Inspection on 13/11/07 for Buttercups & Railway Cottage

This inspection was carried out on 13th November 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 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

Buttercups & Railway Cottage 12/10/09

Buttercups & Railway Cottage 29/04/09

Buttercups & Railway Cottage 24/11/08

Buttercups & Railway Cottage 02/11/06

Similar services:

Insight - Eastchurch

Southfields

Thorndene

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Buttercups & Railway Cottage 8 Ford Road Arundel West Sussex BN18 0BH Lead Inspector David Bannier Unannounced Inspection 13th November 2007 09:30 Buttercups & Railway Cottage DS0000066692.V349639.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 Buttercups & Railway Cottage DS0000066692.V349639.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. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Buttercups & Railway Cottage Address 8 Ford Road Arundel West Sussex BN18 0BH 01903 884105 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) Corich Community Care Limited Mrs Jacqueline Hooper Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd November 2006 Brief Description of the Service: Buttercups and Railway Cottage is a care home, which is registered to provide personal care for up to twelve service users in the category learning disability (LD) who are between the ages of 18 to 65 years of age. The service has been set up to provide care and accommodation for younger adults with autistic spectrum disorders and challenging behaviours. It is a detached property, which has been extended and adapted for its current use, and is located in the village of Ford. Although it is under one registration it comprises of two adjacent premises - one for three people and the other for nine. The property provides private accommodation to residents in single bedrooms located on the ground and first floors. They also include ensuite WC and bath or shower facilities. Communal accommodation is made up of a lounge and a dining room in each of the premises; they are located on the ground floor. The smaller house has its own private courtyard that people living here can use. An enclosed secure garden, which is available to all residents, is located to the rear of the premises. Fee levels currently range from £1370.00 to 2317.00 per week. The registered provider of this service is Corich Community Care Ltd. The Responsible Individual acting on behalf of the organisation is Mrs Sally Ann Coren and is responsible for supervising the management of the care home. Mrs Jacqueline Hooper is the registered manager and is responsible for the day to day running of the care home. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection has followed the Inspecting for Better Lives methodology and is called a key inspection as it assesses those standards determined by the Commission as key standards. This inspection will also determine the frequency of inspections hereafter. The registered provider returned an Annual Quality Assessment Form (AQAA) prior to the inspection. Residents who were considered capable of completing it and their relatives were sent surveys by the Commission entitled “Have Your Say.” These are designed to enable residents, relatives and other stakeholders to give their opinions about how the care home is being run. Three surveys completed by relatives were returned to us. The information received from these documents will be referred to in this report. A visit to the care home was made on Tuesday13th November 2007. This was an unannounced inspection. However, due to the nature of residents’ disabilities we telephoned the manager so she could tell residents about our visit to reduce any disturbance to their routines. We were unable to have meaningful conversations with residents, however we spent time with some of them during the morning in order to form an opinion of how it is to live at the care home. We spoke to three staff on duty in order to gain a sense of how it was to work at the care home. We also viewed some of the accommodation and observed care practices. Some records were also examined. The visit lasted approximately eight and a half hours. Mrs Hooper was present and kindly assisted us with our enquiries. What the service does well: The care home continues to provide good quality care to residents with severe learning disabilities and challenging behaviours. Residents are provided with a range of activities. Residents’ physical and emotional health care needs have been provided for. They have also been provided with a wholesome, varied and nutritious diet. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 6 The staff team is provided with a range of training to ensure they have the necessary knowledge and skills to work effectively with the residents accommodated. They also supported and supervised by experienced and more senior staff. Staffing levels provided are sufficient to meet the varied needs of residents accommodated. What has improved since the last inspection? What they could do better: It is recommended that where residents need to have a special diet, the details are recorded in individual care plans. This will mean that all staff will have the necessary information to ensure residents’ needs are met. The registered manager has been advised to review the current practices for administering medication to ensure they are safe. It is recommended that the manager draw up local procedures with regard to infection control. This will ensure residents and staff are not at risk of cross infection. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 7 The registered manager has been advised to consult with the local fire safety officer with regard to the practice of wedging doors open. It is recommended that this advice should be used to research suitable equipment for keeping doors open without putting residents and staff at risk in the event of fire. 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. The summary of this inspection report can be made available in other formats on request. Buttercups & Railway Cottage DS0000066692.V349639.