Inspection on 29/11/05 for Cote House

This inspection was carried out on 29th November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cote House 04/09/07

Cote House 31/08/06

Cote House 18/07/05

Cote House 08/02/05

Cote House 05/07/04

Cote House 27/01/04

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 Cote House Rowden Hill Chippenham Wiltshire SN15 2AG Lead Inspector Steve Cousins Unannounced Inspection 29th November 2005 10:00 Cote House DS0000015901.V262494.R01.S.doc Version 5.0 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 Cote House DS0000015901.V262494.R01.S.doc Version 5.0 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. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cote House Address Rowden Hill Chippenham Wiltshire SN15 2AG 01249 653760 01249 653888 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) Milbury Care Services Limited Mrs Jennifer Boyne-Aitken Care Home 11 Category(ies) of Physical disability (11) registration, with number of places Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 10 persons in receipt of day care at any one time Date of last inspection 18th July 2005 Brief Description of the Service: Cote House provides personal care, or care with nursing, for up to 11 people with physical disability. Service users may be adults between the ages of 18 and 65 years. The home offers long-term, short-term, and convalescent care. There are also up to 4 day care places. Because the home is registered to provide nursing care, a qualified nurse is on duty at all times, supported by a team of carers. The service is operated by Milbury Care Services. This is a national private sector organisation, which is best known for its work in the learning disability field. Cote House is situated in a residential area, within easy reach of the centre of Chippenham. Accommodation is offered on the ground and first floors. All rooms have ceiling tracks for hoists. Wash hand basins are in all 11 single bedrooms, but only one room has an en suite bath. Bedrooms are available to accommodate wheelchair users and there is a passenger lift. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 9.30am and 3.45pm. There were eleven service users resident in the home. The findings from this inspection are based on a tour of the premises, speaking to service users, the manager, deputy manager and staff, and inspecting a number of records, including care plans. The inspector then met with the deputy manager, to report the findings of the inspection. What the service does well: What has improved since the last inspection? What they could do better: Some bedroom carpets and furniture need to be replaced and, as recommended in the last inspection report, the garden could be improved to make it more attractive and accessible to service users. Staff CRB checks need to be available in the home until seen by a CSCI inspector. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 6 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. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 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 Cote House DS0000015901.V262494.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3, and 4. Prospective service users have the information and the opportunity to make an informed choice about living at Cote House and the home is able to meet their needs and aspirations as far as is possible. EVIDENCE: A statement of purpose has been produced. The service users guide reflects the service provided and a small information leaflet is also available. Potential service users also have the opportunity for trial visits and stays if required. A copy of the last CSCI inspection report was available in the homes foyer. There had been no new service users admitted to the home since the previous inspection held in July 2005. Care plans contained comprehensive pre admission assessment documents. Either the manager or her deputy had carried out the pre admission assessments. The home is equipped and suitable for people with physical disabilities who require personal or nursing care, either on a long or short-term basis. Specialised equipment is in place, the staff have a good awareness of service users needs and appropriate training is available. Social needs are also addressed. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Service users needs are reflected in care plans. They are able to make decisions about their lifestyle and receive support in maintaining independence as far as is possible. EVIDENCE: Service users care plans appeared to reflect assessed needs, contained appropriate risk assessments and were reviewed regularly. Where a service users needs were changing, this was reflected in the plan. Plans clearly focussed on the service users perspective. In one case, a service user with an increased risk of developing pressure damage did not have an associated care plan and this was brought to the attention of the deputy manager, and was completed during the inspection. Appropriate equipment was available to meet service users assessed needs. Interventions such as fluid/nutritional intake and regular weighing were undertaken and recorded as required. Service users are involved in the care planning process, which enables them to make decisions about what support they require and how they would like to live, such as having staff support them to access the community for social interaction. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 17 Service users have the choice to engage in appropriate leisure activities and to access the community. A varied diet is offered and nutritional needs are met. EVIDENCE: An activity programme was displayed on a notice board and included in-house and external activity. Service users commented that they enjoyed the activities provided. Those who did not wish to join in had their decision respected. Personal home entertainment equipment was available in bedrooms and other entertainment equipment in the main lounge. Service users are able to access the local community if they so wish, either independently with friends and relatives, or with the support of staff. There were mainly positive comments regarding the meals provided. There are a variety of choices from the menu available throughout the day and meals are prepared in a domestic style kitchen by the support workers. There is a separate dining area, however service users can choose where they wish to eat. A range of dietary needs can be catered for, including specialised feeding regimes. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Support is provided the way service users prefer and physical and emotional health needs appear to be met. The arrangements for handling medications protect the service users. EVIDENCE: As found at the previous inspection, the service users spoken with were positive about the support provided by the home. One staying for respite said ‘I am always well looked after here’; another said that ‘the staff are wonderful. I have no complaints’. Service users support needs are detailed in care plans. There were some frail, fully dependant service users who were receiving appropriate support, their personal hygiene needs were being met and they appeared well hydrated and nourished. There were no service users with pressure sores. A physiotherapist attends the home weekly and a physiotherapy assistant is employed. All service users were registered with a local GP surgery. Care plans also showed evidence that health and emotional issues were dealt with promptly and that other health care professionals were involved where necessary. The arrangements for dealing with medicines were found to be satisfactory and hand written amendments of additions or alterations to MAR sheets now had Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 12 two witness signatures. Arrangements for the disposal of medicines were in place. