Inspection on 12/06/07 for Country Home Care

This inspection was carried out on 12th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Country Home Care 25/01/06

Country Home Care 30/09/05

Country Home Care 18/08/04

Country Home Care 26/04/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Country Home Care 2 Sedgebrook Cottage Brook Lane Plaxtol Sevenoaks Kent TN15 0QU Lead Inspector Julie Sumner Key Unannounced Inspection 12th June 2007 13:00 Country Home Care DS0000023820.V336926.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 Country Home Care DS0000023820.V336926.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. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Country Home Care Address 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) 2 Sedgebrook Cottage Brook Lane Plaxtol Sevenoaks Kent TN15 0QU 01732 810821 thepells@plaxtolkent15.freeserve.co.uk Mr Brian Pell Ms Lesley Pell Ms Lesley Pell Mr Brian Pell Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user over the age of 65 years may be accommodated within the home. 25th January 2006 Date of last inspection Brief Description of the Service: Country Home Care is a care home registered to provide personal care and accommodation to five younger adults, it is owned and run by Mr and Mrs Pell. The home is located on the outskirts of the rural village of Plaxtol. The towns of Sevenoaks, Tonbridge and Maidstone are a short drive away, where there are all the usual facilities of large towns. There is a post office, pub and a church in the village. The home is a semi-detached two-storey building that has been extended. All the bedrooms are single, two are upstairs and three are on the ground floor. Two of the bedrooms have an en-suite bathroom and one bedroom has a shower fitted. There is a stair lift to the first floor with two further bedrooms and separate living accommodation for the owner/manager. There is an enclosed garden to the front and rear of the property with seating areas and a swimming/Jacuzzi pool. Fields surround the property and there is a driveway with some parking for vehicles. The current fees for the service at the time of the visit range from £411.70 to £817.65 per week. This fee can be increased to the assessed needs of the residents. There are additional charges for chiropody, physiotherapy, some activities, transport, hairdressing, clothes and toiletries. The residents are able to go on holiday for frequent short breaks using a private caravan in Whitstable. The accommodation and staff support are paid for by the home. Information on the homes services and the CSCI reports for prospective service users/relatives will be referred to in the Statement of Purpose and Service User Guide. The owners have many years of experience in caring for people with learning disabilities. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection. The inspector visited the home to talk to residents and staff and view records and practices. The visit lasted just over 4 hours. Information was gathered for this inspection in a variety of ways both prior to and during the visits to the home. Some surveys were completed partially with residents depending on their level of understanding and all indicated that residents are happy with the care and support received. Surveys were sent out to visiting professionals and relatives and there were no comments received at this time. Surveys have been completed by relatives and visiting professionals in previous inspections and all past comments have been positive. The people living in Sedgebrook cottage (Country Home Care) have limited communication skills and they are not all able to fully participate in the inspection. Time was spent with the residents whilst they carried on with their usual routines for this day and one resident talked a little, answering some questions about his lifestyle and most recent holiday. It was evident that the residents were able to make their wishes known to the owners and staff. Some photo collages were looked at and talked about depicting recent outings and events. There is a vacancy since the registration has been increased from 4, to providing for 5 people. There were no outstanding requirements or recommendations from the previous inspection and none were made from this inspection visit. What the service does well: The home is providing an excellent standard of care. One response from the home’s recent quality assurance questionnaires sent to relatives contained comments like: “the care in the home couldn’t be better”. The owners and staff spend lots of time talking and spending time with residents. A variety of well thought out communication aids are provided to assist residents to say what they want in all aspects of their day-to-day living. The home places great value on providing the residents with the opportunity for trips out both locally and further afield, either as a group or individually. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 6 This is very much a small family home and visitors are welcome at all reasonable times. Residents are supported well with their personal and health care. Country Home Care provides a homely and safe environment that is appropriately equipped to support residents who have physical and learning disabilities. What has improved since the last inspection? 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 Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 7 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 8 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 Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 9 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, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provide clear information and assessments are carried out prior to admission to make sure prospective residents’ needs can be met. EVIDENCE: The home has recently made an application to increase its registration to accommodate 5 residents. A ground floor bedroom with en-suite bathroom has been built for this purpose and the registration has been approved. At present this room is vacant. There have been some referrals but so far no one has been suitable. The statement of purpose has been updated to reflect the change of registration. Pictorial service user guides have been developed individually for each person. The manager explained that a service user guide will be developed for a prospective resident when their communication has been assessed so that it can be designed to suit them. Country Home Care DS0000023820.V336926.