Inspection on 31/10/06 for Cameroon

This inspection was carried out on 31st October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cameroon 03/05/07

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 31st October 2006 09:00 Cameroon DS0000063214.V317953.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.V317953.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.V317953.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.V317953.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 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. Cameroon DS0000063214.V317953.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 7.5 hours during October 2006. A complete tour of the home was undertaken as part of the inspection process and four residents were consulted individually. Samples of the care records were examined and two of the staff team were interviewed individually in private. Evidence was also obtained from two healthcare professionals that provide a service to the home. The inspection was undertaken with the assistance of Mr B Marlow the homes advisor and the new proposed registered manager. What the service does well: What has improved since the last inspection? The home has had several recent management changes, however, there is now a new proposed manager who has been is post for three weeks and the home looks forward to a stable future. Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 6 A sensory room has been provided and it was understood is much enjoyed by some of the residents. The home has been through a difficult period due to a vacancy of a manager, however, a good service has been maintained to the residents, which is commendable. Most of the requirements called for in the last report have been satisfied, a quality assurance system is in place, accidents are appropriately recorded, the fire precautions are undertaken and suitable maintenance has been completed in one of the home’s bathrooms. 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. Cameroon DS0000063214.V317953.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 Cameroon DS0000063214.V317953.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 adequate. Detailed assessments were in place for residents that covered all their requirements in the areas of health, personal and social needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Four assessments were examined in detail and the needs in the areas of health, personal and social were included. The home undertakes the assessment process prior to them offering a place to the prospective resident; this approach ensures that all the person’s needs are able to be met by the service provided. Healthcare professionals are also consulted as necessary to ensure all needs are known. Cameroon DS0000063214.V317953.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 and 9 - Quality in this outcome area is adequate. Appropriate care plans were in place that had been agreed with the individual concerned. Residents were supported and assisted to make their own decisions and appropriate risk are undertaken by residents after proper assessment had been completed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of the inspection the home was introducing another new care planning system. Four of the care plans were examined and it was apparent that some of the information required was missing. It is acknowledged that this information could probably be found elsewhere in the home but it is necessary that it be integrated into the individuals’ care planning process. A requirement has been raised in this report to ensure this is achieved with a timescale agreed. Residents are given sensitive support and assistance to make decisions about matters that affected them and were very positive about this process when asked about it. One resident that was going on holiday at the time of the last Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 10 inspection was able to say how much he had enjoyed it and how he had been given help and assistance by carers. Risk assessments are undertaken and form part of the care planning process to enable residents to take appropriate risks. Cameroon DS0000063214.V317953.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): 12, 13, 15, 16 and 17 - Quality in this outcome area is adequate. Residents take part in appropriate activities including leisure activities and regularly use the facilities available in the community. Service users have appropriate relationships and their rights and responsibilities are recognised daily. A wholesome balanced diet is provided at the home that is to the liking of the residents. 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. Some activities are provided in the home, however, in addition to this programme there are regular trips out undertaken such as ten-pin bowling, shopping, where the choices of what is purchased are made by residents and meals in local public houses. Residents confirmed in conversation that they enjoyed life at Cameroon and particularly enjoyed the holidays provided. Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 12 At the time of the inspection a meal was being organised to celebrate Halloween, care had been taken and a colourful party atmosphere that was much appreciated by the residents was provided. 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 residents advised that they liked the meals provided. One resident said he thought the food was “smashing” and another said, “I can have what I like”. Meals are usually taken in a dining area situation next to the kitchen. Cameroon DS0000063214.V317953.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 adequate. Care and support is provided to residents 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: Residents confirmed when asked that they received help and assistance in a way that they preferred. It was also clear from many observations made during the inspection process that care was delivered in a sensitive way to residents. 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 professionals were consulted as part of this inspection process and they expressed satisfaction with the service currently provided at Cameroon. One specialist did say that he had had occasions when the home had not kept appointments in the past but since the new proposed registered manager had taken up the post he was confident that this would not be repeated. Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 14 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 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 safe. Cameroon DS0000063214.V317953.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 adequate. The residents consulted were confident that any issue raised by them would be taken seriously and resolved without delay. Service users were protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The residents 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 staff at the home had the complete confidence of the residents and were seen 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. Cameroon DS0000063214.V317953.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 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 lounge is equipped with a large coloured television and the fitted carpet had been replaced since the last inspection. A well-used table is in the centre of the kitchen and is used for cooking lessons etc with the residents. The home did have a large Aga cooker but this was judged to be dangerous for residents and it has been replaced by a more conventional unit since the last inspection. Some of the kitchen cabinets are showing their age and consideration should be given to their replacement. Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 17 Residents bedrooms were seen that were personalised and all the residents consulted advised that they liked their own rooms best of all. One resident said, “This is my room I really like it, I have all I need, I have a television and a sound system for music”. A new sensory room has come on line since the last inspection and some residents are tasking advantage of using it. It was understood from the proposed new manager that the home is going to get advice to ensure they make the most of this facility. Toilets and bathrooms were also seen and high standards of hygiene were evident throughout. At the time of the inspection there was a malodour outside the home that appeared to come from the home’s own sewage treatment system. This is going to be investigated by the manager and resolved. Outside the grounds that surround the home are well tended and access is provided for wheelchairs to ensure residents can use it when they wish. Cameroon DS0000063214.V317953.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 and 35 - Quality in this outcome area is adequate. Competent carers are available in sufficient numbers to ensure residents’ needs can always be met. Some gaps were apparent in 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 are adequate and remain at the same level as at the last inspection, this ensures that 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. One resident said “ I can always get help when I need it” and another remarked “They take me shopping and I can buy things I choose”. It was clear from observations that the home had a relaxed atmosphere and friendly banter between carers and residents was part of everyday life. Some of the essential documentation required in the personnel files was missing at the time of the inspection. A requirement had been raised in the last Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 19 report to ensure that this was rectified but unfortunately there were still gaps. A requirement has been repeated in this report to ensure this is achieved without delay to ensure that residents are safe. The home has an active training programme in place for carers and induction and basic training is given to all staff with additional courses offered for carers who wish to progress beyond the basic level. Cameroon DS0000063214.V317953.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. Residents benefit from a well run home and they 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 time of the last inspection a new proposed manager has been recruited and taken up the post. This inspection was undertaken with his assistance and he has made a good start in the first three weeks to ensuring all the necessary actions and procedures are undertaken to ensure the service is maintained to the residents. Quality assurance systems are being reviewed to ensure that residents views are made available and that checks and the monitoring of the staff groups performance is in place. Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 21 The new manager and the proprietors are keen to ensure that appropriate priority is given to health and safety issues and that all 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.V317953.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 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.V317953.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15 Requirement The registered provider must provide an individual service user plan for each resident that has been developed and agreed with the individual concerned and or their representative. (Previous timescale of 06/06/06 not met) The registered provider shall not employ a person to work at the care home unless they have obtained in respect of that person the information and documentation specified in paragraphs 1 to 7 of Schedule 2. Timescale for action 31/12/06 2 YA34 19 11/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Cameroon DS0000063214.V317953.R01.S.doc Version 5.2 Page 24 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.V317953.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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