Inspection on 08/12/06 for Cotebrook

This inspection was carried out on 8th December 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 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

Cotebrook 16/03/06

Cotebrook 09/09/05

Cotebrook 01/02/05

Cotebrook 08/09/04

Cotebrook 27/02/04

Similar services:

Ruskin Lodge

Dystlegh Grange

The Good Companions

Springfield Cottage

Cuerden Grange Rest Home

Cornmill Nursing Home

Vitalise Sandpipers Centre

Sue Ryder Care Birchley Hall

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

CARE HOME ADULTS 18-65 Cotebrook Oughtrington Lane Lymm Warrington Cheshire WA13 0QY Lead Inspector Paul Ramsden Unannounced Inspection 8th December 2006 10:30 Cotebrook DS0000026994.V317754.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 Cotebrook DS0000026994.V317754.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. Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cotebrook Address Oughtrington Lane Lymm Warrington Cheshire WA13 0QY 01925 752583 01925 753169 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) Cotebrook Homes Limited Mrs Sidney Timms Care Home 30 Category(ies) of Physical disability (30), Physical disability over registration, with number 65 years of age (10) of places Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 30 service users to include: * Up to 30 service users in the category PD (Physical disability) * Up to 10 service users in the category PD(E) (Physical disability over 65 years of age) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidance that may be issued through the Commission for Social Care Inspection 16th March 2006 2. 3. Date of last inspection Brief Description of the Service: Cotebrook is a care home standing in its own grounds. The home is owned and managed by a voluntary committee and is located in a residential suburb of the village of Lymm, this provides good local shopping and transport links with nearby Warrington. There are adequate car parking facilities available. The original building is a three-storey house; attached to this is a large ground floor extension and day-care facility. Residents are accommodated on the ground floor only. The first and second floors are used for office accommodation and storage. Residents accommodation consists of 30 single bedrooms, two of which are used for respite care. There are a variety of communal facilities available. These include three lounges, two dining rooms and a conservatory. Cotebrook has an adequate number of toilets and a variety of bathrooms available for residents. Aids to help maintain independence are in evidence throughout the home; these include bath hoists, grab rails and an emergency call bell system. The home has a day care facility within the grounds and extensive well-kept grounds for the use of the residents. The current fee for the home is £406.44 per week. Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. An unannounced visit took place on the 8 December 2006 and lasted 5.5 hours. Paul Ramsden, Inspector, undertook the visit. All of the key standards for young adults were looked at. This visit was just one part of the inspection. Before the visit the home manager was also asked to complete a questionnaire to provide up to date information about services in the home. Questionnaires were also made available for residents and families to find out their views. Other information received since the last key inspection was also reviewed. Fourteen resident and five relative forms have been returned. During the visit various records and the premises were looked at. A number of residents, a prospective resident and her social worker and staff members were spoken with, they gave their views about the home and the service provided. What the service does well: What has improved since the last inspection? What they could do better: Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 6 The appointment of new cooks could improve the overall quality of food provided to the residents living in the home. 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. Cotebrook DS0000026994.V317754.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 Cotebrook DS0000026994.V317754.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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information and opportunities to visit before choosing to move in are available and residents are assessed prior to admission to ensure that their needs can be met at the home. EVIDENCE: The statement of purpose and service user guide called “welcome to Cotebrook” was situated in the entrance hall and was available to current and prospective residents. Information about the facilities, services provided, fees, complaints procedure and the terms and conditions of residence are included in these documents. A brochure and other information about the home were available; these can be posted to prospective residents. A resident has written on a survey form, “I have been here for a short stay, then I decided I liked it and wanted to live here”. As part of the inspection process the care files of three people living at the home were looked at. Pre-admission assessments demonstrating that a resident’s individual needs were being assessed in an accurate and consistent way had been carried out. The manager or a member of the senior staff team, with a considerable amount of input from the resident [where possible] and family members undertake the assessments in order to identify specific Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 9 individual needs before a service is provided. Copies of information provided by the placing authority were also seen on the files. Cotebrook DS0000026994.V317754.