Inspection on 23/06/05 for Courtwick Park

This inspection was carried out on 23rd June 2005.

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

Courtwick Park 11/05/10

Courtwick Park 18/03/09

Courtwick Park 29/11/07

Courtwick Park 16/10/06

Courtwick Park 11/10/05

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 J Aston Announced 23 June 2005, V224611 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 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 Stationary 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 H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Courtwick Park Address Courtwick Lane, Wick, Littlehampton, West Sussex, BN17 7PD Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01903 730563 01903 730563 Corich Community Care Ltd Miss Sussan Anne Hooper Care home only-PC 12 Category(ies) of Learning Disability -(LD) 12 places registration, with number of places Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 17 January 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 associatied challenging behaviour. Service users are supported to take part in activities within the home and access a range of facilities at Strawberry Field also owned by Corich Community Care on the same site and local community facilities. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on Thursday 23rd June 2005 and was an announced inspection. The Inspector was in the home from 9.30am to 5pm. The Inspector was unable to obtain the views of the residents during the inspection due to communication difficulties but observed some interactions between members of staff and residents. The Inspector ate lunch with the residents and most of the residents were seen. To gain feedback on the service comment cards were sent to relatives and service users prior to the inspection. Five comment cards were received from relatives and three service users had been assisted to complete a comment card. The inspection process also included: Speaking with a relative who was visiting the home. Speaking with three relatives on the phone. Speaking with a Social worker on the phone. Interviewing six members of staff during the inspection. The Inspector also looked around the home and at a sample of care plans, risk assessments, activity programmes for residents and a sample of staff records. What the service does well: Many positive comments were received from relatives and professionals about the staff team; the management of the home and the lifestyle residents are supported to live. A relative said, “ We are very, very happy with the service.” All relatives who completed comment cards said they were satisfied with the service. The service provides a varied and busy lifestyle for each resident based around his or her needs and choices. The staff team work hard to make sure that residents can choose how they spend their day, what food they may like to eat and what clothes they may wish to wear. Relatives describe the daily life in the home as being relaxed but supervised and supportive. The training available for members of staff is wide ranging but specific to the needs of the residents from induction to National Vocational Qualifications. Residents’ bedrooms are decorated and presented to a high standard and individual taste. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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 standard(s) None The Standards in this section were not assessed at this inspection. EVIDENCE: Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9. Individual care plans provide good information about each resident. Members of staff help and support residents to make choices and decisions about all aspects of their lives. Residents are supported to be involved and have a say in aspects of life in the home. Choices made by residents and activities undertaken by them are supported in a way that considers and lessens any potential risk. EVIDENCE: The Inspector examined individual care plans for four residents. All care plans provided detailed information about the needs of each resident that included their likes and dislikes and a record of activities. Guidelines were in place in respect of how staff should work with those residents who may present with challenging or inappropriate behaviour. A record was also kept of circumstances that may trigger inappropriate behaviour. Residents are unable to be consulted about their needs and have limited ability to make choices and decisions about their lives. Therefore members of staff rely on information gained from observation and from others. There was evidence that relevant professionals are consulted and relatives said their opinions were sought. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 10 A relative said, “ What I like is that they refer to the history of a person, they also ask my opinion and they monitor her behaviour well.” Members of staff described how they offered choices to residents and how the philosophy of the home promotes choice and independence. They said daily routines were planned around activities but the resident determined their own routines. Relatives confirmed they had been involved in reviewing the residents’ needs. Relatives said “she can do what she wants and chooses where she goes.” “He likes his space and has space to spend time on his own and chill out, he has the freedom to choose how he spends his time.” A Social Worker said, “They are good at spotting the changing moods and needs of individuals, they provide good reassurance in an undemanding atmosphere.” Risks to residents are considered before they participate in an activity and the action to be followed to lessen the risk is recorded on a risk assessment. Risk assessments are reviewed regularly. A relative said they appreciated that risks were considered and didn’t feel that this restricted residents but supported them to try new activities. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14,15,16, Activities for residents are well managed, creative and provide a variety of stimulation and interest for residents living in the home. Residents are supported to maintain contact with family and friends. The home recognises service users’ rights. EVIDENCE: Each resident has a planned programme of activities that range from attending college, swimming, horse riding, music, art and crafts and cooking. Individual or small group outings take place on a regular basis; recently to Thorpe Park and Chessington. Residents are supported to use local facilities; shops, pubs, restaurants and leisure centres. Residents at Courtwick Park also have the use of day centre facilities at Strawberry Fields on the same site. A Social Worker said “the home provides them with a lifestyle that suits them.” Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 12 The home establishes and maintains good links and relationships with relatives and support a resident to keep in contact or visit their relatives regularly. Relatives said, “They always keep me informed, I can visit any time.” “They assist her to remember Birthdays and send cards etc.” “I can come and take her out.” “ I like to have him home for some weekends.” A Social Worker said, “They maintain family contact and relationships well.” All of the relatives who completed comment cards said: They were made welcome in the home; were kept informed; and were consulted about their relatives care. Members of staff recognised the rights of residents’ to have freedom of choice, be treated with respect and should be supported to access services and facilities. Training is provided by the organisation on Disability and the Law. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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 standard(s) 18,19. There are good individual care plans for all residents that ensure their health is monitored and personal support is provided in an appropriate and sensitive manner. EVIDENCE: Most residents require supervision with personal care and assistance with bathing or showering. Some residents need total support with personal care. Individual plans provide good guidance on how this support should be offered and provided to ensure a resident’s independence is promoted and maintained. A sample of four individual plans was seen all of which had good details about the health needs of each resident. A record of appointments for the chiropodist, dentist and Doctor were also recorded and treatment or advice for any health problems noted. Where a resident has an accident this is recorded appropriately. A relative “said they monitor her health and behaviour very well I am always informed if she is not well.” Another said, “they always phone me after a Doctors appointment and they ensure he has physiotherapy regularly.” Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 14 New members of staff said that the induction training provided them with good instructions on providing personal care and were able to shadow other members of staff to observe how this support should be provided. They confirmed that they were only able to assist with personal care when they felt confident to do this. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 23 Improvements should be made in the recording of specific guidance on the appropriate physical intervention that maybe required for each resident. Failure to provide this leaves residents and members of staff unprotected against the risk of abuse and allegations. EVIDENCE: Individual plans and risk assessments did not provide specific guidelines for members of staff to follow when a resident becomes at risk to themselves or others due to challenging behaviour. It was recommended that the Registered Manager obtained the Department of Health’s guidance on the use of physical intervention with people with learning difficulties. Training for all members of staff in respect of working with challenging behaviour or adult protection has been provided. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 16 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 standard(s) 24, 25, 26, 27,28, 29,30. Courtwick Park provides residents with an attractive comfortable home that is safe and well maintained. Residents’ rooms are individually decorated and provide a comfortable space for each resident. Sufficient toilets and bathrooms are provided. The communal space is comfortable and has recently been refurbished. EVIDENCE: The home has been able to make improvements to the general up keep and refurbishment of the home as a person responsible for maintenance is now allocated to the home on a weekly basis. A programme of maintenance and refurbishment is now planned. Relatives said, “ they have just decorated his room and provided new carpet and bedding we are very pleased with this.” “Her room is lovely and we are happy that the rooms are locked and only she can have access to her room and not others.” “We like where the home is and the amount of space around it.” Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 17 The Inspector looked around the home and observed that the home generally is well maintained and residents’ bedrooms are furnished to a high standard and are very individual. The basement area of the home used by staff and does require some improvement. The residents’ privacy is respected in bathrooms, toilets and bedrooms by using a magnetic locking device. This necessitates members of staff and residents, where able, wearing a magnetic key. The resident from Strawberry Field is currently sleeping in the quiet lounge and although screening has been provided so the room can still be used this is not acceptable and needs to be rectified as soon as possible. As stated in the summary of the report an immediate requirement was made to rectify the situation. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32,33,34,35,36 Members of staff have clearly defined roles and understand their responsibilities. Residents are supported and protected by an effective staff team who have received appropriate mandatory training. Members of staff receive support; guidance and supervision from the Manager to ensure the residents’ needs are met in an appropriate and professional manner. Residents are not fully protected by the homes recruitment procedures. EVIDENCE: New members of staff have been employed recently and have been allowed to work in the home under supervision without a criminal record check being confirmed. There was no documentary evidence available to show that a check against the register for vulnerable adults had been undertaken prior to the member of staff commencing work. A requirement has been made to ensure that the Registered Manager obtains and keeps evidence of a POVA first check that has been undertaken prior to employment. Members of staff spoken with confirmed that they understood their roles and their responsibilities. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 19 They confirmed that regular supervision and staff meetings were provided. Members of staff and relatives felt there was enough staff around at most times. Relatives said “ good at giving plenty of attention,” “there is a high ratio of staff, always enough staff around.” “Good staff training. Good rapport with residents.” The organisation provides a good standard of training from induction to undertaking National Vocational Qualifications. New members of staff said their induction programme was good and they felt supported. They confirmed that they only worked alone when they felt confident to do so and their practice had been assessed. Relatives commented on the quality of the staff employed: “He has had the same key worker ever since he has lived there and he has a very good relationship with her.” “We like the fact that separate staff are employed to do the cooking, laundry and cleaning.” “There is a stable staff team, very few new people. “Good staff training.” “Courtwick staff are always friendly and welcome her with a smile.” “This is the best place she has been the care is brilliant.” “I have only just realised due to him being ill that the staff care as much about him as I do.” Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38, The Registered Manager is experienced and has the skills required to undertake the work. There is clear leadership and direction provided to members of staff that ensures residents receive a good quality of care and lead varied and fulfilling lives. EVIDENCE: Members of staff spoken with said that the Manager of the home was approachable and provided opportunities for members of staff to raise concerns or suggestions. Relatives said, “The home is run really well it is friendly and residents are happy.” “They’ve got it right.” Members of staff said they felt supported and there is always a manager on call in the evenings and weekends. However a concern was raised with the Manager about staff feeling that they should not call Managers into the home. The Registered Manager confirmed that this would be addressed. Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Courtwick Park Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x x x H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 22 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. 1. Standard Regulation Requirement The Registered Person must supply an action plan that details how the following requirement will be met. The Registered Person shall not employ a person to work at the care home unless he has obtained in respect of that person a POVA first check and CRB. Timescale for action 28/7/05 2. 34 19 23/6/05 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 23 Good Practice Recommendations To obtain the Department of Health’s guidance on the use of physical intervention with people with learning difficulties. (2002). Courtwick Park H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection 2nd Floor, Ridgeworth House Liverpool Gardens Worthing, West Sussex BN11 1RY 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 H60-H11 S14475 Courtwick Park V224611 230605 Stage 4.doc Version 1.30 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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