Inspection on 09/09/05 for Cotebrook

This inspection was carried out on 9th September 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 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 08/12/06

Cotebrook 16/03/06

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 9th September 2005 09:50 Cotebrook DS0000026994.V255559.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 Cotebrook DS0000026994.V255559.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. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 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.V255559.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The total number of Service Users must not exceed 30 30 of the Service Users may be PD 10 of the Service Users may be PD(E) Date of last inspection 1st February 2005 Brief Description of the Service: Cotebrook is a care home owned and managed by a voluntary committee. The home is located in a residential suburb of the village of Lymm, this provides good local shopping and transport links with nearby Warrington. The home has a day care facility within the grounds. The original building is a three-storey house; attached to this is a large ground floor extension. 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. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 9 September 2005 by Paul Ramsden and lasted five hours and forty minutes. The home manager was on duty together with the agreed numbers of senior, care and ancillary staff. Twenty-eight people were living in the home at the time of the visit. During the inspection six residents, the manager and three of the staff on duty were spoken with. A range of care, health and home records were examined and a tour of the premises, including all lounges, other shared areas and a number of bedrooms, was undertaken. What the service does well: What has improved since the last inspection? The home manager gave details of a number of improvements made since the last inspection. These include; overhead tracking has been fitted in eleven bedrooms, the décor within the home has been improved, accessibility to the garden has been improved, a new monthly quality assurance system has been implemented. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 6 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. Cotebrook DS0000026994.V255559.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 Cotebrook DS0000026994.V255559.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): 2 Residents are assessed prior to admission to ensure that the home will be able to meet their needs. New residents are introduced into the home on a planned and gradual basis. EVIDENCE: As part of the inspection process the care files of three people living at the home were reviewed. Pre-admission assessments that demonstrated that resident’s individual needs were being assessed in an accurate and consistent way had been carried out. Those seen contained enough information for staff to be able to meet individual needs. Residents, relatives and other healthcare professionals are involved with the pre-admission assessment. Various risk assessments were also completed. A gradual process of introductory visits and activities are usually undertaken prior to admission to the home. Cotebrook DS0000026994.V255559.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 and 8 All residents have a care plan that shows how their individual needs are being met. The systems used to identify and meet an individual residents needs are good. EVIDENCE: The six care plans seen as part of the inspection process provided staff members with the necessary information for them to look after a person’s needs. There was written evidence to confirm that care plans were being reviewed as and when necessary. The care plans seen contained evidence of consultation with residents or their families/advocates. Records relating to support from other professionals such as GP visits, social worker contact, continence advisors, etc were available. It was evident that the health and well being of residents was carefully and appropriately monitored, and an appropriate record of development and actions taken is being kept. Residents are able to participate in the development of the home by their involvement in both committee and residents meetings. The current system of care planning is in the process of being changed. Activities and forthcoming events are posted on the notice board in the entrance hall of the home. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 10 Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 17 Routines at the home are flexible to suit residents’ individual preferences. Appropriate activities are available and individual rights are respected. EVIDENCE: There is a commitment to enabling residents to have access to a wide range of social and community activities; these include participation in local colleges, a luncheon club and church attendance. Residents were seen going to and returning from the on site day service building. People who had chosen not to attend were occupying themselves. Individuals have built up their personal networks of friends and relatives either within or external to the home. Residents living in the home are able to develop and maintain skills, which will aid their personal development. These include opportunities to choose and buy items for themselves or their rooms. Residents confirmed that routines within the home were flexible and that they were able to make choices in many areas of daily living, for example times of rising and retiring, where to spend time and with whom. Staff members were observed to knock on the door and to await permission before entering a resident’s bedroom. Meals are usually eaten in the dining room. There is a menu that has the flexibility to meet individual needs and choices. All of the residents that Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 12 commented said that the food was good and that choices were available. Special diets are prepared where necessary. 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.V255559.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 The health needs of each resident are being appropriately met. EVIDENCE: All of the residents are dependent on care staff for varying degrees of practical support. All personal care is carried out in the privacy of a resident’s bedroom or one of the bathrooms. It was seen during the visit that the staff members treated individuals with respect and dignity. The healthcare needs of residents were being assessed and monitored appropriately. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 14 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 Residents are able to voice their opinions and are confident that appropriate action would be taken to address any problems or complaints. Appropriate complaint and adult protection policies and procedures are in place. 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 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”. Staff members have received training in this area. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 15 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, 25, 26 and 30 The home provides good facilities to meet the needs of the residents accommodated. Standards of hygiene and cleanliness are satisfactory. EVIDENCE: A tour of the premises was undertaken; this included all communal areas and a number of bedrooms. Communal areas and bedrooms seen during the inspection were comfortable and well furnished. The level of personalisation within bedrooms is very high. Appropriate good quality furniture and soft furnishings are provided; these meet the required standard. All bedroom doors have locks, which can be overridden in an emergency. The home manager explained that overhead tracking for service users that have mobility problems has been fitted into eleven bedrooms since the previous inspection. Whilst redecoration/refurbishment is ongoing some of the areas within the home are showing signs of wear. The carpet leading from the hallway towards the ground floor extension was badly stained and in need of thorough cleaning or replacement. Written confirmation has since been received from the manager that this carpet has been cleaned and a quote for a new carpet is being obtained. A requirement has therefore not been made. Cotebrook DS0000026994.V255559.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): 33, 35 and 36 Staff members were seen to be working positively with residents to improve the quality of life of people living in the home. Staff training and supervision is ongoing. EVIDENCE: Staff on duty and rotas seen demonstrated that staffing levels and the skill mix of staff were adequate to meet the needs of the residents within the home. The staff members seen on the day were cheerful and friendly and were seen to have a good relationship with the people that they were caring for. The agreed staffing levels are as follows: 7.00am – 2.30pm - One senior and four care assistants. 2.15pm – 10.15pm – One senior and three care staff. 10.00pm – 7.30am – Two waking staff members and one person sleeping in. The manager, training officer, day centre staff, administration and ancillary staff hours are in addition to the above. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 17 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, 38 and 39 The home is being well run and managed on a day-to-day basis EVIDENCE: The home has an experienced and competent manager who is registered with the Commission for Social Care Inspection. There is a management team at Cotebrook to support the home manager; this includes a training officer and senior carers. There are clear lines of accountability and responsibility within the home. The manager has recently completed the registered managers award. Staff members were receiving training in areas such as moving and handling, first aid and fire safety. The fire precautions record book was up to date and demonstrated that checks of the alarm system, emergency lighting, fire drills and staff training were taking place. A quality assurance survey has recently been undertaken in order to obtain the views of service users and their representatives regarding the service provided. The results from this survey will be made available to all interested parties and a copy will be sent to the CSCI as required under the regulations. Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 18 Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 19 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 x 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x x x 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 x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cotebrook Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x x x DS0000026994.V255559.R01.S.doc Version 5.0 Page 20 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. Refer to Standard Good Practice Recommendations Cotebrook DS0000026994.V255559.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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. 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