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 Buttercups & Railway Cottage DS0000066692.V349639.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents’ individual needs and aspirations have been assessed. EVIDENCE: Four residents were identified for case tracking purposes. Documents and records seen confirmed that the needs of the identified residents had been appropriately assessed. Assessments included a history of the resident, behaviour needs, personal care needs, eating and drinking, communication, social skills, sleep and rest patterns, activities and interests, mobility, physical health, family support, and also a summary of the assessment. Surveys returned by relatives confirmed that they had received enough information about the care home to help them make decisions. However, one relative commented, “We would like more contact with senior staff… Staff are always happy to talk when we call, but they are never proactive.” Discussions with staff on duty confirmed they had been made fully aware of the needs of each resident and how they should be met. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 10 Information returned by the registered provider confirmed that, “We spend quality time on each referral that is received. We make sure each family receives all current brochures and gets the opportunity to visit us. We visit the prospective service user and do a clear assessment to see if we can meet their needs.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 11 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): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ assessed needs are reflected in their individual care plan. Residents can make decisions about their lives with assistance as needed. Residents are enabled to take risks as part of an independent lifestyle. EVIDENCE: The information provided in care plans is comprehensive and detailed. It gave a clear diagnosis for each resident and also outlined his or her individual needs. The registered manager is supported by a clinical manager whose role and expertise within the organisation is to develop and produce care plans and guidelines with regard to ensuring residents’ identified needs have been met. Staff are expected to follow guidelines, which gives them specific instructions Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 12 to ensure they work in a consistent and continuous manner with residents. Guidelines have been reviewed regularly to ensure they are up to date and reflect the current needs of each resident. Residents’ families are encouraged to take an active part in reviews of care plans to ensure they include each resident’s own aspirations and goals. Residents are encouraged to make choices on a daily basis with regard to what to eat, how to spend leisure time, when to go to bed, what to wear etc. However, in order to take account of residents’ safety and wellbeing a number of limitations are placed on them. They include locked rooms throughout the house and one person has equipment to restrict their movement. These measures have been taken to prevent residents harming themselves and others. They are kept under constant review to ensure they are used appropriately. In the case of restraining equipment, this is used with the consent of relatives and at times when that person is particularly distressed and most likely to hurt themselves. Written risk assessments have been kept as residents lead an active life which includes taking risks. Areas assessed include eating, night time care, drinking, challenging behaviour in public spaces and activities such as swimming and horse riding. Surveys returned by relatives confirmed that the care home does meet the needs of residents. One relative commented, “Personal care always seems excellent in every way.” Information supplied by the registered provider confirmed that, “Each service user has an individual care plan and activity plan that shows the independent living skills, enabling each service user to make choices and to be able to fulfil their own needs.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 13 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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in appropriate activities. Residents have been encouraged to become part of the community. Residents have been supported in maintaining family relationships. Residents rights have been respected whilst ensuring their safety is maintained. Residents have been provided with a healthy, varied and appropriate diet. EVIDENCE: Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 14 Each resident has an individual activity programme for each day. This includes clear information about a range of activities, including free time, in which they wish to participate. They include in house activities such as baking, art and craftwork, individual relaxation and time and massages. Activities arranged for residents, which are located in the community include college courses, swimming and horse riding. Residents are assisted in making use of public transport such as the local train service as well as using a minibus located at the care home. There is also a day care facility for residents, located at another site and run by the registered provider. During the course of our visit we saw residents occupied and engaged in a range of activities. We also observed an occasion when a resident, who did not wish to participate in an activity that had been arranged, offered an alternative choice. Staff on duty responded to the resident skilfully and sensitively to the resident. Relatives who returned surveys confirmed activities provided meet residents’ needs. However, one relative commented, “Generally they try to meet our relative’s needs, but undoubtedly there are times when staff levels are low, or there are no staff to drive the bus, and therefore residents cannot go out anywhere.” Information supplied by the registered provider confirmed that, “We have a full time activity coordinator who helps to plan each individual’s week ahead. This will include many community based sessions where possible and finding out what suits the