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. There is a system to ensure that service users views are listened to and acted on and, as far as possible, they are protected from abuse and neglect. EVIDENCE: A complaints procedure was available, along with large print and abridged versions; these were also contained in the service users guide. The manager stated that no complaints had been received since the previous inspection. No complaints had been sent directly to CSCI and service users’ or relatives raised none during this inspection. One service user said she would know who to complain to but stated ‘I have had no need to do so’. CRB/POVA checks had been carried out on all staff and abuse awareness training was available and also included within NVQ. A ‘whistle blowing’ policy is available for staff to report any concerns about practices in the home. The arrangements for the safekeeping of residents’ money were reviewed and found to be satisfactory and regularly checked. The comments of the service users indicated that they were well treated by the staff. There had been no referrals to, or from, the local Vulnerable Adults Unit regarding Cote House. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27,29 and 30. Internally the home is comfortable, clean and safe and there are adequate toilet and bathing facilities. Equipment is available to maximise independence. External areas require some improvement. EVIDENCE: The manager reported that there were plans to internally refurbish the home. A tour of the building indicated that some carpets are stained and require replacement, notably in rooms 1,2,3,5 and 7. The wardrobe in room 2 was in poor condition as was the bedside cabinet. Work had commenced externally on the building and windows were being replaced. Safety measures included all fire doors having self-closing mechanisms linked to the fire alarm system, controlled hot water supply and all radiators are covered, although the one opposite room 10 needs to be repaired. As reported at the last two inspections, there is a large garden to the rear of the home that could be greatly improved to the benefit of service users, particularly with regard to appearance and accessibility. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 15 There are two toilets, one bathroom and one shower room on the ground floor and a bathroom and toilet on the first floor; all are suitable for use by people with physical disability. One bedroom has an en-suite bathroom. Ceiling hoists are available in all toilets and bathrooms. Grab rails are also fitted. Both baths for general use are of an adapted design. Specialised seating, wheelchairs and beds to suit the needs of the service users are in use. All main doors have wheelchair access. There is a lift to the first floor. Some service users have system, which enable them to control various aspects of their environment with minimal movement. There are ceiling hoists throughout the building. The home was clean and there were no unpleasant odours. There were gloves and aprons available in the laundry. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34 and 35 There are enough qualified, competent and effective staff to support the service users and the recruitment practice protects them. Training records were not always in place to evidence staff training. EVIDENCE: Duty rotas indicate that the home achieves the minimum staffing levels as detailed on the staffing notice set by the previous registration authority. Additional staff are on duty to meet the needs of the day care clients. The manager reported some concerns about the number of permanent staff employed and was trying to recruit another registered nurse to cover weekends, along with further support assistants. The comments of the service users indicated that there are generally enough staff members on duty in the home. Review of staff recruitment files indicated that recruitment procedure was generally satisfactory and appears non discriminatory. Identification documents were in place, the inspector was reassured that all staff have had CRB checks, although not all certificates were available as the process was administered by Milbury Care head office. There is a need to retain CRB checks on the premises until seen by a CSCI inspector. Training records indicated that staff had received mandatory training, however individual records needed to be updated to fully evidence the training provided. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 17 There were records of induction training for new staff and an updated induction training programme had been produced The manager reported that three out of eleven support assistants had an NVQ and a further four were currently undertaking one. . Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. The home is well run. Service users are consulted about their views on the service and there are good quality assurance systems. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The registered manager is Mrs Jenny Boyne-Aitken. She is a first level general nurse who has the ENB 941 qualification in Nursing Elderly People. She is also a qualified NVQ assessor and internal verifier. Mrs Boyne –Aitken has commenced an NVQ Level 5 in management. The deputy manager was undertaking NVQ 4, Registered Managers Award. Service users surveys are undertaken to try and ascertain their views on the home and there are monthly and annual audits, which include service users perceptions of living in Cote House. Regular staff meetings are held and recorded. Thermostatic control valves are fitted to hot water outlets and temperatures are regularly checked. Radiators are covered. Food hygiene and infection Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 19 control procedures are carried out. Ceiling hoists are available throughout the home, a manual handling trainer is in place and training is ongoing. The fire log indicated that fire safety tests were carried out at the required intervals. A monthly health and safety audit is carried out. Accidents were recorded and reviewed. There had been no major accidents and no referrals to hospital due to accidents. The maintenance record indicated that gas, water and electrical safety tests had been completed. Lifting equipment had been serviced. Routine checks of hot water temperatures and the call bell system were also recorded. Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cote House Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000015901.V262494.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA24 Regulation 23 (2,b) Requirement The registered provider is required to ensure that the carpets referred to in the report be replaced. The registered provider is required to ensure that the bedroom furniture referred to in the report be replaced. The registered person is required to ensure that staff CRB checks are available on the premises, until seen by a CSCI inspector. The registered manager is required to ensure that training records are updated in order to fully evidence training provided. Timescale for action 01/02/06 2 YA24 23 (2,b) 01/02/06 3 YA34 19 (Schedule 2) 18 (1,c,i) 29/11/05 4 YA35 01/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations It is recommended that further work be carried out on the garden area in order to improve accessibility and enhance the external environment for service users. DS0000015901.V262494.R01.S.doc Version 5.0 Page 22 Cote House Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 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 Cote House DS0000015901.V262494.R01.S.doc Version 5.0 Page 23 - 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!