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. This judgement has been made using available evidence including a visit to this service. The clients care plans seen provided sufficient information for staff members to be able to take appropriate action to meet an individuals needs. EVIDENCE: The care plans seen as part of the case tracking process provided staff members with the necessary information for them to look after a person’s needs. The health and well being of residents was being monitored and an appropriate record of development and actions taken was being kept. Care plans were being reviewed and where necessary re-written on a regular basis. Residents or their families/advocates are involved in the care planning process; those seen were signed by residents to show that they agreed with the contents. The staff members at the care home continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate support from health care professionals. This included GPs, community nurses, optician, dentist and chiropodist. Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 11 The residents spoken with during the inspection all said that the standards of care provided were very good and that they had been able to express their opinions and wishes about their daily routines. It was also seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. Staff members were seen to be interacting with individuals in an appropriate and respectful manner and were addressing people with respect and dignity. The risk assessments seen in the residents’ files had been completed appropriately. Cotebrook DS0000026994.V317754.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. This judgement has been made using available evidence including a visit to this service. Residents were positive about the home and the support they received so they could maintain contact with friends and family and make choices about their daily lives. EVIDENCE: On the day of the visit residents were seen going to and returning from the on site day service building. This is open for five day per week, 9.30am until 3.30pm. People who had chosen not to go were occupying themselves. A number of residents also attend the local college for various courses. There were a variety of opportunities for residents to become involved in community activities and events; these include, attendance at a local church, visits to the pub and shopping trips. The purchase of a new mini-bus has helped residents to organise and plan social activities and on the day of the visit some people had gone out for a Christmas lunch. A wide-range of activities was displayed on the notice board. Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 13 Individuals have built up their personal networks of friends and relatives either within or external to the home. Lots of evidence showing that residents have a variety of hobbies and interests were seen during the visit. Residents confirmed that they are able to exercise choice in how they live at Cotebrook, especially in relation to leisure, activities and daily life in general. This includes times of rising and retiring, where they spent their time and with whom. Their rights are respected and they are able to take responsibility in their daily lives. The telephone number of the advocacy service is displayed on the notice board. Residents are able to participate in the development of the home by their involvement in both committee and residents meetings. Meals can be eaten in the dining room or in the privacy of residents’ own rooms. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that commented said that the food was generally good but there have been some problems recently. This was discussed with the training officer [the home manager was on holiday at the time of the visit] she explained that the two cooks had left recently and a number of people were cooking the meals on a temporary basis. This issue was in hand and the home was advertising for a new cook. Special diets are prepared where necessary; some of the assessments and care plans seen confirmed that individual dietary needs are discussed and where necessary addressed. In addition to water available from a cooler in the main lounge, orange juice, tea and coffee making facilities are available in the conservatory. Cotebrook DS0000026994.V317754.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. This judgement has been made using available evidence including a visit to this service. Residents were positive about the home and the support they received so they could maintain as much independence as possible. EVIDENCE: Residents are enabled to live their lives as independently as possible. Staff members do this by respecting privacy and offering choices. Personal care, if required is provided in private and takes into account individual service users preferences and needs. Staff members spoken to have a good understanding of the people they were supporting and were able to meet their diverse needs. The changing needs of individuals are discussed as and when required; the inspector was able to see this in practice during the visit. It was seen throughout the visit that residents were being treated with courtesy, respect and good humour by staff. A relative has written on a survey form; “I am very satisfied with the care that my relative receives”. The staff members at the care home continually monitor the residents’ health needs and there was evidence to show that they were receiving appropriate Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 15 support from health care professionals. This included GPs, community nurses, diabetic clinic, optician, dentist and chiropodist. The home uses a blister pack system dispensed by a local pharmacist. No major issues concerning the medication system were seen during the inspection visit. Cotebrook DS0000026994.V317754.