individual’s lifestyle.” Residents are encouraged to maintain contact with family and friends. The majority of residents have some contact with family. There is a small visitor’s room just off the main lounge. This provides residents with an opportunity meet their family in private. There is a facility here for visitors to make themselves tea and coffee if they wish. Residents also keep in touch with their family by telephone. All contacts with relatives are recorded. Surveys returned by relatives confirmed that the care home helps their relative keep in touch. Information supplied by the registered provider confirmed that, “We have good relationships with residents’ families and have regular contact with them through visits, phone calls and contact books.” We observed residents being constantly and closely supervised by staff members during the visit. Staff members are aware of the need to strike the right balance between keeping residents safe and also allowing some freedom for residents. Where appropriate residents’ bedrooms are used to enable them to have privacy and time to themselves. We observed one resident using their room in this way. Sensory equipment had been provided for the resident so that they can relax and enjoy their personal time. Residents do not have Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 15 unrestricted use of the care home as it would be unsafe for them or for other residents. We observed staff are alert to residents’ needs and wishes. They are on hand to ensure residents needs are met safely. The main cooked meal is provided at midday. All residents and staff on duty sit together for this meal. This means that staff can supervise residents and provide assistance where needed. At the time of our visit, the main meal consisted of roast chicken with stuffing, roast potatoes, cabbage, carrots, Yorkshire puddings and gravy, followed by rice pudding. Alternative meals are also provided if any resident does not want the main choice. These include a variety of pasta dishes and jacket potatoes with various fillings. Some residents require special diets to ensure their physical needs are met. As there was no information about this together with the reasons for the special diet, it was recommended that this is included, where appropriate, in residents’ care plans. This will mean staff will have the necessary information to follow to ensure each resident’s needs are met. The manager agreed to make the necessary amendments to residents’ care records. We were provided with copies of the menus to examine. The information provided demonstrated residents have been provided with a varied, wholesome and nutritious diet appropriate to their needs. When asked about what the care home does well, within the survey, one relative commented, “Having their own chef means residents eat wholesome, tasty meals.” Information supplied by the registered provider confirmed that, “Meals which go on the menu are chosen by residents. They are also given the opportunity to eat out regularly. A four week menu plan is set out. Each individual’s diet is closely monitored and changed where necessary if a resident’s taste changes or to take account of the change in season.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 16 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): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support and personal care provided takes into account the wishes and personal preferences of each resident. The physical and emotional health care needs of residents have been met. Staff deal with medicines in a way that protects and supports residents. EVIDENCE: Guidance has been developed for each resident to ensure care plans have been implemented. This includes clear information about the manner in which each resident gets up and has care provided. It also includes detailed guidance for staff to follow to ensure challenging behaviours are dealt with appropriately. Staff are expected to follow guidelines which gives specific instructions to staff to ensure they work in a consistent and continuous manner with residents. Following observations of staff interacting with Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 17 residents we concluded that staff do follow these guidelines. Guidelines have been reviewed regularly to ensure they are up to date and reflect the current needs of each resident. Residents’ families are encouraged to take an active part in reviews of care plans to ensure they include each resident’s own wishes regarding how they want care and support to be provided. Records seen included a clear record of medical appointments made to health care services such as GP’s, opticians and dentists. This also includes a record of the outcome of the consultation and, where necessary, the treatment to be provided. Relatives who returned surveys confirmed that the care home does give the support or care each resident need. One relative commented, this is “completely down to individual staff – some staff are superb in identifying my relative’s needs and managing them well.” Information supplied by the registered provider confirmed, “All service users receive personal support as they require to ensure their physical and emotional health care needs are met.” We noted that medication has been appropriately and securely stored. Records seen had been well maintained and up to date. We were advised that only staff who have been appropriately trained are allowed to administer medication. Training records seen confirmed that staff have received in house training in the safe administration and dispensing of medication. We were informed that, currently, no resident is considered to be capable of administering his or her own medication safely. Some discussion took place with regard to the current practices for administering medication. We were informed that it is not possible to transport medication around the care home as there is a significant risk of some residents trying to take it from the member of staff. Residents who may do this do not want to taken the medication for themselves. They find it unsettling to see staff carrying such containers and want to get rid of them. This means that staff are taking medication from containers marked by the dispensing chemist with directions for administering medication and administering medicines from unmarked containers. This practice is known as pre administering medication and is considered to be poor practice as there is a risk that residents may not receive the correct medication prescribed to them. The manager acknowledged there is a risk and agreed to review practices so that a safer means of administering medication may be found. We also recommended that the manager obtain a copy of the amended guidance for administering medication in care homes, which has recently been published by the Royal Pharmaceutical Society of Great Britain. (RPSGB). This will assist the manager in reviewing and amending the home’s procedures. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 18 Information supplied by the registered provider confirmed that, “No service users are able to administer their own medication, so the home’s policies and procedures ensure they receive their correct medication.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 19 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. 22 and 23 The home has set up a system for ensuring residents’ views are listened to. Residents are protected from abuse, neglect and self harm. EVIDENCE: A complaint procedure has been drawn up so that residents’ families know how to make a complaint if they wish to do so. Residents do not have the ability to make a complaint. Surveys returned by relatives confirmed that the service has responded appropriately if concerns have been raised with them. One relative confirmed, “We feel comfortable about expressing concerns, and these are always dealt with properly and promptly. Information supplied by the registered provider confirmed that, “ A key worker system is in place and, with an individual communication programme, service users are able to express their views.” It was also confirmed that this service has received no complaints in the last 12 months. Staff on duty confirmed they know how to identify different types of abuse and also know what to do if they witness a resident being abused. Training records confirmed that staff are provided with training about adult protection. The registered provider has also provided information that confirms appropriate Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 20 policies and procedures are in place that are designed to protect vulnerable adults from harm. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 21 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): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents have been provided with a homely, comfortable and safe environment in which to live. The home has been kept to a good standard of cleanliness and hygiene. EVIDENCE: We visited the bedrooms of eight residents, the lounge and dining room of each house, and the visitor’s room. Those areas of the home seen were presented in a homely and comfortable manner. The decoration and furnishings provided ensured residents live in a comfortable and safe environment. Residents have been able to personalise their own rooms. Colour schemes and soft furnishings have been chosen which reflect the personality and interests of each resident. Other items bought on behalf of residents Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 22 include posters and pictures, televisions, CD players, and sensory equipment. Comments made by relatives in surveys were positive and confirmed the environment is kept fresh and clean. We viewed the kitchens and the utility rooms in each part of the accommodation. These areas of the premises were fresh, clean and hygienic. Cleaning schedules are in place to ensure all areas are cleaned on a regular basis. Staff support residents accommodated in the smaller group at Railway Cottage with their personal laundry. Dedicated cleaning and laundry staff have been appointed to ensure the premises is kept clean and residents’ clothes are properly laundered. Information supplied by the registered manager prior to this visit confirmed the registered provider has also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. There is an internal system for staff to use to record and report any issues related to the maintenance of the premises to ensure any defects or repairs are dealt with. The manager commented, “Service users live in a comfortable and safe environment adapted to their needs. Their bedrooms suit their needs and they all have ensuite facilities. The communal areas reflect the needs and challenges that the service users may present. The home is kept clean and hygienic.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 23 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): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Competent and qualified staff support residents. The home’s recruitment practices and procedures protect vulnerable residents. The staff team have met residents’ needs. EVIDENCE: During the last inspection we found that, There is a thorough recruitment procedure at the home although records do not demonstrate that this is always followed. For example, two people had only one reference and there was no record of a Criminal Records Bureau (CRB) check in one case. We examined the recruitment records of three staff who have been appointed since our last visit. We found that all appropriate information and checks were in place to ensure vulnerable residents have been protected. This included two written references, proof of identity and criminal record checks (CRB). Information Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 24 supplied by the registered provider confirmed that, “Service users are … protected by the recruitment procedure.” We looked at staff training records. They demonstrated that newly appointed staff undertake structured induction training. This includes providing an understanding of the principles of good care practices and covers the promoting of residents’ rights, independence, choice and dignity. We noted that the