Inspection on 29/01/08 for Camberley Cottage

This inspection was carried out on 29th January 2008.

CSCI found this care home to be providing an Adequate service.

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

Camberley Cottage 14/01/09

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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 Camberley Cottage 1 Coolarne Rise Camberley Surrey GU15 1NA Lead Inspector Amanda Longman Unannounced Inspection 29 January 2008 10:00 th Camberley Cottage DS0000070998.V357972.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 Camberley Cottage DS0000070998.V357972.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. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Camberley Cottage Address 1 Coolarne Rise Camberley Surrey GU15 1NA 01276 686898 02392 251331 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) Dolphin Homes Ltd Mrs Brenda Smith Care Home 6 Category(ies) of Learning disability (0), Physical disability (0), registration, with number Sensory impairment (0) of places Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (PD) Sensory impairment (SI) The maximum number of service users to be accommodated is 6. 2. Date of last inspection N/a Brief Description of the Service: Camberley Cottage is owned by Dolphin Homes. It is a newly built home for up to 6 people with learning disability, physical disability or sensory impairment. It has been suitably adapted for access and has a lift to the first floor. It is located in a residential road in Camberley with access to buses and local facilities. It has policies and procedures in place to address equality and diversity, which were reviewed in February 2007. The fees charged will be included in the final report. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This was the home’s first inspection as it has only been open since October 2007. It therefore does not yet have a track record of evidence for how it meets all the national minimum standards. It does meet most of the national minimum standards examined and the manager has plans in place to further develop the service. It is very homely with a relaxed atmosphere. At the time of the site visit there were three residents but the home has space for up to six people. This inspection of the service was an unannounced ‘Key Inspection’. It was a thorough look at how well the service is doing. A site visit was undertaken on 29 January 2008. During this site visit we (the commission) toured the home, observed care practices. spoke with service users and staff and examined care records. A long discussion was had with the manager who has plans to develop and improve the service. What the service does well: Individual’s needs are fully assessed before being offered a place at Camberley Cottage. People are generally supported to live a lifestyle of their choice, including educational and leisure activities and personal and social networking. People receive health and personal care that is based on their individual needs and preferences. Privacy and dignity are respected. People are supported to make complaints and these are addressed. The home ensures people are safeguarded but the manager needs to bring the home’s procedures for safeguarding vulnerable adults in line with the locally agreed multi agency procedures. People here live in a homely, comfortable and safe environment that is clean and hygienic. They have good quality, private, suitably adapted bathrooms and have the specialist equipment they need to maximise their independence. They are supported by competent staff who are appropriately supported. Recruitment practices are generally safe but need some improvement. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 6 People here benefit from a well run home where the manager recognises that some improvements need to be made. The health and safety of service users is promoted and protected. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 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 Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Individual’s needs are fully assessed before being offered a place at Camberley Cottage. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was not possible to review original assessment material during the site visit as the manager informed us this was kept at head office. The manager explained that the service users care manager submits a detailed assessment of needs. Each service user then had an initial visit to the home. During this visit the manager identifies with the service user what services are required to meet their needs, what can be offered by the provider and what arrangements can be made to meet other needs, for example educational needs. The service user would then have future opportunities to visit the home to enable them and the provider to form an opinion of whether it would be the right home for them. If a place is offered it is subject to a three month trial period. The written admissions policy states Camberley Cottage has a homely atmosphere and that they aim to enhance the quality of life for each individual and that care will be offered regardless of cultural background, religious persuasion or sexuality. We spoke with two service users who both said they had plenty of information about the home and how it could meet their needs and had made their own choice about moving to the home. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9. Quality in this outcome area is good. The home enables service users to make choices about their lifestyles and care, and plans to work with service users to improve their person centred approach. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans are detailed and include support needs for aspects of care and a target monitoring record. Goals and action plans are included and regularly reviewed. We saw one example of where a goal has not been pursued. The key worker in this instance had left. We discussed with the manager the need to re-allocate a key worker quickly. The manager will address this. Some comments in the care plans were written about the service user rather than with the service user and a minority of notes were written in inappropriate styles and based on the writers value judgements about peoples behaviour. We discussed with the manager the need to involve service users more in the development of their care plans to ensure they are factual and person centred. The manager agreed to take this forward as a Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 10 matter of urgency and explained that these comments had been written by a member of staff who is no longer working for the organisation. Service users have individual activities timetabled but have freedom to decide whether or not they participate. It was obvious through talking with staff that they know the service users very well. Observations and discussions with service users showed they make their own decisions about their lifestyles and how they spend their time. There is an appropriate policy and procedure in place for managing risks that was set up in February 2007. Risk assessments and management plans were in place for all activities. However risk assessment and support plans were not in place for all aspects of personal relationships. We discussed this with the registered manager who will address this. Observations and discussions with service users and staff confirmed that service users do participate in the running of their home. They plan meals, shop and cook, and decide how their rooms are decorated. The manager stated that service users have also been involved informally in the recruitment of staff and confirmed that this process is to be formalised. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 11 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): 11, 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. Service users are generally supported to live a lifestyle of their choice, including educational and leisure activities and personal and social networking. The manager recognises where improvements can be made and is addressing these areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence was seen of service users supported to access appropriate college courses and this was linked to longer term plans and goals. Likewise leisure centre activities such as gym and swimming. Other activities in the community include shopping, walks, pubs, cinema and bowling. The home has links with another home that provides a wider circle of contacts and where activities include communication skills and information technology skills. None of the current service users wish to practise religion but facilities for identifying these needs and meeting them exist within the care plans. Service users confirmed they have freedom to join in or decline activities and that staff will support them to access facilities. One service user wishes to go out independently and staff are accessing information about local buses to assist Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 12 this. Staff spoken with said they encouraged service users to maintain their family and social relationships and evidence of social networks were seen on care plans. However, as referred to above we did discuss with the manager the need to have support plans in place regarding personal relationships. One service user spoken with, who has close family ties, is supported to go home and on holiday with their family and confirmed that social visitors were welcomed. All service users are registered to vote. Menus are planned at service user meetings which are held once or twice a week. However we witnessed that there is daily flexibility. If someone doesnt fancy what was planned for lunch that day they will have something else. Actual meals eaten, as well as those planned are recorded. The kitchen is domestic in style and appears to be appropriate and hygienic, for example food labelling and storage systems are in place, fridge and freezer temperatures are monitored and chopping boards are colour coded. We noticed that fridge temperatures exceeded the recommended levels and the manager will seek advice and turn down the fridge temperature. We had lunch with the service users who had all chosen what they wanted to eat. There was a homely atmosphere. Staff engaged in conversation with service users and provided appropriate assistance when it was required. Service users confirmed they do get involved in cooking. One service user has recently requested some new cookery books be bought, and service users now have a baking session on Sundays if they wish to bake cakes or similar. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 13 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. People receive health and personal care that is based on their individual needs and preferences. Privacy and dignity are respected. The manager recognises where improvements can be made and is addressing these areas. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Personal support plans are very detailed covering the personal support needs of individuals and their preferences, for example their morning routines and hygiene routines. Service users we spoke with confirmed that support in these areas was flexible and appropriate. Physical health needs are also very detailed and include support from other professionals for example GP and physiotherapist. With regard to emotional care needs, as noted above there is appropriate support for family contacts and friends are welcomed in to the home. The home does have a personal relationships and sexuality policy which refers to the right to be sexually active or not, the right to privacy and confidentiality and the right to sexual preferences. The manager provided evidence that this policy is beginning to be implemented and recognises more work needs to be done to ensure this policy is fully implemented. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 14 Staff spoken with were mindful of peoples rights to privacy and dignity. We observed that their rooms were respected as their private areas and service users confirmed this. There is an appropriate medication policy and procedure in place (February 2007). Currently none of the service users are on regular medication. One is prescribed paracetamol as required and one has vitamins. There are appropriate storage and recording systems for medication and these were appropriately completed. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 15 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): 22 and 23. Quality in this outcome area is good. Service users are supported to make complaints and these will be addressed. The home ensures service users are safeguarded but the manager needs to bring the homes procedures in line with the locally agreed multi agency procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We noticed that the complaints procedure implies CSCI is a complaints/ appeal organisation. This was pointed out to the manager who will address this. The current complaints procedure does not have time scales for responding to complaints, and again, the manager will address this. There were no recorded complaints and The Commission has not received any information relating to complaints. Comments and suggestions were recorded in service user meetings and these minutes also included how these points would be addressed. Staff spoken to were clear about how they would assist service users to complain. The protection of vulnerable adults policy in place provides relevant information. However it implies the home will take independent action. We discussed with the manager the need to obtain a copy of the local multi agency procedure, which includes referring any safeguarding issues to social services in the first instance. All staff working at the home are qualified to at least NVQ level 2 and have therefore previously received training in safeguarding vulnerable adults. The home has no recorded instances of any safeguarding issues. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 16 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, 27, 29 and 30. Quality in this outcome area is good. Service users live in a homely, comfortable and safe environment which is clean and hygienic. They have private, suitably adapted bathrooms and have the specialist equipment they need to maximise their independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is newly built and has been suitably adapted for people with physical disabilities, this includes ramps and a lift within the home. It is homely and comfortable. All six bedrooms are suitable sizes, individually decorated and have suitable en-suite shower rooms. One service user showed us round his bedroom which was well equiped to meet his needs. The home has a communal lounge and a kitchen dining room all of which are decorated and furnished in a comfortable domestic syle. Service users we spoke with confirmed the home was always clean and comfortable. The home is owned and maintained by Dolphin Homes. The manager told us that they support service users to access any specialist equipment service users require. One service user we spoke with uses an Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 17 electric wheelchair and communication device and the staff were assisting this service user to chase up a spare part. The home appeared to be clean and hygeinic throughout. A cleaning rota is in place for tasks and service users help with their own rooms if they are able. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 18 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, 35 and 36. Quality in this outcome area is good. Service users are supported by competent staff who are appropriately supported. Recruitment practices are generally safe but improvements should be made to the procedure for obtaining references. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff rotas are planned in advance and showed consistency of cover and support for service users. Our observations showed that service users appear to have a good relationship with staff and are at ease with them. One member of staff is a nurse, all other staff are qualified to a minimum of NVQ level 2. The manager informed us that the organisation supports the training of staff beyond the minimium requirements. One member of staff is currently doing NVQ level 4 and those with NVQ level 2 will be going on to do NVQ level 3. New staff follow a one month induction portfolio and the manager agreed to check that this is in line with the recommended Skills For Care induction procedure. Aside from NVQ and induction the home does not have a training plan in place but the manager informed us she plans to develop a 12 month training plan. Staff appeared knowledgable about service users needs. Recruitment records are usually kept at head office and we discussed with the manager the need to keep, in the home, evidence that all required recruitment Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 19 procedures had been followed. However, we were able to view some of the recruitment records of the most recently recruited member of staff. The manager confirmed that all relevant pre employment checks had been undertaken. The application form seen asked several irrelevant questions for example: number and ages of children, and marital status. We recommended that the manager review this with Dolphin Homes . Also the application does not state that one reference should be from the most recent employer. Service users have been involved in the recruitment process in an informal way and the manager plans to formalise this. Formal supervision and staff team meeting procedures are in place and records were seen for both. Staff spoken with confirmed the supervsion arrangements and said they felt well supported. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 20 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): 37, 39 and 42. Quality in this outcome area is adequate. Service users benefit from a well run home. Its person centred approach to care needs to be developed further. The health and safety of service users is promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is run by a suitably qualified manager who is registered with the commission. Service users spoken with did generally feel that their views are sought in the running of the home. They have regular service user meetings, once or twice each week which are minuted. They can discuss any aspect of the home and plans for the future. We saw that these minutes are reviewed by the manager and transferred in to actions. For example service users wanted to do more home baking so they were supported to buy cookery books and now regularly bake cakes and other things. One service user was keen to develop further their independent livestyle and whilst the home was working Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 21 with them to do this the service user would like progress to be quicker. We discussed with the manager the need to further develop its person centred approach to ensure that when care is reviewed it is from the service users point of view and that the prioroties and needs of the people who live at the home, as they themselves see them, are central to decisions made. The manager was keen to adress these issues. The manager returned the Annual Quality Assurance Assessment but in some areas it contained only limited information or little evidence for how standards are being met. However, the home had only been operating for just over two months at the time the manager completed it and she commented that providing more evidence is something they could do better. There was some information about there plans for improvements over the following 12 months. The home has quality assurance policies and procedures in place. A monthly quality assurance review is undertaken for each service user which is passed to head office. The home has only been open for a few months so overall quality assurance information has not yet been collated. However, procedures are in place to do this including satisfaction surveys. The manager plans to improve staff awareness of equality and diversity issues through training and development of the team and will promote equality issues through the practices in the home, regular review of policies and procedures, d updataed care plans and the use of advocates. The home has health and safety policies and procedures in place including incident and accident reporting, control of substances hazardous to health procedures, temperature monitoring procedures, and fire procedures and risk assessments. Infection control procedures are in place and the manager is planning training for staff. The building is new, as are the gas and electrical appliances, lift and hoists, all of which were certified in October 2007. Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 22 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 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 2 X X 3 X Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 23 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 Camberley Cottage DS0000070998.V357972.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone 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. 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