Staff received training prior to being recognized as competent to administer medication. Records were well maintained of all medication received and administered within the home. However, there were medicines which were discontinued were still stored and not returned for disposal nor a record for returns was available for inspection. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 12 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 & 23 The complaints procedure is sufficient and adequate in order for the service users to feel that their individual views are listened too. Robust policies, procedures and training were in place to ensure service users are protected and safe. EVIDENCE: A comprehensive complaints procedure is in place, which details that all complaints are responded to within 28 days. A record is maintained of complaints made detailing actions and outcomes as necessary. All services users have been informed about the complaints procedure. Robust procedures are in place to ensure that service users are protected from abuse and harm. Staff receive suitable and adequate Protection of Vulnerable Adults (POVA) training, which is currently occurring within the home. Staff employed are all subject to enhanced Criminal Records Bureau (CRB) checks. Records were well maintained. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 13 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 & 30 Each service users individual space was well decorated and maintained, reflecting individual choices and preferences. However, communal and shared space require some maintenance work in order to promote a safe, well maintained, comfortable, homely feel for the service users. It was noted that the organisation was very slow in ensuring that repairs were carried out this includes not providing toilet seats. EVIDENCE: The staff team has ensured that the environment was homely and welcoming for all service users. But due to the volume of maintenance work required within the home many areas were looking worn and tired, including walls, skirting boards, ceilings, doors and flooring. The ground floor toilets do not have toilet seat. The first floor bedroom which provides access to the stationery room in the loft must not be used as a bedroom for service user until a separate access has been provided. This is to safeguard the service users privacy. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 14 Each individual service user has a bedroom that meets their individual needs and preferences. The staff team has worked extremely hard to ensure that individual space for the service users was maintained and should be commended. Lockable space was also provided so ensuring security and privacy. Aids and equipment within the home were provided as required and are currently suitable for needs. A separate laundry facility was available within the home, but there was no hand washing and drying facilities provided. The washing machine had suitable programmes to comply with infection control requirements. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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): 31,32,33,35 & 36 Service users were supported by a competent, qualified staff team. Effective systems were in place to ensure sound recruitment practices. Staff files were not inspected on this occasion. EVIDENCE: Each member of staff has a clear and well-defined role; this is supported by clear and concise job descriptions and person specifications. Staff were familiar with the General Social Care Council (GSCC) Code Of Conduct and have received this booklet during their induction programme. Relevant training was in place and offered on a regular basis. The home has sufficient staff rostered on duty and it used regular agency and bank staff to ensure and maintained a consistent approach. Staff said that regular meetings were planned within the home and supervision was provided. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 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 & 42 The home is running reasonably smoothly and this ensures that all aspects of the service users’ needs can be met. Systems for effective health and safety management were in place but required further work to ensure the safety of everyone was maintained within the home. A quality assurance system based on seeking the views of service users and other relative parties must be developed so that proactive action can be taken to enhance service users experiences of living at Brickfields Cottage. EVIDENCE: Staff spoken to said that they were happy to be working at the home and that the manager enabled them to support service users in meeting their needs. The processes for managing and running the home were open and transparent. The home’s policies and procedures were kept in the office and were available to staff. The manager ensures that all staff complete the statutory training to maintain safe working practices and the home complies with all relevant legislations to safeguard the health, safety and welfare of service users and Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 17 staff. All staff who handled food have undertaken food and hygiene training. Fire drills, alarm tests and emergency light checks were carried out on a regular basis. Accidents, injuries, incidents of illness were recorded and reported. The home has a valid insurance cover for legal liabilities to employees, service users and third party persons to a limit commensurate with the level and extent of activities undertaken or to a minimum of £5 million. A vast range of policies and procedural guidelines are in place. Staff are requested to read and sign risk assessments and polices. The home has many risk assessments in place. COSHH data sheets had been produced by the home were in need of reviewing and signing along with other risk assessments completed. All records required by regulation were available and maintained. Individual service user records were not being stored to protect their individual confidentiality as per the homes policy. All accident and incidences within the home were recorded, however not in the required format under the Data Protection Act 1998. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 18 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 2 2 3 3 3 4 3 5 2 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 1 25 3 26 1 27 3 28 3 29 3 30 2 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 1 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 2 3 1 2 1 3 x Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? YES YES 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 YA1 Regulation 6(a) Requirement The Registered Manager must ensure that the Statement of Purpose is reviewed and updated to contain the correct details for the Commission for Social Care Inspection (Previous time scale of 15/11/04 not met). The Service Users Guide is to be in a user friendly format or a record maintained that communication with the service user has to explain their rights and its details (Outstanding since last inspection of 05/04/05) All records must be kept securely in the home (Outstanding since the last inspection of 05/04/05) Discontinued medicines must be returned for disposal. A record of all medicines returned must be kept. Broken toilet seats must be replaced. Hand drying facilities must be provided in the laundry room (Previous time scale of 21/11/04 not met). DS0000019297.V283866.R01.S.doc Timescale for action 28/04/06 2 YA5 5(1)(c) 28/04/06 3 YA10&YA41 17(1)(b) 28/04/06 4 5 6 7 YA20 YA20 YA24 YA24Y& A30 13(2) 13(2) 23(2)(b) 16(2)(j) 28/04/06 28/04/06 31/03/06 28/04/06 Brickfields Cottage Version 5.1 Page 20 8 YA24 9 YA26 10 YA41 11 YA39 A maintenance, renewal and redecoration plan must be developed detailing all areas in the home that require works with time scales for action and works to be completed (Outstanding since last inspection of 05/04/05) 23(1)(a)&(b) The first floor bedroom which provides access to the stationery room in the loft must not be used as a bedroom for service user. 17(1)(b) All records of incidences and Sch3(3)(j) accidents within the home must be recorded on records that comply with the Data Protection Act 1998 (Outstanding from last inspection of 05/04/05) 24(1)(b) The home must establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided and a copy of the report supplied to the Commission. 23(2)(b)(c) (d)&(h) 28/04/06 27/02/06 28/04/06 28/04/06 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 2 Refer to Standard YA37 YA40 Good Practice Recommendations The acting manager should commence a management qualification to support her in the role. Risk assessments should be signed and dated once complete so accurate reviewing of them can take place. Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Brickfields Cottage DS0000019297.V283866.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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