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, 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has a “can do” attitude and risks are managed positively to help people using the service lead the life they want. Staff are responsive and residents are provided with appropriate communication aids to be able to influence decisions about their own lives. EVIDENCE: A sample of care plans were viewed and discussed with the owner/manager. The care plans are clearly written and contain all relevant information to support each individual. Photos and pictures are used as part of daily life in the home. Care plans are reviewed six monthly or as needed. One person’s care plan is under daily review due to deteriorating health and ageing. The owner/manager is aware of person centred planning which was discussed during the visit in light of individual changing needs. Decision making is supported with residents using pictures and experiences known to individuals. Staff interpret facial expressions and sounds that Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 11 indicate responses to questions and testing out responses to experiences. Staff were responsive to these communications from residents. Non-verbal residents were given as much attention as verbal residents. The speech and language therapist has reviewed the residents at different times on referral and has given advice that the staff are following to support individual communication. Risk assessments have been designed around assisting residents to participate in different experiences including cooking and going in the Jacuzzi. There are moving and handling risk assessments for getting in and out of the car and using the hoist. Country Home Care DS0000023820.V336926.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, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents participate in a range of activities that meet their social, leisure and development needs. They are supported in maintaining friendships and family links and receive a healthy balanced diet that includes their choice of meals. EVIDENCE: This is a family orientated home and residents participate in a variety of activities as part of the ongoing running of the house. Art, craft and sensory activities are carried out daily. There is a dip pool and a Jacuzzi that are enjoyed and the physiotherapist has given staff advice on exercises that are incorporated into their activities. The manager and a member of staff have attended a course on back, shoulder and head massage which they both carry out on individuals. Residents participate in meal preparation and made cakes in the morning of the visit, which is also a regular activity. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 13 The owner/manager explained about the changes in local adult education activities that were attended by residents but are no longer provided leaving a gap in the community activities that they had originally attended. The home have been proactive in finding new activities and being part of a new community development including a sports hall, café, library and social centre. Residents are able to participate with social activities, play games and use a trampoline. The owners obtained a small dog for one of the residents. The owner/manager talked about the regular outings. Residents go to the local pub for lunch and also go to the cinema, ten-pin bowling and have been greyhound racing. Picture books, scrapbooks and photograph albums were viewed showing numerous outings and activities the service users had participated in. Residents are able to go on regular holidays to the seaside and stay in a caravan. The residents had some photos and one resident talked about his experiences and how much he enjoyed it. All service users have family who are welcome to visit at any time and one service user goes home some weekends for a short stay. Meals were discussed with the owner and staff. The home use pictures and packets to assist with choices. Meals are family occasions and residents participate in the preparation as much as they are able. Country Home Care DS0000023820.V336926.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, 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff members are very alert to changes in mood, behaviour and general wellbeing and fully understand how they should respond and take action. Staff are trained and competent in health care matters particularly in the care of individuals who remain immobile for long periods of time. EVIDENCE: Residents require assistance with all of their personal care needs. Individuals have mobility equipment and pressure care equipment to support them. Staff have training in appropriate moving and handling techniques. Details of how to support each individual are in their care plans. Individual health care needs are also detailed in their care plan. Staff demonstrated their knowledge in how to support people. One person suffers from hay fever in the summer and the symptoms were being treated sensitively. One person has become frail and is also under the care of the district nurse. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 15 The community physiotherapist visits the home every two weeks and gives advice on movement and exercise to maintain mobility and flexibility. Staff carried out the exercises during the visit. Residents are unable to administer their own medication due to their disabilities and depend on the staff team to assist with this task. The medication storage has been moved out of the kitchen to the dining area. It is kept in a locked cupboard. The stored medication was viewed and was kept in good order. Medication administration sheets were viewed and completed accurately. All staff have attended training and the owner/manager has attended a more detailed course. Country Home Care DS0000023820.V336926.