Inspection on 29/11/07 for Courtwick Park

This inspection was carried out on 29th November 2007.

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 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 16/10/06

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 J Hough Unannounced Inspection 29th November 2007 11:30 Courtwick Park DS0000014475.V355031.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.V355031.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.V355031.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 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) Consensus. Post vacant Care Home 12 Category(ies) of Learning disability (12) registration, with number of places Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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. 2. 3. Date of last inspection 16th October 2006 Brief Description of the Service: Courtwick Park is a large detached property owned by Consensus. 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 Consensus and on the same site, as well as local community facilities. Current scale of fees start from £1370.55 to £2369.00 per week. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out by June Hough on 29th November 2007 and started at 11:30 hours and finished at 14:30 hours. Prior to the site visit records were reviewed from previous inspection reports, and information gathered about the home since the previous visit on 16th October 2006 together with eight surveys returned to the Commission of Social Care Inspection (CSCI) from relatives of people using the service. During the site visit communal areas and some of the people’s rooms were visited. Two care plans, three staff files, complaints and accidents records were all looked at. The Annual Quality Assurance Assessment (AQAA) was returned to the Commission of Social Care Inspection (CSCI) prior to the visit to the home and information provided in this has been included in this inspection report. The acting manager and the registered manager from another unit were present at the inspection and provided the information required. One recommendation for improved ventilation in the kitchen is outstanding from the previous inspection. No requirements or further recommendations were made following this inspection. What the service does well: Thorough assessments are carried out prior to people moving into the home to ensure the home is suitable for their needs. The admission process includes trial visits and short stays in the home that are arranged to suit individual needs. People are given opportunities to participate in a variety of activities both in house and outside the home, to enable them to lead a fulfilling and active life and feel part of the local community. People are given a good choice of nourishing food that is freshly prepared and well cooked. Dietary needs are well catered for. The staff are competent and experienced and provided with the appropriate training for their work. Relative’s comments on surveys said “ We are impressed with the energy staff put into their work, and they appear to have good training”. Courtwick Park DS0000014475.V355031.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. Courtwick Park DS0000014475.V355031.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.V355031.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have a detailed assessment of their needs carried out, prior to moving into the home. People can visit the home and stay for periods of time to suit them. EVIDENCE: There have been no new admissions to the home since the previous inspection. People referred through Care Management have a health and social services assessment and a care plan. Records seen showed that people also have an assessment carried out by the manager of the home working closely with the family. The acting manager confirmed that the admission process is arranged to suit individual needs and people can visit and stay in the home for short periods of time before a decision is made about moving in on a permanent basis. Courtwick Park DS0000014475.V355031.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have individual care plans and risk assessments in place that enables them to take responsible risks as part of an independent lifestyle and get the support they need from staff. People who are unable to manage their own money are supported by staff and money is handled and all transactions recorded appropriately. EVIDENCE: Individual care records were detailed in all aspects of the needs of the people as well as personal profiles giving information about people with regards to family and friends, interests and lifestyle. Detailed risk assessments are completed to enable people to take responsible risks and lead a full and active life. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 10 Clear guidelines are drawn up for staff in how to manage behaviour that can be challenging. People have limited and different abilities to make decisions about their life so the home works closely with families in assessing and planning people’s personal, social and healthcare needs. There is a key worker system in place and the manager and key workers review care plans every three months or when needs change None of the people are able to manage their own money. At the previous inspection records kept for people’s money was in one case inaccurate. The home has since changed the way money is accessed and recorded. The manager and the deputy manager are the only people able to access people’s money that is held in money tins for each individual. All transactions now require two signatures, and money tins are checked each month. Courtwick Park DS0000014475.V355031.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People take part in various activities both in the home and in the local community, and are supported to keep in contact with family and friends. People are offered a good choice of nourishing and well-cooked food. EVIDENCE: The home employs an activity co-ordinator who works closely with care workers to develop individual activity programmes for people. There is an activity centre on site where a variety of activities are provided such as arts and crafts, cooking, music sessions, trampoline, and a sensory room. Trips out in the mini bus include eating out, theatre, cinema, sports centres and shopping etc. Plans for the future include designing a sensory garden. People are supported to stay in contact with family and friends, and some have regular stays with parents over the weekends and holidays. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 12 A comment given by relatives on a survey stated “We are pleased the way the home involves people in the community like going out to eat and going away on holiday”. Generally people are able to access all communal areas and the garden, although mainly under supervision for their safety. The small lounge that is generally used as a quiet area has been occupied for several weeks by a person needing constant supervision awaiting a move to another home. This means people are not able to use this area although there is another lounge in the home. The acting manager confirmed the situation is not ideal but the situation is about to change, as arrangements for the move to a new home are being finalised next week. Staff respect people’s privacy and dignity by making sure they are dressed appropriately and giving personal care in private. A relative’s comment on a survey stated, “the staff are always caring and polite and good humoured”. The home employs a cook and the menus seen showed a nourishing and well balanced diet. The cook ensures there are fresh vegetables cooked daily and fresh fruit is always available. The meat and vegetables are purchased from a local farm shop. People’s likes and dislikes in food and special dietary needs are displayed on the notice board in the kitchen. The main meal is served around midday and a light tea is offered around 5pm. Lunch was observed in the dining area that was relaxed with people and staff eating together. Special utensils are provided where necessary to assist people to eat independently. Courtwick Park DS0000014475.V355031.