Inspection on 19/05/06 for Cowley Cottage

This inspection was carried out on 19th May 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Cowley Cottage 11/09/07

Cowley Cottage 15/11/05

Cowley Cottage 05/07/05

Cowley Cottage 15/10/04

Cowley Cottage 11/07/04

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Dalewood Respite Care

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Fairways

Treloar College

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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 Cowley Cottage Ray Park Road Maidenhead Berkshire SL6 8PZ Lead Inspector Katy Brown Unannounced Inspection 19th May 2006 14:45 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Cowley Cottage Address Ray Park Road Maidenhead Berkshire SL6 8PZ 01628 776542 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) www.caremanagementgroup.com Care Management Group Limited Ms Geraldine Dummer Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th November 2005 Brief Description of the Service: The house is situated in a residential area of an attractive town on the River Thames. There are shops in the town though it is a distance to walk. The garden is shared with a second larger home on the same site. The staff and residents of both homes mix on a daily basis. Residents have access to a patio area and lawn. The home is based in a large detached house and has two distinct areas. The larger house provides accommodation for seven residents with communal space plus a two-bedroom apartment over two floors. All of the residents accommodation is single rooms. The residents in the larger house have moderate to mild learning disabilities and are all older men. Two females live in a separated area known as the Lodge and are supported to do more for themselves by the staff. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Cowley Cottage is a community home for adults with learning disabilities, providing support to nine residents. The site visit/inspection was unannounced and undertaken at the home on 19 May. Prior to the site visit, other inspection activity included; an examination of a pre-inspection questionnaire completed by the manager of the home and surveys sent to the residents. Nine surveys were completed and returned to the Commission. Telephone conversations were also held with relatives and two care managers. Nine residents were spoken to and three residents files were examined during the site visit. The manager and a senior support worker were interviewed and the home’s record of complaints and staff training records were also examined. What the service does well: What has improved since the last inspection? What they could do better: There is an outstanding requirement that procedures are developed for emergency admissions and there has been an emergency admission since this requirement was made. A resident that was admitted to the home last August, has still not received a care needs assessment. Detailed risk assessments and clear guidelines have not been completed for residents, staff and visitors subsequent to an allegation being made and a formal record has not been kept of this allegation. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 6 There is an outstanding requirement that staff receive training in the care of older people. These are things that are required by the Care Homes Regulations 2001. There is no policy for smoking within the home, although three residents smoke. This is a recommendation that has been made. 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. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Not all resident’s aspirations and care needs are assessed and a procedure for emergency admissions has still not been developed, although residents are still being admitted in emergency circumstances. EVIDENCE: The resident most recently admitted to the home had received a comprehensive care needs assessment. He was however, admitted under emergency conditions and the provider has still not developed emergency admission procedures, although this was previously required by the Commission. A resident that was admitted to the home in August 2005, has still not received a care needs assessment. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents make decisions, which are reflected in their care planning process. They are provided with a good standard of care that is consistent with their identified needs and risk management plans. EVIDENCE: Individual plans of care are available for all residents and they contain all the information that is specific to their personal care and social care needs. Staff keep a daily record of residents’ activities and any visits that they had received or appointments that they had attended. Clear guidance is in place to ensure that the residents’ needs are met. Risk management plans have been completed for the residents and staff are aware of the risks and adhere to procedures. The residents care managers and relatives are involved in the process for identifying and minimising risks. It was noted however, that clear risk assessments and detailed guidelines had not been completed for specific residents, staff and visitors, subsequent to a serious allegation that had been made. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 10 Reviews of the care provided and risk management strategies are completed regularly and the resident’s, relatives’ and care managers that were spoken to, confirm that they attend reviews. Residents’ say that they are involved in their care planning and that they do make decisions about their lives. They attend regular meetings, where they discuss, life at the home, forthcoming events, holidays and meals. Relatives and care managers spoke positively about the staff at the home and the good standard of care that is provided. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in age, peer and culturally appropriate activities within the local community, and are enabled to maintain personal relationships with family and friends and make decisions about the way the home is run. EVIDENCE: Relatives that were spoken to, prior to the visit, said that the residents take part in a number of activities, including swimming, college attendance, the gym, bowling and visits to the pub for drinks and meals and day service attendance. Residents spoke of their enjoyment of visiting the local pub and some ‘popped out for a pint’ during the visit. The residents have recently discussed going on holiday and they have decided that a trip to the Isle of Wight later this year. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 12 Staff and resident meetings are held and residents confirmed that they discuss, which recreational activities they want to be involved in. One resident spoke of staff seeking to find him voluntary employment in the future, while others spoke of the frequent trips into the town. There is a key worker system in place and residents say that their key-workers help to resolve any issues or problems that might arise. Residents are aware of the rules and policies within the home. The home is non-smoking; however, there is no smoking policy available for the residents, although three of them smoke. Relatives confirmed that they are encouraged to visit the home and residents say that their families and friends are made to feel welcome. A fiancé of one of the residents says that he is always welcome at the home and regularly sleeps over. He also says that the staff are ‘great’ and that the residents are treated very well. Residents say that they enjoy the meals at the home and the menus reflect their likes and dislikes. They do have enough to eat and are given a variety of options if they are offered food that they do not want. Relatives say that the meals are nutritious and well balanced. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ are provided with a good standard of care that reflects their wishes and meets their health needs. They are protected by the homes policy/procedures for managing medication. EVIDENCE: Staff are provided with appropriate information to identify the support that residents require with their personal care and also to ensure that their preferred routine is respected. Residents say ‘the staff and the home are ‘fantastic’ and have a good understanding of their needs and wishes. Elder residents have received occupational therapy assessments and appropriate equipment has now been provided. All residents have their own room where privacy is assured. The manager has a good awareness and understanding of the residents’ health needs and individual records are kept for all health related visits. Relatives and care managers say that staff are proactive when a resident’s health changes or deteriorates and records indicate that all appointments with health professionals are kept. A resident that was admitted to the home dependent on a wheelchair, is now independently mobile and historical problems with her Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 14 eyesight have now been resolved.. Care managers report that residents with behavioural difficulties have improved since their admission to the home and relatives confirmed that the residents do visit the doctor, dentist, dietician and hospital nurse. There are no residents that self-medicate. All staff that provide support with medication, receive appropriate training and the pharmacist that visits the home, has not raised any concerns. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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 the following standard(s): 22 & 23. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents views are listened to and they are protected from abuse, neglect and self-harm. EVIDENCE: Residents, relatives and care managers that were spoken to, said that they would be comfortable making a complaint as they believed that their complaint would be taken seriously. Residents confirmed that staff do resolve any issues or concerns that they have. The manager and staff keep a satisfactory record of any complaints that are made and appropriate investigations are carried out. The CSCI has not received any complaints in respect of this service. The home as adopted the Berkshire Vulnerable Adults, inter-agency procedures and both care staff and the manager have received training in abuse. There has been one vulnerable adult investigation in the home, within this inspection year and although the Berkshire inter-agency procedures were adhered to, the manager has not kept a formal record of the allegation that was made. Residents that were spoken to, say that they feel safe at the home. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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 the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a warm, homely and clean environment. EVIDENCE: A tour of the premises identified that the home is well decorated and the furniture looks nice. Parts of the home, including some bedrooms have been recently re-decorated and new carpets have been purchased. The residents say that they are happy with their accommodation and some said, they really enjoy relaxing in their rooms. There is a large garden that has furniture that the residents are able to use. The home has satisfactory policies for infection and control and the environment is clean and hygienic. The manager has attended health and safety training that covered hygiene and infection. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported and protected and have their needs met by competent and trained staff. EVIDENCE: The home has a satisfactory policy for the recruitment of staff and the manager confirmed that required checks are completed prior to care staff working at the home. Staff records indicate that they receive training that helps them meet the needs of residents. A previous requirement made by the Commission stated that staff must receive training in care of the elderly residents as three are over the age of sixty-five. This has not yet been done. Staff receive an induction that is compliant with TOPSS specifications and also receive refresher training on a regular basis. Records indicate that staff are competent and are completing NVQ’s in care. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 18 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 19 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. 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 and residents views are sought. The safety and welfare of residents’ is met through the health and safety policies and procedures and care practices at the home. EVIDENCE: Residents, relatives and care managers say that the home is well run and that they like and trust the manager. The manager has been employed by the providers for seven years and is completing the Registers Managers Award. A care manager said that the home was ‘marvellous’ and a relative said that it was ‘brilliant’. Residents say that the home is ‘fantastic’ The home has a satisfactory policy for quality assurance. Relatives and residents say that the manager and staff seek their views and opinions of the service and that changes are made where possible. Questionnaires are sent to both residents and relatives. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 20 The home has satisfactory health and safety policies and procedures in place and an inspection of records identified that regular maintenance checks are completed for equipment used at the home. The fire officer and the environmental health officer have visited the home; however, no requirements were made. Fire fighting equipment checks are completed by the appropriate agencies and staff ensure that fire drills take place. Staff receive training in health and safety and manual handling. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 1 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 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 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA2 Regulation 14 Requirement The registered person must ensure that all residents living at the home have a completed care needs assessment in place. The registered Person must ensure that a policy and procedure is developed for residents admitted to the home in an emergency. (Outstanding from the previous inspection) The registered person must ensure that clear risk assessments and risk reduction plans are completed for residents. Satisfactory guidelines must also be completed to reduce the level of risk to residents, staff and visitors. The registered person must ensure that a record is kept of all allegations of abuse. The registered Person must ensure that appropriate training is provided in the care of older people. (Outstanding from the previous inspection) Timescale for action 19/05/06 2. YA4 14 19/05/06 3 YA9 13 (4) (c) 19/05/06 3 4 YA23 YA351. 17 (1) (a) 18 (1) (c) i 19/05/06 19/08/06 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 23 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 YA16 Good Practice Recommendations The registered person should ensure that a policy that outlines the conditions for smoking is developed for the residents. Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Cowley Cottage DS0000011287.V289987.R01.S.doc Version 5.1 Page 25 - 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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