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, 23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home has an open culture that supports residents to express their views. Staff are attentive to individual needs and are able to determine if individuals are unhappy. All staff are fully trained in safeguarding adults and know how to respond in the event of an alert. EVIDENCE: There is a complaints procedure in place, including one in a pictorial format for the service users. To make the complaints procedure accessible, one of the staff goes though the pictures of expressions including: happy, sad, examples of different actions of something happening, pictures of people speaking to each other and on the telephone to say you can speak to someone. Each person is asked each week and their responses are documented to make sure they have the opportunity to say if they have a complaint. Relatives have also signed to acknowledge the procedure and these are retained within the service users’ records. The owner/manager stated that all staff have undergone adult protection training and a refresher course has also been attended. Staff were responsive to residents’ non-verbal communication. The financial procedures for supporting residents were discussed with the owner/manager. A sample of records for personal allowance and mobility allowance were viewed to see how the procedures work in practice. Money is Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 17 kept in individual containers and securely. All the money and records are audited monthly. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 18 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable and well maintained. EVIDENCE: A tour of the home was carried out with the owner/manager. All areas of the home were decorated and well furnished to meet the needs and comfort of the residents. There is a cycle of redecoration and the owner was discussing further plans to improve one of the resident’s bedrooms. A new bedroom has been built (and registered) with ensuite bathroom, which is well furnished and decorated ready for an occupant. Equipment and adapted furniture has been provided to give maximum support to residents’ lifestyles. The downstairs areas of the home are accessible to residents in wheelchairs and the home has been organised so that individuals can move around freely. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 19 There is a large garden which is used frequently and there is a Jacuzzi and dip pool outside for residents’ use. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 20 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, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is proactive rather than reactive in its staffing, recruitment and training with planning for the potential needs of residents. EVIDENCE: This is a family run home. The staff team is made up of the owners who also live in the home, two experienced care staff and a cleaner. Residents are treated as part of the family. There have been no new staff since the last inspection visit and staff files have been viewed previously and found to be in order with good recruitment processes. One staff file was viewed and discussed at this visit. The staff training records were viewed and discussed with the owner/manager. There is a good range of training including managing challenging behaviour, adult protection with ‘Voluntary Action West Kent’ in Tonbridge and care of people through the changing conditions of ageing. Staff are given appraisal and supervision and supported with their own personal development. One of the staff is currently studying NVQ level 4. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 21 Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 22 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, 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The manager communicates a clear sense of direction and is able to evidence a sound understanding and application of best practice. This is particularly in relation to continuous improvement and responding to what residents, relatives and staff say. There is effective implementation of risk assessments and good maintenance to provide a safe environment for residents to live in and staff to work in. EVIDENCE: The home’s manager has many years experience of working in care and is qualified in The Registered Managers Award, NVQ4 in Care and holds an NVQ assessors award. All written information needed during the visit was Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 23 accessible and clearly written. There was a very positive atmosphere in the home with staff speaking highly of the home and its management. The owner/manager has found alternatives and been part of developing services when there have been changes to provision outside the home. This has been done to make sure the residents do not miss out and continue to lead a stimulating and fun lifestyle. The owner/manager has created a system of both service quality monitoring and planning development of the home. They have weekly meetings with everybody, which is held in 2 parts. Minutes are taken and a sample of these was viewed including the action plans that are made as a result of the meetings. The owner/manager said she uses the NMS as a checklist. Questionnaires have been sent out to relatives and other interested people for feedback annually. Some of the feedback was sampled and all was positive. Environmental risk assessments have been carried out and written for all relevant aspects of the home. A sample was viewed including one for the Jacuzzi. Moving and handling risk assessments for each individual were in their files. The sample viewed contained good guidelines and detail for use in the swimming pool, Jacuzzi, shower, hoist, going to bed, going out in the minibus etc. The procedures for fire safety were discussed with the owner/manager. The fire risk assessment has been completed and was up to date. The owners and staff have received training. Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 24 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 4 23 4 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 4 4 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 x 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 x 4 x x 3 x Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 25 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 Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Country Home Care DS0000023820.V336926.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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