Inspection on 25/06/08 for Courthill

This inspection was carried out on 25th June 2008.

CSCI found this care home to be providing an Good service.

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

Courthill 04/07/07

Courthill 18/01/07

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 27/09/2008.

CARE HOME ADULTS 18-65 Courthill 2 Court Road Caterham Surrey CR3 5RD Lead Inspector Ruth Burnham Unannounced Inspection 25th June 2008 11:00 Courthill DS0000067720.V367115.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 Courthill DS0000067720.V367115.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. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Courthill Address 2 Court Road Caterham Surrey CR3 5RD 01883 343850 01883 341024 roshanwest@aol.com 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) Ms Simlah Panchoo Mr Roshan Panchoo Ms Simlah Panchoo Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2007 Brief Description of the Service: The service is registered with the CSCI (Commission for Social Care Inspection) to provide accommodation and care home for six people with learning disabilities some of whom may be over the age of 65 years. Courthill is a large detached family styled house is in a residential street in Caterham-on-the-Hill. The service is close to shops, public amenities and transport in addition the service has its own transport to enable the service users to enjoy a flexible service. The accommodation is arranged over two floors of the house. On the ground floor one large bedroom with an en suite, a communal lounge, separate dining room, kitchen one toilet and the office. The first floor has five good-sized bedrooms and the bathroom. There is a moderately sized garden at the rear of the property, and a limited amount of off street parking for cars at the front of the house. The service does not have a lift. The provider is owner/manager and is involved in the day-to-day provision of care and management of the service. At the time of this inspection 25/06/2008 the fees ranged from £12.000 to £15.000 a year. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the Service was an unannounced “Key Inspection”. The Inspector arrived at the Service at 11:00 a.m.and was in the Service for four and a half hours. It was a thorough look at how well the Service is doing. It took into account detailed information provided by the Service’s owner or manager and any information that CSCI has received about the Service since the last inspection. There are no Required Developments at the end of this Report. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the service does well: People who are considering moving into the home are provided with helpful information about what life is like there. Thorough assessment and admission procedures mean people can be confident their needs will be understood and can be met. People can be confident care will be provided in line with their individual needs, wishes and preferences and their personal information will remain confidential. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a range of training, social and leisure activities. They can be confident their nutritional needs will be met. Their personal and healthcare needs are met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. They are listened to and protected from abuse. The safe, homely, well-equipped and clean environment enhances the quality of life of people who live in the home. People benefit from the support of the committed, and competent staff team who understand their needs and actively promote their best interests. Effective quality assurance systems promote year on year improvement in the service. People’s health and safety is promoted. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 6 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 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1&2 People who use the service experience good outcomes in this area. People who are considering moving into the home are provided with helpful information about what life is like there. Thorough assessment and admission procedures mean people can be confident their needs will be understood and can be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who are considering moving into the home are provided with helpful information about what life is like there. Information is contained in the statement of purpose and service user guide, which have been updated. There are currently 3 people living in the home. One person was admitted since the last inspection and documentation relating to this admission was examined. The assessment was thorough and detailed. The home has an Admission and Referral policy dated August 2006. The manager agreed to revise this document to more accurately reflect how admissions are managed by the home. Documents examined showed that a full assessment of need was carried out by the manager . This was based on the social care professional’s assessment. The manager visited the prospective resident at his former residence as part of the assessment process and he was able to visit the home to experience what life would be like there before moving in. The manager Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 9 stated that admissions would always take account of compatibility with people currently living at the home, and their opinions would be sought in regard to new admissions. The success of the placement and subsequent improvement in the wellbeing of the last person to move into the home reflects the thoroughness of the assessment process. The Annual Quality Assurance Assessment (AQAA) completed by the manager contained no specific information in regard to these standards. The home does not offer intermediate care. Courthill DS0000067720.V367115.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 - 10 People who use the service experience good outcomes in this area. People can be confident their needs are understood and care will be provided in line with their individual needs, wishes and preferences. People can be sure their personal information will remain confidential. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person who lives in the home has an individual plan of care. Care plans are developed with the involvement of residents as far as possible in consultation with care managers and relevant healthcare professionals. Care plans are person centred, detailed and take account of individual needs, abilities and choices. They provide clear guidance for staff on how to provide appropriate care. They are reviewed regularly and updated to reflect changing needs. Formal reviews are carried out with the person’s care manager each year. Care managers commented within these reviews about the improvement Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 11 in the wellbeing of their clients who are living in the home. People can be confident their needs will continue to be met. People’s needs are complex, varied and can be challenging. Two people were at home during the visit. One person has no verbal communication and very limited hearing. However staff observed during the visit clearly knew the resident very well and understand how he preferred to communicate. The other resident told the inspector how happy he was in the home and how things had improved since the new owner had taken over. Support is offered and provided discreetly in a way that promotes privacy and dignity. All interaction observed was respectful, good humoured and kind. People’s rights to make decisions about how they wish to live their lives are respected. They are supported to make decisions in a number of ways. Staff know the residents well and understand their needs. Life skills are being developed through involvement in household chores. People are supported to maintain contact with relatives who are able to visit the home and spend time with them. People are protected from harm through good risk management processes for all activities. People can be confident their personal information remains confidential. Personal information is stored securely and is available solely to authorised and appropriate people. Courthill DS0000067720.V367115.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 – 17 People who use the service experience good outcomes in this area. People who live in the home are encouraged to be as independent as possible. They enjoy opportunities to take part in a range of training, social and leisure activities. They can be confident their nutritional needs will be met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People are supported to be as independent as possible. They are actively encouraged to make their own choices and to live their lives as they wish, so far as they are able. Records seen indicate that religious and cultural needs are known and respected. One person chooses to attend a local church regularly and friends he has made there are welcomed into the home to visit him. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 13 Regular trips are also organised to places of interest to residents. Each person has their own activity plan detailing activities they enjoy. Staff support people to use local services such as hairdressers, pubs, leisure centres and local restaurants. One person told the inspector he enjoys going shopping with staff. People are supported to maintain contact with family and friends; visitors are welcome in the home at all reasonable times. One resident had gone out to spend the day with a friend on the day of the visit. Peoples’ privacy is respected. Observation of staff during the visit shows they are committed to promoting the interests of people who live in the home. Interaction observed during the visit was warm, supportive and respectful. Staff know the residents well and understand their needs. People who live in the home are involved in preparing and choosing meals. Advice has been obtained from a dietician about nutritional screening, peoples’ nutritional needs are being assessed. One resident said, ‘The food is very good and there is always plenty of it.’ Courthill DS0000067720.V367115.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 – 20 People who use the service experience good outcomes in this area. People who live in the home can be confident their personal and healthcare needs will be met in a way that respects their individual wishes and preferences and upholds their privacy and dignity. They are protected through safe systems for handling medication. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home are provided with care in a way that respects their individual wishes and preferences and upholds their privacy and dignity. Routines are flexible and relevant within the context of peoples’ individual needs and abilities. People are able to choose when to go to bed and when to get up and are supported to choose their own clothes, hairstyles and other aspects of personal grooming. People are supported with their healthcare needs. The manager has developed detailed, person centred, individual health plans for each person through which their health is monitored and appointments and any follow up actions are tracked. Visits are arranged to the local G.P and people have regular health Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 15 checks. People are supported in to access other healthcare professionals where necessary, including dentists and opticians. Where people have specialist healthcare needs, the home liaises with specialist healthcare professionals to ensure they receive the best possible care. People are protected from harm through the safe handling of medication. Medication is managed through a monitored dosage system. Where medication is only used periodically as required there are clear administration procedures in place. Medicines are stored securely and records seen were well maintained and up to date. Courthill DS0000067720.V367115.