Inspection on 21/11/05 for Cotswold Cottage

This inspection was carried out on 21st 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 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

Cotswold Cottage 27/09/06

Cotswold Cottage 04/05/05

Cotswold Cottage 02/08/04

Cotswold Cottage 29/04/04

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Orchard,The

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Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

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

CARE HOME ADULTS 18-65 Cotswold Cottage Grange Road Hazlemere High Wycombe Bucks HP15 7QZ Lead Inspector Chris Schwarz Unannounced Inspection 21st November 2005 1:40 Cotswold Cottage DS0000022965.V264679.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 Cotswold Cottage DS0000022965.V264679.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. Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Cotswold Cottage Address Grange Road Hazlemere High Wycombe Bucks HP15 7QZ 01494 527642 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) manager.cotswold@fremantletrust.org The Fremantle Trust Diane Bryant Care Home 8 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2005 Brief Description of the Service: Cotswold Cottage is a detached property located at the end of a quiet residential road in Hazlemere, High Wycombe. The home is run by The Fremantle Trust and is registered to provide accommodation for up to eight people with learning and physical disabilities. The home is near to local shops and public transport links into High Wycombe and Amersham. Cotswold Cottage has eight single bedrooms, some on the ground floor, and two lounge areas. There is a large kitchen/dining area and sufficient bathrooms and toilets. The home has an enclosed garden and overlooks farmland to the rear. Each person living at the home has considerable care needs and the home has appropriate aids and adaptations to assist with daily living tasks. Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on a weekday and lasted from 1.40 pm until 5.15 pm. The inspection included discussion with staff, examination of some of the home’s required records and spending time with service users. This was a positive inspection and staff and service users are thanked for their hospitality and co-operation. What the service does well: What has improved since the last inspection? What they could do better: There were no areas for improvement identified during the course of this visit. Cotswold Cottage DS0000022965.V264679.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. Cotswold Cottage DS0000022965.V264679.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 Cotswold Cottage DS0000022965.V264679.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 The home undertakes a thorough admissions process to ensure that prospective service users’ needs can be met. EVIDENCE: A prospective service user was being considered for the vacant room at the home at the time of this visit. It was possible to see that a file has been established containing background information on the individual, including a photograph, pen picture, review notes from a respite care service and notes provided by the family. A record was being maintained to show that visits have been undertaken and how these have gone. Equipment to assist with daily living had already been obtained by the home, such as a hoist. Feedback from staff indicated that visits are being made at the prospective service user’s pace and that care needs can be met. This all showed that the home is using a well rounded process before admitting a new service user. Cotswold Cottage DS0000022965.V264679.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 The home has effective assessment and reviewing systems to ensure that the changing needs of service users are documented and met by staff. The home enables service users to make decisions, with assistance, in order that they can exercise choice. Service users are enabled to take acceptable risks in order that they can be as independent as possible. EVIDENCE: A sample of care plan folders was looked at. These were found to be up-todate with evidence of recent reviewing taking place. Risk assessments had also been updated in individual files, enabling service users to take acceptable risks as part of everyday living. No one had gone missing from the home during the period under review. Staff were observed throughout the inspection responded appropriately to service users’ non-verbal communication and use of sign language. Cotswold Cottage DS0000022965.V264679.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, 15, 16 and 17 Service users have opportunities to take part in age, peer and culturally appropriate activities and are part of the local community, in order that they have stimulation and variety. Service users are enabled to maintain personal and family relationships, in order that important social contacts are continued. Staff promote service users’ independence, choice and freedom of movement, within risk assessment, to enable them to lead fulfilled lives. A healthy and varied diet is provided for service users, to meet their nutritional needs. EVIDENCE: Each service user attends day services during the week, collected and returned by transport provided by the centres. Around the home videos and sensory equipment were being used and there was interest from some service users in preparation of the evening meal. Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 11 Daily report records showed that service users have contact with family and friends and they are invited to service users’ reviews. A recent holiday in Worcester had been undertaken by two of the service users and this was described as a successful and enjoyable short break. Menus showed that the home continues to provide a varied and wholesome range of meals for service users and records are now being maintained of what each person has eaten. Food likes and dislikes are noted in the menu folder, to ensure that appropriate meals are provided. Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 12 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 20 The home provides personal support to service users in preferred ways, to ensure that needs are adequately met. Medication is appropriately handled and administered, to ensure that health care needs are promoted. EVIDENCE: All personal care given to service users was carried out in the privacy of bathrooms or bedrooms. Each person was appropriately dressed for the weather conditions and service users had been assisted to wear co-ordinated clothing. The home is fitted with adaptations necessary to move and assist service users with all aspects of daily living and input from specialist services such as the dietician and speech and language therapist continue. A recommendation made at that time to secure a free-standing supplementary medication cabinet has now been attended to, enabling the standard to now be met. Cotswold Cottage DS0000022965.V264679.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 The home has procedures for service users and their representatives to make complaints, to ensure that their views are listened to and acted upon. There are appropriate adult protection measures in place, to ensure that service users are protected from the risk of harm. EVIDENCE: The home was maintaining a complaints log book, which provided evidence of complaints being appropriately responded to. It was also possible to see that several compliments were recorded from relatives and outside agencies regarding the standard of care. A requirement to update the complaints procedure had been responded to, in order that the change in regulator was clearly identifiable. Training for staff on adult protection had been undertaken, as required at the last inspection, to supplement the policy on protection from abuse. Cotswold Cottage DS0000022965.V264679.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, 26, 28, 29 and 30 The building is homely, comfortable and safe, to ensure that service users have an attractive and well maintained environment in which to live. Bedrooms and communal rooms are attractively decorated and appropriately furnished, providing service users with comfortable and homely surroundings. Specialist equipment is in place at the home, to ensure that service users’ independence is maximised. The home is clean and hygienic, promoting a safe, odour-free and homely environment for service users. EVIDENCE: Cotswold Cottage is a well presented building which is indistinguishable as a care home from other properties in the road. There is a good range of local shops in the area and public transport links are a few minutes walk away. The lounge and most of the bedrooms overlook farmland and there is ramped access to the building. Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 15 Each service user has their own bedroom, decorated and arranged to different tastes and all have been personalised effectively. Communal rooms were comfortable, spacious and well decorated; all parts of the home were heated and there was ample light. Specialist equipment was in place to meet service users’ needs, such as overhead tracking, hoists and an adapted bath. Since the last inspection, the home has acquired a footplate for the shower chair. All parts of the home were clean, hygienic and there were no offensive odours. Cotswold Cottage DS0000022965.V264679.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 and 35 Service users are supported by an effective staff team, in order that their needs are met. Staff are appropriately trained to best meet service users’ care needs. EVIDENCE: Two staff were initially in the building with three service users at home, rising to three staff later on in the day to provide cover into the evening. Staff were friendly, cheerful and engaged with service users and carried out their duties in a calm and unrushed manner. Rotas showed that appropriate levels of cover are also arranged at other times and a recommendation to add further information to rotas was being met. Training records of seven staff were looked at and these showed that mandatory courses had been brought up-to-date, as required at the last inspection, and there had been further input on oral care, as recommended. Cotswold Cottage DS0000022965.V264679.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): 41 and 42 Records are well maintained at the home, safeguarding the best interests of service users. The health and safety of service users is promoted at the home, to keep them safe and well. EVIDENCE: The office was locked when not in use, keeping personal information about service users safe and confidential. It was a joy to spend time unaccompanied in the office to appreciate how easy it was to locate any records required for inspection purposes. All records seen were up-to-date and well maintained. Requirements were made at the last inspection to improve the standard of health and safety at the home, plus one recommendation. On this occasion it was possible to see that these have been met through the preparation of an up-to-date fire based risk assessment, a risk assessment had been prepared on the use of the gas fires and clinical waste bins had been replaced with a Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 18 safer design. The risk assessment on the use of matting on the patios had been revised, as recommended. Cotswold Cottage DS0000022965.V264679.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 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 X 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cotswold Cottage Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 X X X 3 3 X DS0000022965.V264679.R01.S.doc Version 5.0 Page 20 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 Cotswold Cottage DS0000022965.V264679.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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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