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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive appropriate personal support and their health needs are met. Staff manage people’s medicines and accurate records are kept to ensure medicines are given and stored safely. EVIDENCE: People’s preferences on how they are supported and cared for are recorded on individual care plans. Personal support is given by a care worker of the same gender where possible. Equipment and aids are provided such as hoists, handrails and sit in showers. A relatives comment made on a survey stated “that every support possible, is given to help people with their day to day living”. Support and advice is sought from other health professionals such as speech therapists, physiotherapists, psychologists and psychiatrists when required. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 14 People are assisted to access healthcare facilities as needed with the consent and involvement from parents. All medication is managed by staff in the home that are trained in the safe handling and administration of medicines. The storage, administration and disposal of medicines are managed safely and good records are kept. At present the home is not storing or giving any Controlled Drugs to people. Medicines given when required are carefully monitored showing reasons for giving and there effects. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The policies and procedures and staff training protect people as far as possible from abuse. Information is available for people and their relatives on the procedures for making a complaint. EVIDENCE: There is a clear complaints procedure, which is made available to the people’s relatives and representatives. Whilst people would find it difficult to make a formal complaint without assistance, the manner in which staff respect them indicates that they would make representation on their behalf should this be necessary. The complaints log showed that there have been no formal complaints about the home since 2001. Responses on relative’s surveys indicated that they are aware of how to make a complaint. The home has its own policy and procedure as well as the West Sussex Adult Protection procedures. The home has appointed a training manager who showed evidence of recent training for all staff on the Protection of Vulnerable Adults (POVA). Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 16 There has been one Protection of Vulnerable Adults (POVA) investigation in the home that has resulted in one person being moved to another home. Staff are aware of what constitutes abuse and when incidents and allegations need reporting to the appropriate authorities. Courtwick Park DS0000014475.V355031.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a comfortable and reasonably maintained home. A plan is in place to make improvements to some areas of the home. EVIDENCE: The home is situated in a semi-rural location although not far from local amenities. The home has a mini bus for taking people out and they have regular use of the activity centre located on the same site. There is sufficient communal space including two lounges, one of which is used for quieter times. However as previously mentioned in this report the smaller lounge is being used for other purposes at present. On visiting all communal areas and some of the people’s bedrooms it was noted that the home is reasonably maintained and all areas seen were clean. Due to the people living in the home damage frequently occurs to the décor and furnishings that is unavoidable. Following the change of provider a Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 18 business plan is being developed for the next five years, that includes plans to replace some furnishings, and refurbish bathrooms and other areas of the home. Hallways and landings have been painted since the previous inspection. The improvements highlighted at the previous inspection in relation to the ventilation in the kitchen remain outstanding. People have their own rooms, which are personalised with their own furniture and possessions and decorated to their choice. The home had a comfortable and homely atmosphere. The laundry facilities are suitable for the number and size of the home and washing machines meet disinfectant standards. Hand washing facilities are provided in all areas where there might be a risk of infection such as the laundry, bathrooms and toilets. Courtwick Park DS0000014475.V355031.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are protected as far as possible by the homes recruitment policy and practices. People are supported by suitably trained and experienced staff. EVIDENCE: Three staff files checked showed they contained relevant checks and information. Staff are only appointed following a Protection of Vulnerable Adults (POVA) check and a Criminal Records Bureau (CRB) check, plus two satisfactory references. There are seven care workers plus the manager or deputy manager plus one senior care worker or team leader working throughout the day. At night there is one senior care worker and one care worker. An on call system is in operation at night for support when needed. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 20 At present due to one person needing two to one support during the day and one to one at night agency staff are being used to compliment the staffing numbers. There is a training manager and individual training records and a programme of training show staff are provided with a good level of training and support for their work. Specialist training includes dysphagia, epilepsy, challenging behaviour, physical intervention techniques and breakaway. A relatives comment on a survey stated, “The staff do a good job under what can sometimes be difficult and unpredictable circumstances, and they appear to have had good training”. The Annual Quality Assurance Assessment showed that twelve care workers have achieved the National Vocational Qualifications and five care workers are undertaking the training. Induction training for new staff includes care workers being supervised for the first few weeks of employment. Supervision continues until the member of staff has been assessed as competent for their work. The home has staff vacancies for a deputy manager, and one senior and one support worker. Courtwick Park DS0000014475.V355031.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run with support from senior management. The health and safety and welfare of people is protected Relatives and health professionals are sent surveys to find out their views on the home. EVIDENCE: Whilst there is no registered manager for the home a person was appointed two weeks ago and is working a three-month probation period before applying to the Commission of Social Care Inspection (CSCI) to become the registered manager. The person concerned is competent and has worked in the home as a senior care worker and deputy manager for several years. She has a National Vocational Qualification (NVQ) at level 3 and is working towards level 4. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 22 During the probation period good support is being provided by the Registered Manager from another unit as well as the clinical manager. The home had fallen down in the past notifying the Commission of Social Care Inspection (CSCI) about certain incidents involving people and the current changes to the day-to-day management of the home. The acting manager confirmed that she is aware of the incidents that need reporting and all notifications are now sent to the clinical manager. A quality assurance system is in place, which includes sending surveys to relatives and health professionals involved with the home. The last surveys were sent out at the end of September 2007 and returned to head office so feedback from surveys was unavailable. There are policies and procedures for staff to follow to protect the health and safety of people living in the home. Equipment and systems are regularly serviced and maintained and records kept. Accidents and incidents are recorded and collated weekly in order to monitor frequency and trends, and risk assessment reviewed as appropriate. Courtwick Park DS0000014475.V355031.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 X 2 3 3 X 4 3 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 X 26 X 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 3 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 X 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 X 3 X X 3 X Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations Ventilation in the kitchen should be improved. Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Courtwick Park DS0000014475.V355031.R01.S.doc Version 5.2 Page 26 - 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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