Inspection on 03/05/07 for Cameroon

This inspection was carried out on 3rd May 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

Cameroon 31/10/06

Cameroon 13/06/06

Cameroon 14/03/06

Cameroon 06/04/05

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Cameroon Heath Cross Whitestone Exeter Devon EX4 2HR Lead Inspector James Rose Unannounced Inspection 3rd May 2007 08:30 Cameroon DS0000063214.V333873.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 Cameroon DS0000063214.V333873.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. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cameroon Address Heath Cross Whitestone Exeter Devon EX4 2HR 01483 772901 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) Honeybourne House Limited Vacant Care Home 13 Category(ies) of Learning disability (13), Old age, not falling registration, with number within any other category (13), Physical of places disability (13) Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. PD - Physical disability, 13 service users male of female LD - Learning disability, 13 service users male of female OP - Old Age, not falling within any other category There will be a maximum of 13 beds Date of last inspection 31st October 2006 Brief Description of the Service: Cameroon is a Registered Home for up to 13 service users with learning difficulties and a physical disability. The home is a large detached single story building with one double bedroom, the remainder are singles, it stands in its own grounds with extensive views over the surrounding countryside. The home is situated within walking distance of the village of Whitestone and is four and half miles from Exeter. The communal areas of the home are comfortably furnished, there is a large lounge and meals are taken in a separate dining room, the kitchen is also spacious and has a large central table. The home is well maintained and adaptations have been made to meet the needs of the service users. A mini bus is provided to transport service users to appointments and to take them out on excursions. Outside the home there is off road parking and well-tended gardens. A lawn area is also available with seating provided for service users. The weekly cost of care at Cameroon is, lowest £364.84 and the highest is £1051.62. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was undertaken over 7 hours during May 2007. A complete tour of the home was undertaken as part of the inspection process and three residents were consulted individually. Samples of the care records were examined and two of the staff team were interviewed individually in private. Evidence was taken from returned questionnaires and the views were also obtained of two healthcare professionals that provide a service to the home. The inspection was undertaken with the assistance of the acting deputy. What the service does well: What has improved since the last inspection? Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 6 Since the last inspection the home has a new manager who has made substantial progress in providing the appropriate administration procedures in the home. The requirements made in the last report calling for detailed individual care planning to be completed on each resident in the home has been achieved and the personnel files have been completed which ensures that residents are in safe hands. The care team at the home has continued to provide a good service to the residents who were relaxed and happy at this inspection. The home has provided the care team with additional training, which is beyond the basic training expected. One event that took place during the inspection was a breakthrough with a particular resident with regard to communication where it was found he is able to respond positively to music and this is being followed up by the home and additions made to his care plans. Three residents were consulted individually as part of the inspection process, they were all very positive about life at Cameroon and said they very much enjoyed being with their carers. One resident was keen to say, “I like it hear with my friends and they are taking me on holiday again”. Some of the residents were unable to verbalise their feelings but were none the less able to demonstrate that they were very happy at the home. The building and grounds of the home are well maintained and a comfortable, safe environment is provided for the residents. What they could do better: On the last two inspections there has been a strong odour from the home’s sewerage treatment system and when enquiries were made the inspector was told it was because the weather was warm. A recommendation has been raised in this report for a specialist review to be undertaken to ensure the correct working of these arrangements as the odour is offensive and could well inhibit the residents from using the only lawn area of the grounds. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 7 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. Cameroon DS0000063214.V333873.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 Cameroon DS0000063214.V333873.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. The assessments undertaken at Cameroon are comprehensive and include the aspirations and needs of residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The new manager has introduced a comprehensive system of assessment and a detailed record of residents’ needs and aspirations was available for each person receiving a service in the home. Three of these were examined in detail and were found to be appropriate. There have been no new residents admitted into Cameroon for sometime, however, the system in place will ensure that detailed assessments are completed before the home makes a judgement about offering a service. Cameroon DS0000063214.V333873.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): 6, 7 and 9. Quality in this outcome area is good. Detailed and comprehensive care plans are available for each resident in the home; they demonstrate that residents make their own decisions about matters that affect them. Residents are supported to take risks as part of an independent lifestyle. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Detailed, comprehensive care planning is in place for each resident in the home, these records have been introduced since the last inspection and represent substantial progress. The care plans have been drawn up with the person concerned and agreed with them. This element was discussed with the acting deputy during the inspection and it was agreed that this approach would be recorded and made clearer as to how this was achieved in the individual care plan. The residents at the home are assisted and supported to make their own decisions about issues that affect them and staff have been given additional training to ensure residents are understood. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 11 It was clear from observations made during the inspection that time and care is taken by carers to take residents views into account and deliver care, activities etc in the way the resident wishes. Risk assessments are undertaken and recorded in detail by the home and included as part of the care planning process. Carers enable residents to take responsible risks. The way residents are cared for was discussed with residents who felt they were well looked after and advised that they had confidence that they would be consulted about any changes to the process and that their input would be seen as important. Cameroon DS0000063214.V333873.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): 12, 13, 15, 16 and 17. Quality in this outcome area is good. Residents are able to take part in appropriate leisure activities and regularly use the facilities in the community. Service users can have appropriate relationships and their rights and responsibilities are recognised daily. A wholesome balanced diet is provided at the home that residents liked. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The activities to be undertaken by a resident are agreed with them on an individual basis and recorded in their care plans. Activities are provided in the home some examples are aroma and massage, music and specialist music sessions and in addition to this programme there are regular trips out undertaken such as ten-pin bowling, swimming and shopping, where the choices of what are purchased are made by residents, meals in local public houses are also undertaken. The trips out are arranged in the home’s own minibus or car. Regular holidays are provided for residents twice a year. Residents confirmed in conversation that they enjoyed life at Cameroon and particularly enjoyed the holidays provided. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 13 At the time of the inspection it was particularly pleasing to hear that the use of specialist sound therapy had enabled a resident with sever communication difficulties a way of being able to express himself. This approach now discovered is going to be pursued by the home and added to the care planning process. There is an unrestricted policy and procedure concerning visits made by family and friends who are made welcome in the home. Fresh produce is delivered regularly to the home and ‘home cooked’ cakes etc are produced in the home’s kitchen. Residents advised that they liked the meals provided. One resident said he thought the food was “smashing” and another advised, “I like eating this…” Meals are usually taken in a dining area situated next to the kitchen. Cameroon DS0000063214.V333873.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): 18, 19 and 20. Quality in this outcome area is good. Care and support is provided to service users in the way that they prefer. Residents can self medicate if they have the capacity and the administration of medication undertaken by the home is appropriate and ensures residents are safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care is taken by the care team to ensure that they deliver service in the way that the individual resident prefers. Residents confirmed when they were asked that they received assistance in a way that they liked. It was clear from observations made during the inspection that care was delivered in a sensitive way to residents with their needs very well known to their carer. Some residents in the home were unable to state their views verbally but all were well able to express their likes and dislikes in a way that was quite clear. Residents’ emotional and physical health is appropriately monitored and access is provided to healthcare professionals when required. Two healthcare Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 15 professionals were consulted for their views of the service provided and they expressed satisfaction with the service currently provided at Cameroon. Residents are able to self medicate subject to a risk assessment process to ensure this is appropriate and they have the capacity. The recordings undertaken of the administration of medication completed by the home were examined and were found to be clear, complete and up to date. Medication was checked and booked in correctly when received and the issue and recording of medication is undertaken by two members of the care team and a record is maintained of all medication returned to the pharmacist. Medication was stored under secure conditions in the home. These processes ensure that residents are always safe. Cameroon DS0000063214.V333873.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): 22 and 23. Quality in this outcome area is good. Residents were confident that if they raised an issue this would be resolved quickly for them. Service users are protected from all forms of abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents that were consulted as part of the inspection process advised that if they raised an issue with the staff it was taken seriously and resolved quickly for them. It was clear from observations made that the care team in the home had the complete confidence of the residents and were observed to react quickly to requests made. The home has an active training programme running for the home’s carers that includes adult protection procedures. Two staff team members were interviewed individually in private and it was clear that they understood the issues involved and were clear what action should be taken if they discovered abuse taking place in the home. The home keeps a copy of the complaints procedure, the local authorities ‘alerters guide’ and the abuse guidance given by the health service in the entrance hall of the home to provide access to anyone. Cameroon DS0000063214.V333873.