Inspection on 07/06/05 for Derwent Cottage

This inspection was carried out on 7th June 2005.

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

Derwent Cottage 16/07/08

Derwent Cottage 17/07/07

Derwent Cottage 08/08/06

Derwent Cottage 11/10/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Derwent Cottage 27 Eastgate Seamer Scarborough YO12 4RB Lead Inspector Brian Hallgate Unannounced 7 June 2005 09:00 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. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Derwent Cottage Address 27 Eastgate, Seamer, Scarborough, North Yorkshire, YO12 4RB 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) 01723 866146 01723 866146 Milbury Care Services Care Home 4 Category(ies) of Learning Disability (LD) 4 registration, with number of places Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection First inspection Brief Description of the Service: Derwent Cottage is a detached house in a small village, approximately 5 miles from the centre of Scarborough. The home is close to the village centre and amenities. Accommodation and care are provided for up to four people with learning disabilities. One en-suite bedroom, a lounge, dining room and kitchen are at ground floor level. There are 3 en-suite bedrooms, a shower room and an activity room on the first floor. There is a passenger lift between floors. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 7th June 2005 and took four and a half hours, including preparation time. The inspection commenced at 9.00am. Only one member of staff was on duty who was inexperienced in caring for adults with learning disabilities and complex needs. Only two service users are in residence at the present time. One service user requires one to one care for 14 hours each day according to the care management assessment. A tour of the home was made with the person on duty and a number of records inspected. The service users were observed interacting with the member of staff. What the service does well: What has improved since the last inspection? What they could do better: The staffing situation is unacceptable. At the time of the inspection there was only one inexperienced member of staff on duty caring for two people with challenging behaviour and complex needs. One care plan clearly states that one to one care is required during the 14 hour waking day. The registered person is receiving funding from the Local Authority to provide this service. There is no registered manager for the home. No registered manager has been appointed since the home opened. The member of staff on duty stated that she had only worked for the organisation for approximately two months and that she had no training in caring for adults with complex needs and challenging behaviour. Appropriate training must be given to all staff to work with this client group. Four wedges were found holding fire doors open on the ground floor. This is unacceptable and alternative means must be found to keep the doors open, if it is essential that they be open, to protect service users and staff in the event of a fire. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 6 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. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_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 Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_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) 2 There is a clear plan that ensures that all prospective service users have a comprehensive assessment prior to admission EVIDENCE: Service users are only admitted to the home after a full care management assessment has been completed by Social Services. Files examined had comprehensive assessments completed before admission took place Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_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 and 9 There is a clear care planning system in place to adequately provide staff with the information that they need to satisfactorily meet service users needs. EVIDENCE: There are only two service users resident at the present time. Both service users have complex needs and are unable to verbally express if their assessed needs are being met. Observation of the interaction with the member of staff on duty showed that both service users communicated non-verbally. One service user using basic Makaton and both service users point when choosing from a number of options. They clearly inform staff if they do not wish to participate in activities by refusing to get involved. There are comprehensive care plans detailing their needs. There was evidence on their records that the plans are reviewed on a regular basis. The reviews involve other professionals, including community nurses from the health team and psychiatrists. Detailed risk assessments have been completed on both service users and are available for staff. There is evidence in the daily records that staff allow service users to take appropriate risks under the supervision of the staff. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 10 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) None EVIDENCE: Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 11 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 and 20 The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. EVIDENCE: The case files showed that both service users are registered with a GP and receive specialist services from the learning disabilities health team, including visits and reviews by community nurses and psychiatrists. The member of staff was observed to give support to the service users in accordance with their written care plans and risk assessments. The service users are unable to self medicate. There is a monitored dosage system. The member of staff on duty was observed correctly administering medication to a service user. The medication and records checked were in order and up to date. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 12 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) 22 and 23 Staff need to be more aware of the complaints and abuse procedures. EVIDENCE: It was not possible to assess if the service users thought that they were listened to by staff because of their complex needs and lack of verbal communication skills. From discussion with and observations of the member of staff on duty it appeared that the non-verbal communication was acted upon. There are complaints and abuse procedures held in a number of files in the office but the member of staff on duty was unaware of a complaint book or complaint form if a complaint was made. The member of staff stated correctly that she would contact the homes manager or the duty manager if she suspected a service user had been abused. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 13 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 and 30 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: The home is a detached property with an en-suite bathroom, lounge, dining room, kitchen, utility and office on the ground floor. There are three en-suite bedrooms, a shower room and an activities room on the first floor. There is a passenger lift between the floors. An attractive grassed area is provided to the rear of the house with garden furniture and evidence of use by service users. The home was totally refurbished by the provider when it was purchased last year. All the furniture and fittings are new, comfortable and appear safe. The home is clean and hygienic and meets the needs of the service users. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 14 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) 33 and 35 There is a staffing shortage and as a result service users do not receive consistent care. This situation is having a detrimental impact on the standard and consistency of care offered within the home. EVIDENCE: Only one member of staff was on duty during this inspection. The member of staff was inexperienced having worked approximately two months for the provider. She had previous care experience but no experience of caring for people with learning disabilities. The two service users have complex needs and challenging behaviour. One service user, according to her assessment and contract, requires one to one care for the fourteen hours of the working day. The Social Services Department responsible funds the provider for this level of care. It is totally unacceptable for one inexperienced member of staff to provide care for the two service users. The operations manager of the home was contacted at the time of the inspection and an immediate requirement notice issued for the appropriate staff to be on duty. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 15 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 and42 The fire precaution arrangements to protect the safety of the service users were not satisfactory. EVIDENCE: On a tour of the building it was noticed that four of the fire doors on the ground floor were wedged open with either rubber of wooden wedges. A bedroom door that has a magnetic catch on was wedged open. The member of staff stated that the magnetic catch was not working. The office door, kitchen door and laundry door did not have magnetic catches fitted. All the doors lead onto the corridor which is the only escape route for service users and staff on the ground floor. In the event of a fire this practice could put both service users and staff at risk. An immediate requirement notice was issued. The temperature of the hot water in a service users en-suite bathroom was around 43 degrees Centigrade. There is no registered manager for the home. No person has been registered since the home opened. An early application to the Commission to register a manager must be made. Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 16 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 3 x x x Standard No 22 23 ENVIRONMENT Score 1 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x 1 x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Derwent Cottage Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 1 x x x x 1 x J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 17 First inspection 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 22 Regulation 22 Requirement The registered person must ensure that there is a policy and procedure that all staff are aware of if a complaint is made. The registered provider must ensure that there are sufficient and suitably experienced and competent persons working at the care home The registered person must ensure that staff receive appropriate training to the work that they are to perform The registered person must ensure that an application is made to the Commission by a person to be registered as the manaqer of the home The registered person must take adequate precautions against the risk of fire and provide means of escape Timescale for action 30 June 2005 Immediate Req notice issued 30 June 2005 30th June 2005 2. 33 18 3. 35 18 4. 37 9 5. 42 23 Immediate Req notice issued RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Good Practice Recommendations J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 18 Derwent Cottage Standard 1. None Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ 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 Derwent Cottage J53_J04_S61996_Derwent Cottage_V230902_070605_Stage 4.doc Version 1.30 Page 20 - 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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