Inspection on 30/09/05 for Country Home Care

This inspection was carried out on 30th 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Country Home Care 12/06/07

Country Home Care 25/01/06

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 Paul Stibbons Unannounced Inspection 30th September 2005 11:15 Country Home Care DS0000023820.V250202.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 Country Home Care DS0000023820.V250202.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. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 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 Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 2004 Brief Description of the Service: Country Home Care is a care home providing personal care and accommodation to four 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 church in the village. The home was first registered in 1995 with Kent County Council as a small home it is a semi-detached two-storey building that has been extended upon. All the home’s bedrooms are single, two being on the ground floor of which one has an en-suite facility. There is a stair lift to the first floor with two further bedrooms and separate living accommodation for the owners/manager. There is an enclosed garden to the front and rear of the property with seating areas and a swimming pool. Fields surround the property and there is a driveway with limited parking for vehicles; on road parking is available. The owners have many years experience in caring for people with learning disabilities. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulatory Inspector Paul Stibbons conducted this unannounced inspection and the owners/manager were present. A tour of the building was undertaken and various records and documentation were examined. The inspector spoke with all of the four service users, a member of staff and a visiting relative. What the service does well: What has improved since the last inspection? What they could do better: The medication cabinet should be moved to a more appropriate location away from heat sources and a thermometer installed to monitor temperatures. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 6 Medication for internal use and external use should be stored separately and only homely remedies that have been agreed with the GP and listed should be kept and administered. Records of medication returned to the pharmacy must be kept on the premises to provide a clear audit trail. Formal supervision of staff should take place at least six times a year and details of these must be recorded. A business and financial plan must be in place and made available for inspection. 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. Country Home Care DS0000023820.V250202.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 Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Service users are provided with sufficient information for them to make an informed choice about the home and whether their needs will be catered for within the service, and at what cost. EVIDENCE: The home conducts a comprehensive assessment of service users’ needs covering all aspects of their lives, this includes their social, physical and emotional needs. Input from other professionals is part of the process and specialised equipment is provided where required. The manager stated that prospective service users are given the opportunity to have visits and trial periods to assess the appropriateness of the placement. Evidence of these assessments was viewed in care plans and the support plans contained guidance for the care team on the delivery of care requirements. Service user guides were in an accessible format and contained a written contract of terms and conditions that were agreed and signed by the service user’s next of kin. Country Home Care DS0000023820.V250202.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): 7, 8, 9, 10 Service users are consulted with on all aspects of life in the home and are supported in taking reasonable risks as part of an independent lifestyle. Their right to confidentiality is upheld by the home. EVIDENCE: The home operates a keyworker system and service users are involved where possible in devising their individual plans to cover personal care, social activities and healthcare needs. One service user has an independent advocate who regularly visits her. Service users are encouraged to participate in household chores within the limits of their abilities and a risk assessed framework. The home has picture cards in place to enable service users to make choices on the meals and food they would like. There is secure storage for personal information to maintain service users’ rights to confidentiality and service users were not discussed in front of others. Country Home Care DS0000023820.V250202.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): 11, 12, 13, 14, 15, 17 Service users 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: All of the service users were observed to be engaged in some form of stimulating activity during the inspection, a visiting relative spoke highly of the home and the opportunities afforded to her son. Some service users attend pottery and art classes but these had been cancelled on the day of the inspection due to the absence of the tutor; many examples of works were displayed around the home. The manager stated that service users use the local public house socially and also go to the cinema, ten-pin bowling and even greyhound racing. Picture books, scrapbooks and photograph albums were viewed showing numerous outings and activities the service users had participated in. Communication with some service users was difficult due to their disabilities but responses and observation indicated that they were happy with the service provided. All service users have family who are welcome to Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 11 visit at any time and one service user goes home some weekends for a short stay. Menus that were viewed indicated that they receive a healthy and balanced diet in accordance with their choices. Country Home Care DS0000023820.V250202.