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): 24 and 30. Quality in this outcome area is good. . The home is well maintained and a comfortable, safe environment is provided. Cameroon was clean throughout with high standards of hygiene evident. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complete tour of the building was undertaken as part of the inspection process and all rooms were seen. The lounge and dining room provided a comfortable environment for residents who all advised that they liked this area of the home. The kitchen has a large table in the centre that is used for cooking lessons etc with the residents. Some of the kitchen cabinets have doors that are not fitting properly and it is recommended that they should be repaired or replaced. Residents bedrooms were seen that had been personalised and all the residents consulted advised that they liked their own rooms best of all. One resident said, “I really like my bedroom, it’s the way I like it” another resident was keen to say that she had picked the colour of her room. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 18 All toilets and bathrooms were seen and high standards of hygiene were evident throughout. A malodour was still apparent from the home’s sewage treatment system, this was present at the last inspection and it was understood that it was going to be dealt with. A recommendation has been raised in this report that a specialist review should be undertaken to ensure the system is working correctly. This is an important issue as the odour could well inhibit residents from using the only lawn facility available in the garden. Cameroon DS0000063214.V333873.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): 32, 34 and 35. Quality in this outcome area is good. There are sufficient competent carers available in to ensure residents’ needs are always appropriately met. Residents are protected by the home’s recruitment practices. The home has an active training programme in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing levels in the home have been increased by 21 hours a week to ensure residents’ needs are met 24-hours per day. Carers have a job description and understood their role in the home. Two carers were interviewed individually and in private as part of the inspection process, they advised that they liked working at the home and were clear concerning the policies and procedures including the adult protection procedure. Residents consulted said they liked the staff and got on well with them all. It was clear from observations made during the inspection that the home had a relaxed atmosphere and friendly banter between carers and residents was part of everyday life. One resident said,” I like the carers here” and another remarked “I get help when I want it”. The homes recruitment practices and recording ensures that residents are in safe hands. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 20 The home has an active training programme in place for carers and induction and basic training is given to all staff with additional specialist courses offered for carers. Cameroon DS0000063214.V333873.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): 37,39 and 42. Quality in this outcome area is good. Service users benefit from a well run home and are confident that their views are taken into account when the service is developed. Health and safety issues are given appropriate priority. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a new manager has been recruited and taken up the post. He has introduced a new assessments and care planning process that is clear and reflects all the needs of the residents concerned. Service users are consulted about any development being undertaken and regular reviews are undertaken to ensure changing needs are recognised and adjustments made to the care provided. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 22 All the residents consulted advised that they liked the new manager of the home. Quality assurance systems are in place and ensure residents views are made known and that checks and the monitoring of the staff groups performance is in place. The new manager and the proprietors are keen to ensure that appropriate priority is given to health and safety issues and that residents in the home are safe. The recordings of the fire precautions undertaken by the home were examined and were satisfactory at the time of the inspection. The regulations concerning the secure storage of harmful chemicals were in place and appropriate reports were made when dangerous occurrences were experienced. The electrical installation and appliances are regularly tested to ensure they are safe and the water supply is monitored for unwanted bacteria. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 23 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 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 Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 24 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. 1 2 Refer to Standard YA24 YA24 Good Practice Recommendations The registered manager should arrange for a specialist review to be undertaken to ensure the home’s sewage treatment unit is operating appropriately. The registered manager should have the kitchen units repaired or replaced that are below working standard. Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Cameroon DS0000063214.V333873.R01.S.doc Version 5.2 Page 26 - 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. 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