Inspection on 20/06/07 for Burton Cottages

This inspection was carried out on 20th June 2007.

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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Burton Cottages 18/12/08

Burton Cottages 22/10/08

Burton Cottages 26/04/06

Burton Cottages 18/10/05

Burton Cottages 27/04/05

Burton Cottages 24/09/04

Burton Cottages 26/04/04

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

CARE HOME ADULTS 18-65 Burton Cottages Bishop`s Lane Robertsbridge East Sussex TN32 5BA Lead Inspector Caroline Johnson Key Unannounced Inspection 20th June 2007 09:50a Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 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 Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 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. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Burton Cottages Address Bishop`s Lane Robertsbridge East Sussex TN32 5BA 01580 881715 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) Sussex Autistic Community Trust (Care Services) Limited Mrs Margaret Griggs Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. That service users on admission will be diagnosed with an autistic spectrum disorder The maximum number of service users to be accommodated must not exceed twelve Service users accommodated must be between the ages of nineteen (19) and sixty-five (65) years of age on admission. 26th January 2007 Date of last inspection Brief Description of the Service: Burton Cottages is registered to provide accommodation for twelve adults with autistic spectrum disorders. The property is owned by Downland Housing Association and is run by the Sussex Autistic Community Trust. It is one of four homes in East Sussex run by the Trust. Burton Cottages is purpose built and is situated in a quiet residential area of Robertsbridge. The town centre with its shops and access to bus and rail services is a short walk away. The building is split into two units, each accommodating six residents. Each of the units has their own communal facilities and a kitchen. Accommodation is on two floors and all bedroom accommodation is in single rooms. The home makes CSCI reports available to prospective residents and their relatives/representatives upon request. The gross weekly fee inclusive of income support is £1,112 to £2,000 as at 20 June 2007. In addition residents need to pay for hairdressing, chiropody and toiletries and they pay a contribution towards the use of the home’s vehicles. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this inspection process an unannounced site visit was carried out on 20 June 2007. The visit lasted from 9.50am until 6.50pm. During the visit there were opportunities to observe staff working with the residents as they arrived back from their day centres. The majority of residents have limited communication skills so emphasis was spent on observation and interactions. Time was also spent with the manager and with three care staff individually in private. A wide range of documentation was examined including care plans for three residents, records held in relation to staff recruitment, rotas and training, daily activities, quality assurance documentation, medication, health and safety records, complaints and menus. A full tour of the building was also carried out. Prior to the inspection comment cards were sent to the residents to provide them with an opportunity to share their views on the running of their home. Six of the residents completed forms with assistance and the response to the majority of the questions was positive. There were no negative responses, but for a few questions there was no answer, which could be an indicator that they did not understand the question or that they didn’t know how to respond. Following the inspection contact was also made with the relatives of three residents to seek their views on the quality of the care provided in the home. Since the last key inspection a random inspection was carried out in February 2007. At that time significant progress had been made in addressing the majority of the requirements and recommendations from the Key inspection in April 2006. What the service does well: Care planning is comprehensive and staff are provided with clear information about the needs of the service users accommodated. The home continues to work hard to increase the range of activities available to residents to ensure that they are stimulated and have opportunities for leisure and recreation. There are very good training opportunities available to staff covering a wide range of topics. Staff spoken with felt well supported in their roles. A new member of staff spoken with advised that they found the home’s induction to be very thorough. They were impressed with the level of training on offer and stated that since commencing in post staff have been ‘friendly, helpful and very supportive’. All of the relatives spoken with stated that they welcome contact from the home in respect of their relatives’ health and welfare. One of the relatives stated that their relative had ‘not looked back since moving into the home’ and has ‘come on in leaps and bounds’. On the day of inspection the residents appeared content and happy and there were good interactions between staff and the residents. Staff spoken with had a clear understanding Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 6 of the needs of the residents. The home’s continued use of teacch (a tool using symbols, pictures of activities/objects or written words to aid communication) is clearly of benefit to the residents both in terms of providing security and assisting and improving communication, choices and decision making. 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. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 7 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 8 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 Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Thorough pre admission assessments are carried out to determine if the home can or cannot meet prospective residents’ needs. EVIDENCE: Since the last inspection of the home the statement of purpose has been updated to reflect the changes in the management of the home and to ensure that it complies with all areas of Schedule One of the Regulations. It was reported that a copy of the service user guide has been sent to the relatives/representatives of the residents. Following the last key inspection of the home in April 2006, a random inspection was carried out in February 2007. At that time pre-admission documentation was examined in relation to one newly admitted resident. All documentation was detailed and the resident’s move to the home had been planned well. There have been no further admissions to Burton Cottages since that date. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are given clear and detailed information about the needs of the residents, which ensures that their individual needs can be met. Records held in relation to the setting of goals and progress with achievement is not of the same quality. However, the planned training in report writing should assist in this process. EVIDENCE: Three care plans were examined in detail. Each care plan was comprehensive including detailed information and guidance for staff to follow. Religious and cultural needs are assessed as far as it is possible to. Risk assessments were detailed and had been reviewed recently. At the random inspection a recommendation had been made to draw up a behaviour chart in relation to one resident and this had been carried out. In each file there is both general and specific advice in terms of behaviour support. Development goals and training plans are also identified. In respect of the training plans seen, often they were more like guidelines for staff containing detailed information necessary to assist the resident to complete a task in a particular order but not Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 11 necessarily a training plan. Records do not show clearly the progress made in achieving goals. There is a chart in place to record if a goal has been attempted, achieved or refused but it does not provide detailed evidence or advice to staff on exactly what a resident can do and which parts of a task they are working on. This has been raised at previous inspections. The day following the inspection the manager e-mailed a copy of an amended daily record that would hopefully capture more clearly the work undertaken by staff in assisting residents to achieve their goals. The home continues to use teacch as a way of assisting communication. The method used is based very much on the individual needs/wishes of the residents and varies from one to the next. For some it includes pictures of the resident involved in various activities, for some it includes symbols and for some it is just the written word. When the residents return from their day centre they have a drink and then go though with a member of staff the list and order of their activities for the evening. A staff member was observed going through the teacch board with two residents. It was evident that both residents despite their complex communication difficulties understood the board. If having a drink is on the board, staff will then show the choice of drinks available using either pictures of the person having a particular drink, pictures of the drinks available or the types of drink written down. As each activity is completed the resident is encouraged to take the symbol and place the symbol in a pocket at the end of the board. Teacch continues to work very well in practice but there are no records to demonstrate the choices given and the progress made over time in encouraging residents to make a wider variety of choices and decisions. The manager agreed that this was a lost opportunity to demonstrate the work they do. The day following the inspection the manager had e-mailed the inspector a new format that would hopefully capture more clearly the work undertaken by staff in supporting the residents. The manager advised that arrangements have been made for staff to receive training in report writing. This topic has also been discussed at recent staff meetings. The manager is ensuring that all residents have a planned annual review of their care. This has previously been in place for the majority of the residents but where there has been no social worker involved, a review might not always have taken place. The new practice is that social workers will be informed and invited to attend reviews. If they do not attend then a copy of the minutes will be forwarded to them. Good progress has been made with the organising of reviews and there was a review on the day of inspection and another had been arranged for the following week. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. For the majority of the residents the emphasis placed on increasing the range of activities has also increased opportunities for stimulation and had a very positive impact on the quality of their lives. The home continues to strive to provide greater stimulation for a couple of residents who tend to opt out of activities but record keeping to demonstrate the work undertaken in this area needs to improve. EVIDENCE: All but two of the residents continue to attend one of the two-day centres run by the Trust. Each of the residents has a twenty-four hour timetable of the activities that they participate in. Attendance at the day centre means that residents have access to a wide range of activities both at the centre and in the wider community. Activities include arts and crafts, music, trampoline, gym, horse riding, swimming, shopping