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. This judgement has been made using available evidence including a visit to this service. Residents and relatives are able to complain and action is taken to respond to their concerns. Adult protection training for staff is available to ensure the continued safety of residents. EVIDENCE: There is a clear and effective complaints procedure for the home; this is included in the Statement of Purpose and Service User Guide. The welcome to Cotebrook leaflet also contains details about how to complain. The preinspection questionnaire indicates that one complaint has been received during the previous 12 months; this was responded to within the agreed timescale. The residents spoken with during the visit confirmed that they knew what to do if they were unhappy or wanted to make a complaint. The survey forms received confirmed this opinion. The home has an Adult Protection procedure (including Whistle Blowing), which complies with the Public Disclosure Act 1998 and the Department of Health Guidance ‘No Secrets’. The manager has demonstrated previously that she is fully aware of the appropriate procedures to follow should an incident arise. Staff members have received training in this area. Cotebrook DS0000026994.V317754.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. This judgement has been made using available evidence including a visit to this service. The accommodation provides good facilities to meet the needs of the residents accommodated so that they live in a safe, clean and comfortable home. EVIDENCE: A tour of the premises was undertaken; this included communal areas and a number of bedrooms. The home both externally and internally is maintained to a good standard. The quality of décor, furnishings and fittings were good throughout the home, as were standards of hygiene and cleanliness. The home was found to be clean and tidy on the day of inspection. The bedrooms seen during the inspection were comfortable and well furnished. The level of personalisation within bedrooms is very high. Overhead tracking for service users that have mobility problems has been fitted into a number of bedrooms. Cotebrook DS0000026994.V317754.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 good. This judgement has been made using available evidence including a visit to this service. Staff members work positively with residents, families and visiting professionals to improve the quality of life of people living in the home. A robust staff recruitment process is in place in order to protect residents from possible harm. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff was adequate to meet the diverse needs of the residents within the home. Staff members were cheerful and friendly. The residents spoken with during the visit were complimentary about their attitude and competence. According to the information provided in the pre-inspection questionnaire 44 of senior and care staff members have achieved an NVQ in care. A number of other staff members are currently undertaking this qualification. The files for three recently appointed members of staff seen contained all of the required information and a robust recruitment procedure was in place for the protection of residents. Prospective staff members are checked against the POVA list before employment commences and CRB disclosures are obtained. All applications are subject to equal opportunities monitoring. Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 19 New staff members undertake an in-house induction; this lasts for a period of two weeks, evidence of induction training was seen on the day of the visit. Cotebrook DS0000026994.V317754.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 good. This judgement has been made using available evidence including a visit to this service. The home is being well run and managed on a day-to-day basis; this helps to ensure that that residents’ are well cared for and safe from possible harm. EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. She has attended courses/training in order to fulfil her management responsibilities and has demonstrated an awareness of the diverse needs of the resident group and how to manage the staff team. She has completed the registered managers award. Senior staff members and administrators support the manager. This is a strong team that is committed to providing a good quality of care to the residents living in the home. The residents that commented said that the home’s management team were approachable and supportive. A relative has Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 21 written on a survey form; “the standard of care, air of contentment and number of activities have all improved since the manager took charge”. A quality co-ordinator is responsible for seeking the opinions of residents and family members about the service provided by the home. This is an on-going process. Residents’ personal allowances were inspected; those checked had correct balances and were being well managed. The systems for the recording of any monies or valuables held were good. Staff members were receiving training in areas such as moving and handling, first aid and infection control. The fire precautions record book demonstrated that checks of the alarm system, fire drills and staff training in fire safety were taking place. The home manager has confirmed since the visit that the emergency lights are being tested on a monthly basis. Monthly visits to comply with regulation 26 of the Care Homes Regulations are being carried out. Cotebrook DS0000026994.V317754.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 3 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 Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 23 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. 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 Cotebrook DS0000026994.V317754.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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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