Inspection on 16/10/06 for Courtwick Park

This inspection was carried out on 16th October 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Courtwick Park 11/05/10

Courtwick Park 18/03/09

Courtwick Park 29/11/07

Courtwick Park 11/10/05

Courtwick Park 23/06/05

Courtwick Park 17/01/05

Courtwick Park 07/09/04

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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 Courtwick Park Courtwick Lane Wick Littlehampton West Sussex BN17 7PD Lead Inspector Mrs K Allen Key Unannounced Inspection 16th October 2006 09:45 Courtwick Park DS0000014475.V307040.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 Courtwick Park DS0000014475.V307040.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. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Courtwick Park Address Courtwick Lane Wick Littlehampton West Sussex BN17 7PD 01903 730563 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) Corich Community Care Limited *** Post Vacant *** Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Up to twelve (12) male and/or female service users between the ages of eighteen (18) and sixty-five (65) years in the category of Learning Disability may be accommodated/ admitted. Up to 3 male and /or female service users between the ages of 18 and 65 years in the category of mental disorder (MD) may be accommodated. A maximum of 12 service users may be accommodated. Date of last inspection 10th March 2005 Brief Description of the Service: Courtwick Park is a large detached property owned by Corich Community Care Ltd. They provide a service to twelve people with severe and profound learning disabilities and associated challenging behaviour. Service users are supported to take part in activities within the home and access a range of facilities at the day centre at Strawberry Field also owned by Corich Community Care and on the same site, as well as local community facilities. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the inspection a review was made of the contact between the home and the Commission for Social Care Inspection (CSCI) since the last inspection. This included an analysis of incident reports and those of other statutory bodies such as the fire service. The deputy manager completed and returned a pre-inspection questionnaire prior to this unannounced visit. The inspection took place from 9.45 over six hours. During this time all of the residents were seen in communal areas with care staff. A discussion was held with the manager, who is due to apply for registration and her manager. The clinical manager, two care staff and the cook were interviewed and a number of records were seen. Two requirements have been made that the home must be reasonably decorated and kept clean. Two recommendations have been made that money kept on resident’s behalf should be accurately accounted for and that there should be more ventilation in the kitchen. What the service does well: What has improved since the last inspection? What they could do better: Money held on residents behalf should be accurately accounted for to safeguard their financial interests. Staff should be made more aware of adult protection matters so that residents are kept safe at all times. The décor and cleanliness of the premises must be improved so that residents live in a safe and homely environment. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 6 Ventilation in the kitchen should be improved so that cleanliness can be maintained 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. Courtwick Park DS0000014475.V307040.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 Courtwick Park DS0000014475.V307040.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The outcome for residents is good. Prospective service users individual needs and aspirations are assessed. EVIDENCE: Two people have moved into the home since the last inspection. The home had obtained copies of reports from previous carers and other professionals as part of their assessment process. In addition, the managers of the home had undertaken their own assessments and, although only one had been typed up notes were available for both. In one case the prospective person had visited the home with their parents and they had played an active part in the assessment of her needs. When shown some details of this person’s communication as described by previous carers the parent agreed that it was “them to a T”. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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 & 9 The outcome for residents is good. They all have an individual care plan, which reflects their needs. They are enabled to make decisions about their lives and take risks as part of an independent lifestyle. EVIDENCE: Each resident has a written care plan which is regularly reviewed. This gives details of their needs and how they will be met. Any restrictions are recorded and guidelines drawn up in managing behaviour which may be challenging. Staff are designated as key workers to oversee care plans and are able to communicated well with residents. The manner is which staff interact with residents is good. They communicate well and engage them in making decisions about for example what to wear, how they wish to spend their time, who they spend time with, whether they bath or shower and what they have to eat. Staff were responsive to body language and signs which residents displayed. For example, if someone took a member of staff by the hand they went with this person so that they could understand where they wanted to go and what they wanted to do. This made for a relaxed atmosphere where residents felt confident and in control. No residents are considered able to manage their own finances. This is controlled by staff in conjunction with family or other representatives. The Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 10 arrangements for storage and expenditure are satisfactory although the accounting was not accurate in one case. Staff do not check the money held, on a frequent basis and therefore errors could be missed for up to two weeks. A good system of risk assessment is in place, which ensures residents lead a full and active life. They include epilepsy management, road safety, physical intervention and moving around the house. For one person, being in a crowd is upsetting at times so staff have made proper arrangements to avoid this and therefore enable the person concerned to remain calm and less anxious. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 The outcome for residents is good. They take part in age and culturally appropriate activities and have good links with the local community. They maintain personal relationships with family and friends and their rights are respected. Good healthy meals are provided. EVIDENCE: An activities co-ordinator is employed who works closely with care staff to ensure that residents take part in valued and fulfilling activities. These include art and craft, cooking, trampolining, horse riding, music sessions and quiet time with sensory equipment. Whilst the premises are ‘tucked away’ staff ensure residents are part of the local community by using local facilities. For example, people went out to lunch at a local pub on the day of the inspection. Staff are keen to ensure that this is a good experience by choosing the venue carefully. All residents have contact with family members with some having regular stays with parents over weekends or holidays. Daily routines are fairly structured which ensures that residents ‘know where they are’ and can rely on this to feel safe and keep their anxieties to a Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 12 minimum. However, should they go out or their plans change this is accommodated. Staff respect residents dignity by, for example, knocking the door when entering their room, making sure they are dressed appropriately and keeping toilet and bathroom doors closed when in use. Residents enjoy time on their own if this is safe, however most time is spent with staff who engage and interact with them well. Their roles are clear and they know who they a responsible for at any given time. This gives reassurance to residents and means that good communication is built up between the staff and residents. Residents have access to all communal areas of the home and the garden usually with supervision for their safety. The majority do not have free access to their own rooms as this could lead to unsafe behaviour. A cook is employed to provide meals and the menu is varied with plenty of fresh fruit and vegetables. Residents evidently enjoy their meals and their likes and dislikes are accommodated. Special diets are catered for, food is presented in a manner, which helps residents to eat independently, and they are provided with special utensils if necessary. The dining room seats all residents and has good furniture however the décor is poor and some of areas are dirty, for example, the dining chairs. (See requirement 2) Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The outcome for residents is good. They receive appropriate personal support and their health needs are met. They are protected by the homes medication procedure. EVIDENCE: Residents care plans give details about how they are cared for, including their personal care which staff assist them with. Personal support is given by a member of staff of the same gender when possible. Aids and adaptations are provided such as a hoist, handrails and ‘sit in’ showers’. Each resident has a health action plan which is currently under review. These reviews are being carried out in partnership with the local GP surgery who have provided a link person to the home. Advice is sought from other professionals such as speech and physiotherapists, psychologists and psychiatrists when required. In addition, staff endeavour to work closely with relatives for example when they are going to specialist appointments, parents may accompany them. Staff assist residents to access advice about continence, routine screening and monitoring of general health such as the dentist and optician. They support them on all outpatient appointments. Medication is managed in the home by staff who are trained in safe practice. The storage, administration and disposal of medicines are managed well and good records are kept. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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 outcome for residents is good. Their views are listened to and they are protected from abuse. EVIDENCE: There is a written complaints procedure which is made available to relatives and other representatives. Whilst residents would find it difficult to make a formal complaint without assistance the manner is which staff respect them indicates that they would make representation on their behalf should this be necessary. There have been no formal complaints made about the home. The home has a copy of West Sussex Adult Protection procedures as well as it’s own policy and procedure, which is in line with this. New staff are made aware of the need to report anything of concern to senior staff and described how they would do this. However, they were less clear about what constituted an adult protection issue and the manager is advised to raise the profile of this matter with all staff to ensure the ongoing protection of residents. There have been no adult protection referrals made from the home. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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 & 30 The outcome for residents is adequate. They live in a comfortable environment although it is not well maintained or clean in some areas. EVIDENCE: The home is situated in a semi-rural location although not far from local amenities. There is dedicated transport for taking residents out and they have regular use of the activity centre located on the same site. Residents who have any difficulty walking need to use the back entrance to the home as there are a number of steep steps us to the front door. Throughout the premises there are differing levels so that residents have to negotiate steps, and this is taken into account when new people are considered for the service. There is sufficient communal space including two lounges, one of which is used for quieter times. Other than the main lounge the décor is poor in communal areas especially the large hall, stairs, landing and dining room. Plans were in hand to redecorate the dining room, however the management of the home must have a programme of maintenance which ensures that the standard of decoration is maintained. Residents have their own rooms which are personalised and bright with good décor and furnishings. However, one bedroom has a large stain on the ceiling, Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 16 which had been caused by a water leak some time ago. The manager confirmed that this could now be redecorated. The premises meet the requirements of the local fire service. The most recent inspection from the environmental health department recommended cleaning the kitchen and this has been carried out. They also recommended better ventilation in the kitchen and this remains outstanding. Acknowledgment was given for a good training policy. There are satisfactory laundry facilities which enable soiled linen to be washed at appropriate temperatures. Wash hand basins and towels are provided in all areas where there might be a risk of infection such as the laundry, bathrooms and toilets. Some areas of the home were in need of better cleaning. For example, toilet bowls were stained, a hidden window ledge in a bathroom was littered with debris and evidently was not regularly cleaned, there was an odour in one bedroom and the dining chairs were dirty. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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, 34 & 35 The outcome for residents is good. They are supported by competent and trained staff and protected by the homes recruitment policy. EVIDENCE: Staff showed respect to all residents in the way they approached and care for them. They communicated well and responded to resident’s wishes in a constructive manner. Throughout the day they showed interest in their work and were well motivated. Staff had a good understanding of learning disability and the individual needs of residents. They used a variety of ways to communicate with them including signs, eye contact and prompting. Twelve staff have a National Vocational Qualification (NVQ) in care and five are currently undertaking this training. On completion, the home will exceed the standard of 50 of care staff having an NVQ qualification. Staff are appointed to work at the home only after they have provided two references and a check has been made against the Criminal Records Bureau (CRB). Contracts of employment are issued. A training programme is in place in addition to the NVQ programme. Courses include epilepsy, understanding learning disability, medication, first aid and food hygiene. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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, 39 & 42 The outcome for residents is good. The home is well run and residents are taken into account in its development. The health, safety and welfare of residents are protected. EVIDENCE: Whilst there is no registered manager at the home a person has been appointed and an application to the Commission for Social Care Inspection (CSCI) is being prepared. The person concerned is competent and familiar with the needs of the residents. She has an NVQ qualification and is currently undertaking further training towards the Registered Managers Award. During this period good support is being provided by the line manager and responsible individual for the home, both of whom have regular contact. The organisation has recently appointed a clinical manager to advise and develop methods of care and development for residents. She works closely with the manager and is currently helping to update care plans and consult on training needs. A quality assurance system is in place which includes consulting relatives and other professionals involved with the home. Plans are in hand to develop a Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 19 newsletter so that the outcome of any survey can be published and feedback provided to everyone concerned. There are policies and procedures for staff to follow to ensure the health and safety of themselves as well as residents. They are provided with training in areas such as safe lifting, first aid, fire safety and food hygiene. Good arrangements are in place to service boilers, heating systems as well as fire fighting equipment. A record of accidents is kept as well as ‘incidents’, which may include times when resident’s behaviour is difficult and give details of any injuries or strategies employed to ensure the safety of everyone involved. All staff are provided with induction training which ensures they are familiar with safety procedures at the home. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 4 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 2 25 X 26 X 27 X 28 X 29 X 30 2 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 3 3 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 3 3 3 x 3 X 3 X X 3 X Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 21 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. 1. 2 Standard YA24 YA30 Regulation 23 23 All be All be Requirement parts of the care home must reasonably decorated parts of the care home must kept clean Timescale for action 31/01/07 23/10/06 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. 2. Refer to Standard YA7 YA24 Good Practice Recommendations Money held on residents behalf should be accurately accounted for. Ventilation in the kitchen should be improved. Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Southampton LO 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 Courtwick Park DS0000014475.V307040.R01.S.doc Version 5.2 Page 23 - 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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