induction package does not include a basic understanding of the needs of people with learning disabilities or autistic spectrum disorders. The manager informed us that staff are provided with such training after they have completed the induction. Training records also provided evidence that confirmed staff have been provided with mandatory training such as identifying and reporting abuse, fire safety, health and safety, first aid, and food hygiene. Staff have also received training in understanding epilepsy. Staff spoken to confirmed the training and induction training they had received. They also confirmed that they had received training in understanding autism, working with people who have challenging behaviours, and communication techniques. There was also evidence that demonstrated they receive regular support and supervision from a senior member of staff. Following observations of care practices and discussions with staff on duty we concluded they are skilled and knowledgeable in providing support and personal care to residents accommodated at this care home. Surveys returned by relatives confirmed care staff have the right skills and experience to look after residents properly. However, one relative commented, “Some excellent – most are good – a few are really lacking in skills, experience and even basic social/interaction skills.” Information supplied by the registered provider identified an improvement made during the last 12 months is that, “We have appointed a full time training manager and this has enabled staff to access further training.” Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 25 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. 37, 39 and 42 The care home is well run and in the best interests of residents. The views of residents and their families are sought as part of any self – monitoring, review and development of the care home. The health, safety and welfare of residents and staff have been promoted. EVIDENCE: Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 26 Mrs Jackie Hooper is the registered manager of this care home. As a result of the registration process she has demonstrated she has the necessary skills, knowledge and experience to manage the service. The registered manager meets frequently with her staff team to discuss issues related to the service provided and the individual care needs of residents. This ensures the staff team are clear about what is expected of them and are aware of how the aims and objectives of the service should implemented. When asked, in the survey, what they felt the care home does well, a relative commented, “Very good leadership from the top.” Information supplied by the registered provider confirmed that, “Service users benefit from a well run home.” During the last inspection we found that, There is currently no quality assurance system in place. As this is needed to ensure the care home is being run in accordance with current regulations, we made a requirement in the last report. This means that there was no evidence to confirm that the registered provider consults with residents and their relatives as part of monitoring and improving the service provided. On this occasion we found that the manager had sent out to relatives satisfaction questionnaires, which had been completed and returned. Following discussion with the manager, we were advised the information gathered from them will be taken into account when the overall running of the care home is reviewed. During the last inspection we found that, Fire fighting equipment is regularly checked although there was no record of this having been done for the emergency lighting. On this occasion we found evidence that all necessary checks to fire fighting and fire detection equipment had been appropriately recorded. This confirmed that such checks had been carried out in accordance with recommendations made by the fire safety officer. We noted that some fire doors in Railway Cottage had been wedged open. The manager stated that this had been done to allow residents and staff easier access to communal areas. The manager also confirmed that fire doors are closed at night. We recommended that the manager seek advice from the local fire safety department to find out about how fire doors can be kept open whilst ensuring the safety of residents and staff in the event of fire. Following discussion with the manager, we found there was no evidence that a procedure regarding infection control had been drawn up. This means that residents and staff could be at risk of cross infection, particularly when dealing with bodily fluids. We recommended that the manager seek advice from the local environmental health officer before drawing up a local procedure for staff to follow. The manager agreed to take the necessary action to implement this. Information supplied by the registered manager prior to this visit confirmed the registered provider has also taken appropriate steps to ensure the premises and equipment within the care home is safe for use. Gas and electrical appliances have been checked and maintained regularly. There is an Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 27 internal system for staff to use to record and report any issues related to the maintenance of the premises to ensure any defects or repairs are dealt with. The registered manager has developed a system for ensuring we have been notified of those incidents and accidents that are required to be reported. Training records seen confirmed that staff have been provided with training regarding health and safety issues, manual handling and using chemical cleaning products safely. This will ensure the safety and wellbeing of residents and staff. Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 28 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 X 2 2 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 3 X 3 X 3 X X 3 X Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 29 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Buttercups & Railway Cottage DS0000066692.V349639.R01.S.doc Version 5.2 Page 31 - 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!