and walks. Staff also arrange a wide variety of activities in the evenings and at weekends. A staff member stated that one resident enjoys trips to the wild wood at Herne Bay where they can Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 13 see the animals, have a long walk and have lunch. The home are continuing to build up the range of activities that they provide in the home in the evenings and a cupboard is used to house all the craft equipment. Staff advised that they have responsibility for liaising with the relatives of the residents they are keyworker to. In some cases this will mean writing a letter with or on behalf of a resident and it could also mean keeping in contact by telephone. Relatives spoken with also stated that they welcome the contact made by residents’ keyworkers and two relatives also said that they continue to contact the home more regularly so that they can continue to play an active role in their relatives’ lives. The home continues to have difficulty motivating two of the residents to participate in activities. Staff advised that some days are better than others and when the residents are in the right mood to participate in an activity then staff make the most of these times. Activities they enjoy include listening to CDs and watching DVDs, occasional shopping, cafes, using the library, an inhouse aromatherapy session and an in-house music session. In relation to one of the men, the home is seeking advice in respect of their medication to see if a reduction in medication will increase their motivation to participate in activities. One of the residents is due to have a review in a few weeks where this subject will be discussed in detail. The progress since the last key inspection although small is significant particularly for one of the men. However, there are no records in place to demonstrate how staff plan and offer activities and provide alternatives or what they are aiming for in relation to increasing motivation and participation in activities, or in use of the local community. This has been raised at previous inspections. There is a four-week menu in place, which shows variety in the food on offer to the residents. The menu is set for Monday to Friday. Each Monday the menu for the weekend is planned for the weekend so that the food can be bought alongside the weekly shopping. Residents in cottage one, decide one days menu and residents in cottage two decide the second day. This practice was discussed with staff in terms of why it is decided so far in advance and why both homes have the same menu. It was agreed that they would look at their practice to see if they could bring more flexibility and spontaneity. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are good at ensuring that the healthcare needs of the residents are met and specialist advice and support is sought when necessary to meet individual residents’ needs. EVIDENCE: Only senior staff have responsibility for administering medication. A staff member spoken with stated that all staff have recently completed module one of a medication course. The work completed has been sent away for checking and staff are waiting on confirmation that they can start the second module. There are appropriate arrangements in place for the administration and storage of medication. Signs are placed on the door to the treatment room to advise staff not to interrupt or disturb the person responsible for administering medication so that they can concentrate on their task. Records seen were in order. A returns book is kept detailing all medications returned to the local pharmacy. Information is also kept on file or all the medication used in the home, what it is used for and details of side effects. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 15 The home is currently working with professionals from the local Community Learning Disability Service in relation to meeting the needs of four of the residents. Residents are supported to attend a wide range of healthcare appointments as necessary to meet their needs. This includes dentist, chiropodist and hospital appointments. Staff observed in the course of their work were seen to treat residents with respect and dignity and to involve them in tasks that they were undertaking. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are clear arrangements in place to assist anyone wishing to make a complaint to do so. EVIDENCE: Records showed that there had been no complaints recorded since the last inspection of the home. There were however, several compliment cards from relatives thanking the staff for their hard work. The home’s complaint procedure is on display on a notice board at the entrance to the home. At the time of the last key inspection a recommendation had been made in relation to the need to clarify arrangements in place in respect of DLA (disability living allowance) payments to residents with their relatives/representatives. This had been achieved by the random inspection in February 2007. Twelve of the fifteen staff employed have completed training on the protection of vulnerable adults. The home has a detailed policy in place on the action to be taken should abuse be suspected or allegations made. Since the last key inspection there have been six adult protection alerts and in each case the home was found to have acted appropriately in managing the situation. At the time of inspection there was one adult protection investigation where the outcome was still not concluded. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The significant improvements made to the home over the past year, has resulted in a very warm and homely environment for the residents. The residents have also shown their appreciation for the changes made by accepting the new ornaments, pictures and plants and showing pleasure when new furniture and fittings have been delivered. EVIDENCE: A full tour of the building was carried out. The majority of the bedrooms have been refurbished including new carpets, new curtains, new furniture and the rooms repainted. Staff advised that where possible residents were encouraged to choose the colour schemes and the furniture. Some rooms are still to be redecorated and staff were working on this. The lounge areas are decorated well and new televisions have been purchased. New tables, chairs, pictures and ornaments have been purchased for the dining rooms. The locks have been removed from the kitchen cupboards and new cupboard doors will be fitted in the near future. In addition new fridges and freezers have been Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 18 purchased along with new pots and pans. New curtains and carpets have also been purchased for some of the communal areas. A staff member is taking cultural needs/wishes into consideration in the refurbishment of one resident’s bedroom. As part of this process the staff member has carried out research and is taking advice from the resident’s relatives. l In the garden area, new tables and chairs have been purchased and staff advised that the residents enjoy using this area. A new barbeque has also been purchased and it was reported that they have made the most of any good weather to enjoy the garden. There is also a new shed and gazebo in the garden. There was a strong odour in one bedroom. Staff described the cleaning arrangements for this room and the manager advised that they are very much aware of the problem and are working hard to eliminate any unpleasant odours. One of the rooms that was primarily used as an office area is now used as a sensory room. New sensory equipment has been purchased for this area and staff reported that the residents enjoy spending time in this room. There is also a piano in this room so when not used as a sensory room it is used by one of the residents for playing the piano. Another room is designated as a staff sleep-in room at night but through the day it is also used as a mini-gym. New equipment has been purchased and prior to any resident using the equipment a risk assessment is carried out. In relation to fire safety, a fire risk assessment was carried out in January 2007. The manager advised that all recommendations made as a result of the assessment have now been completed. A written action plan detailing all action taken has yet to be drawn up. Records showed that fire alarms and emergency lights are tested and recorded at regular intervals. Staff receive instruction in fire safety and all false alarms are treated as fire drills. Records show the length of the drill and the numbers of staff and residents present. Records do not show the names of the staff present and drills have not been routinely evaluated. In the laundry area there is a large washing machine and two tumble driers. Appropriate measures are taken by staff to minimise cross infection. Night staff have responsibility for all the washing and ironing. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. As long as staffing levels remain consistent the ability to have a number of staff hours that are flexible to meet the changing needs of residents appears appropriate. The home must continue to provide opportunities for all staff to update their knowledge and skills. EVIDENCE: A number of new staff have been appointed recently. However, there are still 82 hours vacant each week. In addition there is a 25-hour cleaning position vacant. The cleaning post and a 10-hour night carer post have been advertised. The remaining 72 hours are covered each week by permanent part-time staff working additional hours. The manager advised that the system whereby permanent part-time staff work additional hours works well and all vacant hours are always covered. This was evident on the rota seen. Where necessary, agency staff covers sickness and annual leave. Staff have regular training opportunities and records showed that the majority of the staff team have received training on the protection of vulnerable adults, studio three and epilepsy. In addition at least half of the staff team have received training on all other mandatory subjects. The manager advised that Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 20 further training courses have been booked so that staff can update their knowledge on a wide variety of subjects. A new member of staff spoken with had already received training in pova, epilepsy, fire safety and an autism specific course. The manager advised that arrangements have been made for staff to receive training on report writing on 31/07/07. Six of the fifteen staff employed to work in the home have completed NVQ at level two or above. Another support worker is currently working towards NVQ at level three. Staff recruitment records were seen in relation to two staff. In each case there was an application form and there were two references. CRB (Criminal Records Bureau) checks had been obtained for both staff. Where an issue was raised in one reference this was explored in more detail with the referee prior to making a decision to appoint the individual. Both staff had received at least one supervision. One member of staff advised that it was their understanding that on completion of their induction they would be put forward for NVQ training. A new member of staff spoken with advised that they found the home’s induction to be very thorough. They were impressed with the level of training on offer and stated that since commencing in post staff have been ‘friendly, helpful and very supportive’. They also stated that they were ‘given clear advice on how to work with residents’ and that they ‘find the routine booklets very useful’. The week prior to the inspection the staff team attended a team-building day. An external trainer ran this. Staff spoken with stated that they found the day very useful. The manager also advised that staff meetings have been used as opportunities to discuss various themes including staff group dynamics, care planning and personal care. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run well and there are good systems in place to ensure the health, safety and welfare of staff and residents. The quality assurance systems in place identify any areas for improvement and the manager is proactive in addressing areas where improvement is identified. EVIDENCE: Since the last inspection of the home the manager has been successful in being registered by the Commission as manager. She has a wealth of experience in managing and caring for adults with autism and has recently completed her Registered Managers Award (RMA). All of the staff spoken with felt well supported by the manager. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 22 As part of the home’s quality assurance system satisfaction questionnaires were distributed to residents and to their relatives in January 2007. The responses have yet to be collated. However, the manager advised that the responses were generally very positive. A few relatives raised the issue of communication, so as a result keyworkers are now phoning relatives on a monthly basis to ensure that where possible relatives are kept up to date on changes in their relatives’ health or welfare. The home has accreditation with the National Autistic Society. In order to maintain their accreditation they are reassessed on an annual basis. Another area of quality assurance is the necessity for the manager to provide a monthly report to take to managers’ meetings. The Trust also ensures that Regulation 26 visits (a monthly unannounced visit where a report is then written on the conduct of the home) are carried out. Following the site visit telephone calls were made to the relatives of three residents. One relative in particular was very impressed with the care and support that their son receives and said that ‘since moving into the home he has never looked back’. He was a bit unsettled to start with but with the good boundaries set by staff he soon settled and is now taking part in a wide range of activities and when they take him out for the day he is always keen to get back to Burton Cottages. All of the relatives spoken with stated that they welcome contact from the home in respect of their relatives’ health and welfare. One relative stated that they would like to see their relative doing more activities but they appreciate the efforts made by the staff team to try to encourage their relative to participate in activities. Prior to the inspection comment cards were sent to the home for distribution to the residents so that they could comment on the care they receive. A new format was used on this occasion, which involved a list of short questions, related pictures and some symbols. Due to the complex needs of the residents all of the residents would have needed some support to complete these forms. Of the twelve residents, six were unable to participate in the completion of forms. The remaining six were partly able to contribute with staff support. Three responded yes to all questions. One responded yes to all but three questions, the three questions related to ‘staff respecting privacy’, ‘if you are unhappy do you know whom to contact’ and ‘do you want to speak with an inspector’. For these questions there was no response. Another responded yes to most questions with the exception of ‘are there enough activities’, ‘if you are unhappy do you know whom to contact’ and ‘do you want to speak with an inspector’. Again for these questions there was no response. The third resident responded yes to three questions and then did not participate any further. At the time of the last key inspection a requirement was made in relation to the updating of the policies and procedures manual. This had been achieved at the time of the random inspection in February 2007. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 23 In relation to health and safety, there are a number of checklists that are carried out on either a monthly, quarterly or six-monthly basis. The checklist is comprehensive and records showed that the quarterly checklist was last carried out in early June. A number of areas were identified and the person responsible for carrying out any work identified was also highlighted. Portable appliances were tested in May 2007. Hot water temperatures were tested at a couple if outlets and both readings obtained were within safety limits. Detailed records are kept of all accidents and incidents that occur in the home. Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 X 5 X 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 2 25 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 X 12 2 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X X 3 X Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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 YA6 Regulation 15(1,2) Requirement Residents’ individual goals must be more specific and any action required by staff to assist the resident in achieving them more detailed. Any progress made must be recorded. [This requirement was made at previous inspections. Timescales given were 21/01/07 and 15/05/07. The registered person must demonstrate more clearly the action taken to offer and provide suitable education/recreation for two service users referred to in this report. Timescale for action 31/10/07 2. YA12 16(2m,n) 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 26 Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Burton Cottages DS0000021064.V338971.R01.S.doc Version 5.2 Page 28 - 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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