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, 19, 20 Service user health needs are fully met and monitored by the staff team and relevant professionals. They are unable to administer their own medication and are supported with this by the staff team. EVIDENCE: Service users require assistance with all of their personal care needs and appropriate equipment and facilities are provided to meet these needs. The support plans viewed provided staff with the guidance re: the service users’ preferred method of care delivery. Due to their disabilities service users are unable to administer their own medication and depend on the staff team to assist with this task. The manager stated that all staff have attended a one day medication course but accredited training courses have now been arranged, which is competence based on the management of medication. Guidelines are in place for the administration of rectal diazepam and the GP has agreed these protocols. Medication records are being maintained correctly. The medication is currently stored in the kitchen and this is not an ideal location to maintain temperature control. A number of medications and homely remedies for staff use were being stored with service users’ medication and there was no separation of internal/external route medication/creams. The Inspector discussed the storage of medication with the home’s manager and the following requirements and recommendations are made. A move of the medication cupboard to a more suitable location with a thermometer in Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 13 place to monitor temperature. Separate medications that are for internal routes from those that are external. Only prescribed medication for service users should be kept in cupboard. A record of homely remedies that are kept in the home must have the agreement of the GP with written directions for use. Records of medication returned to the pharmacy must be kept on the premises to provide a clear audit trail. Country Home Care DS0000023820.V250202.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, 23 The views of service users’ are valued and they are protected from abuse. EVIDENCE: There is a complaints procedure in place, including one in a pictorial format for the service users. Relatives have signed a copy to acknowledge the procedure and these are retained within the service users’ records. The manager stated that all staff have undergone adult protection training and a refresher course is booked. Country Home Care DS0000023820.V250202.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, 27, 28, 29, 30 Service users live in a safe, clean and well-maintained environment with access to adequate personal and communal space. Specialist equipment is provided where required to maximise their comfort and independence. EVIDENCE: The home is very well maintained, bright and homely. Furniture and fittings are of a good quality and are domestic in style. There is access to the home for wheelchair users via a side entrance and a ramp to the front door. The home has adequate personal and communal space available for service users’ use. The provision of furniture and fittings in service users’ bedrooms do not meet the required minimum standards, however, it is agreed with relatives that it is not in the service users’ best interests to have all of the furniture, as required by the standards, in their rooms. This has been recorded in service users’ care plans. There are sufficient toilets, bathrooms and shower rooms close to bedrooms and communal areas to meet service users’ needs. Individual occupational therapist assessments have been carried out and specialist equipment is provided where necessary. Laundry facilities are adequate but lack a sink or wash hand basin. The manager stated that there are plans to change the laundry area; they were advised to consult with the Environmental Health Officer for approval of the plans. On the day of the inspection the home was clean and tidy and free of offensive odours. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 16 Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, 36 An effective, competent and qualified staff team ensures that service users’ individual and joint needs are met. The service users are protected by the home’s recruitment procedures. EVIDENCE: From observing the interaction between staff and service users, staff showed that they have a good understanding of their individual needs. Two members of staff have NVQ 2/3 qualifications together with LDAF training. The individual staff training records viewed indicated a commitment to further training by the home. The home’s owners provide twenty-four hour care in addition to three other carers. The staff team is flexible to accommodate evening activity. Staff files viewed evidenced a robust recruitment procedure with two references and a CRB check obtained before employment starts. Staff spoken with stated that they receive support and supervision but there is a need to formalise this process and document outcomes. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 40, 41, 42, 43 Service users benefit from living in a home that is run by a qualified, approachable and competent manager. They are consulted on their views and their health, safety and welfare is promoted and protected. 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. Staff and a relative spoke very highly of the manager and of her open and inclusive approach to managing the home. The manager stated that she conducts a six monthly self-assessment to measure the service against its aims and objectives. The policies and procedures viewed comply with current legislation and guidance and are regularly reviewed; it was noted the most recent review was undertaken in June 2005. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 19 Equipment and installations are regularly serviced and the records seen of these were in date. The manager has attended a Business Link course and will be producing a business and financial plan for the service; this must be made available for inspection by the Commission. Adequate liability insurance cover was in place. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Country Home Care Score 3 3 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 2 DS0000023820.V250202.R01.S.doc Version 5.0 Page 21 YES 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. 1 Standard YA20 Regulation 13 (2) Timescale for action The registered person shall make 18/12/05 arrangements for the handling, recording and safekeeping of medicines received into the care home. In the context of this report: - Separate storage of medicines for internal and external use. Only prescribed medication for service users and homely remedies that have been agreed with the GP and listed to be stored in the medication cabinet. A record of medication returned to the pharmacist must be kept on the premises to provide a clear audit trail. Staff must have regular, 18/12/05 recorded supervision sessions at least six times a year with their senior/manager. A business and financial plan 18/12/05 must be in place and available for inspection. (Previous timescale of 31 November 2005 not met) Requirement 2 YA36 18 (2) 3 YA43 25 Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA20 Good Practice Recommendations A more appropriate location for the medication cabinet, away from heat sources must be sought and a thermometer installed to monitor temperature requirements. Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Country Home Care DS0000023820.V250202.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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