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 People who use the service experience good outcomes in this area. People who live in the home are listened to. They are protected from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff know and understand how people communicate and recognise when they are unhappy. People are listened to and action is taken to ensure any unhappiness is addressed. This is evidenced by the improvement in one person’s wellbeing and the decrease in incidents of challenging behaviours since they moved into the home. There have been no complaints about the home in the last year. There is a clear complaints procedure; this is available in the entrance hall of the home. People who live in the home can be confident they are protected from abuse. Staff are provided with training in safeguarding vulnerable adults. Where the home acts on behalf of people who live there in relation to their finances, clear records are maintained of all transactions and receipts are kept. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 – 28 & 30 People who use the service experience good outcomes in this area. The safe, homely, well-equipped and clean environment enhances the quality of life of people who live in the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the homely environment and family atmosphere. The home is well furnished and each resident has his or her own room. Accommodation is arranged over 2 floors. On the ground floor, communal areas of the home include a lounge and separate dining room and well-equipped kitchen. There is also a small office and an en suite resident’s bedroom. People benefit from access to the well-maintained rear garden. The detached garage has been converted into additional living space, this is available for residents’ use and for staff events. The well-equipped laundry is also in this building. There are five further bedrooms on the first floor. People are encouraged to personalise their bedrooms, these have been furnished and equipped to meet individual needs. Each person has his or her own en-suite Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 18 facilities. There are sufficient bathrooms and toilets to meet the needs of people who live in the home. The home was warm and clean throughout. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 19 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): 31 – 36 People who use the service experience good outcomes in this area. People who live in the home benefit from the support of the committed, and competent staff team who understand their needs and actively promote their best interests. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People who live in the home benefit from the support of the well trained staff team. Staff clearly have a good understanding of peoples’ needs. All interaction throughout the inspection was warm and respectful. There is a commitment to promoting the best interests of people who live in the home. There are enough staff available to meet peoples’ needs. On the day of the site visit there was one to one staff support for each resident in the home. Recruitment procedures were checked as files for new staff were examined. Two new staff have been recruited since the last inspection. All documentation was in order with the exception of the Criminal Record Bureau check. The manager had accepted enhanced checks from their previous employers rather than requesting a current check. Once the need for new checks for all new Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 20 staff was drawn to the attention of the manager steps were immediately taken to rectify the situation. All three staff files examined contained detailed application forms, 2 written references, photographs and relevant immigration information. People who live in the home can be confident staff are well-supervised and competent to carry out their duties. The majority of staff have NVQ qualifications at level 2, or above, the remaining 2 staff are working towards their qualification. All staff undertake additional training relevant to understanding the specific needs of the people they care for, the manager is currently trying to source training in autism and dementia. Refresher training is arranged regularly for all mandatory training. All staff have regular formal supervision sessions and all new staff complete a formal induction programme. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 21 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 – 42 People who use the service experience good outcomes in this area. Effective quality assurance systems promote year on year improvement in the service. People’s health and safety is promoted. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is qualified in the field of learning disability. People who live in the home are involved as far as possible in decisions about how the home is managed. The manager completed the Annual Quality Assurance Audit for the Commission as part of the inspection. This shows improvements that Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 22 have already been made and further improvements, which are planned, in the coming year. It also shows that people are protected and their health and safety is promoted through good fire safety systems and regular safety checks of equipment and installations. Portable appliance testing had been carried out. Records seen during the visit were very well maintained. Staff have access to a full range of policies and procedures however these are generic having been purchased as a package. The manager agreed to review policies and procedures to make them more accessible to staff and ensure they accurately reflect the service and provide clear and relevant guidance to staff about how to meet service users needs, protect them from harm and promote their independence, privacy and dignity. People are protected from harm through safe working practices. all staff receive training in basic food hygiene, first aid, moving and handling, health and safety, fire safety and infection control. Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 x 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 2 3 x Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 24 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. 1 Refer to Standard YA41 Good Practice Recommendations Courthill DS0000067720.V367115.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection 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. 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