Inspection on 03/11/05 for Eden Cottage

This inspection was carried out on 3rd November 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 found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Eden Cottage 08/08/06

Eden Cottage 31/01/06

Eden Cottage 17/02/05

Eden Cottage 14/12/04

Eden Cottage 19/02/04

Eden Cottage 09/01/04

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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 Eden Cottage 6 The Oval Dymchurch Kent TN29 0LR Lead Inspector Geoff Senior Announced Inspection 3rd November 2005 10:00 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eden Cottage Address 6 The Oval Dymchurch Kent TN29 0LR 01303 872686 01303 875095 eden.cottage@craegmoor.co.uk 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) Lothlorien Community Ltd Miss Joanna Margaret Bumstead Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. That Joanna Bumstead completes NVQ4 by April 2005. Date of last inspection 17th February 2005 Brief Description of the Service: Eden Cottage is registered to provide accommodation and personal care for up to three people who have a learning disability. Parkcare Homes Ltd (Craegmoor)is the registered provider. Ms Joanna Mulcahy (formerly Bumstead) is the manager in the day to day control of the home. At the time of the inspection three people were in residence. Eden Cottage is a chalet style bungalow in a private cul-de-sac close to the centre of Dymchurch. The accommodation is provided on two floors. All of the service users have their own bedroom. The garden area is well kept and access is suitable for the service users. Dymchurch has a selection of shops, cafes and entertainment particularly in the summer months. Local transport facilities are close by as well as the sea with a large sandy beach. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and was undertaken on 3/11/05. The visit commenced at 10am and lasted approximately 6.75 hrs. The Manager Ms. Mulcahy has several years experience working with people with a learning disability in a residential setting. She indicated an awareness of the NM Standards and expressed a commitment to compliance with the standards within a reasonable timescale The Inspector was able to speak with the two members of staff on duty and one of the three service users accommodated at the home The level of functioning of one of the service users precluded the opportunity for any meaningful verbal interaction. However, the inspector observed, throughout the visit, the staff’s attention to the service users’ immediately expressed needs, their patient, friendly and respectful manner and their treatment of each service user as an individual. A range of documentation was viewed and an accompanied tour of the premises undertaken. The findings of the visit and any requirements or recommendations are contained within the body of the report. What the service does well: What has improved since the last inspection? The home has produced an amended and updated Statement of Purpose and Service user agreement that more accurately reflects the individuality of the service within the organisation. The medication storage has been moved from the kitchen cupboard to a dedicated secure storage area. A notice board with pictures and symbols has been introduced as an aid to communication. The Manager acknowledged the requirements and recommendations of the last inspection and has taken action to address the issues raised. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 6 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. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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): 1,2,3. There is written information available for prospective clients and their representatives when considering admission to the home. There is a system in place for making pre-admission assessments of prospective clients. This needs to be further explored to ensure that the judgements made are based on all available information and ensure that the placement will be compatible and needs can be appropriately met. EVIDENCE: The Manager has worked on and presented a revised, more localised version of the Statement of Purpose intended to reflect the individuality of Eden Cottage within the organisation. In the light of recent experience, the document may benefit from further amendment to clearly define the aims, objectives and range of services available, but also the limitations as to what can be offered or managed. There is an Organisation procedure for admissions that includes the completion of assorted documentation. During the pre placement assessment period the Manager needs to check all sources for reliable, thorough and complete information to ensure mutual benefit, compatibility and suitability of the placement. The opportunity for visits to the home during the introductory/assessment period should be pursued where appropriate and possible. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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): 7,8,10. Service user opinion is sought and respected in matters affecting their daily lives. Staff are aware of issues of confidentiality and records are securely stored. EVIDENCE: Two service users are able to verbalise opinions and are consulted whenever appropriate and possible. 1 service user is non verbal with no alternative communication but staff have a good working knowledge of their likes, dislikes and preferred routines Service user response to any change in routine is noted and acted upon accordingly. There are very few set routines at the Home. Decisions are made and choices determined on a daily basis on matters relating to activities, mealtimes and any other issues requiring user participation. Staff were observed interacting with the service users in a friendly and non-patronising manner and efforts were made to include them in any interactions. Staff are aware of issues of confidentiality and records are securely stored. There was no public display of private or confidential information. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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 the following standard(s): 12-17 Daily routines are flexible and respect service users rights and individuality. Service users are provided with a varied and balanced diet. The opportunity for choice in participating in or declining an activity is compromised by the current needs of the group and limited staff numbers. EVIDENCE: A range of activities is offered to service users on a one to one and group basis. Service users are helped to pursue leisure activities both inside and outside of Eden Cottage with staff from the home. There is a company vehicle to enable service user access to the various venues. The number of staff available to address the current needs of the service user group may at times compromise the opportunities for choice. The service users may come and go as they please in the communal areas and grounds. The house is a nonsmoking environment; client and staff may use the garden for this purpose. Staff confirmed that the daily routines are flexible and respect the service users rights and individuality. The menu record showed a varied and balanced selection of meals. Staff are aware of service user likes, dislike and preferences and cater accordingly. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 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 the following standard(s): 18,19,20. Service users are treated in a respectful and non-patronising manner. Healthcare need are identified and addressed. The home needs to demonstrate that staff are trained to an appropriate level in the handling and administration of medication EVIDENCE: Service users are treated with dignity and respect. Bathroom space is limited, however staff endeavour to ensure appropriate levels of privacy are maintained when assisting service users with personal care and hygiene. Service users choose and wear their own clothes. The healthcare needs are monitored and issued addressed The home operates a monitored dosage system of medication administration. The arrangements for storage appeared satisfactory and records were generally up to date. Two omissions were noted in the records, which the Manager agreed to address with the staff involved. The home is now using a dedicated secure medication cabinet that is appropriately sited. The number of staff and level of training in medication administration was not clear. The registered person was reminded at the last inspection that training must include: basic knowledge of how medicines are used and how to recognise and deal with problems in use; and the principles behind all aspects of the home’s policy on medicines handling and records. It is for the provider to evidence that they have invested in training care staff who handle medicines and have Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 12 incorporated a form of competence assessment before allowing care workers to administer medicines. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 13 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): Not inspected at this visit EVIDENCE: Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 14 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): The premises appear to be generally well maintained, clean and hygienic. The home provides a comfortable environment in which to live and work. The bath and wc facilities need to be reviewed in line with changing needs. EVIDENCE: The Home appeared to be generally well maintained and presented a comfortable, environment in which to live and work. There are no requirements following the Environmental Health Officer’s most recent visit. Private rooms seen appeared to be generally well maintained, adequately furnished and reasonably decorated. Service users are encouraged to personalise their private space, some have to a considerable degree, with all manner of possessions, ornament and special items reflecting the individual and their interests. The property is of a domestic style and is in keeping with the neighbourhood. Shared spaces are adequate for the activities of the home. A no smoking policy operates in the home. There is an enclosed rear garden. The current occupants reportedly do not have a need for major environmental adaptations or equipment. As demands on the service have changed it has become apparent that the current toilet and bathroom facilities need to be improved /extended to meet safety/dignity and privacy considerations. The Manager reported that plans are in place to effect the improvements but have yet to be implemented. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 15 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): EVIDENCE: It was confirmed that the company has a written policy on staff recruitment. All staff are offered a job description and a statement of terms and conditions of employment. The staff group is long serving and well established, those spoken to appeared to have an appreciation and understanding of the individual service user’s needs. The general rota pattern indicates two staff per shift At present this includes the manager who does not have separate admin and management time set aside. There are no staff specifically employed to undertake catering and domestic duties. Staffing levels are too low to appropriately address the currently expressed needs of the service user group. Given that the service users conditions may on occasions require at least I-I supervision the registered person needs to ensure that the staffing levels throughout the day and night do not compromise safety of service users or staff or inhibit the opportunity for choice It was reported that staff are offered supervision on a 6-8 weekly basis and following any particular incidents. Staff now have an annual appraisal with their line manager to review performance against job description and agree a career development plan. The Organisation offers a staff development programme. There is an induction process that staff are supported through and mandatory training is provided. Two of the staff group have attained NVQ level 2. Additional courses are also provided covering a wide range of issues from Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 16 epilepsy awareness to managing challenging behaviour. The Manager recognises that some training may need to be refreshed. Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 17 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): Not inspected at this visit EVIDENCE: Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 18 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 2 2 2 X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 2 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score 3 3 1 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eden Cottage Score 3 3 1 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000023208.V258765.R01.S.doc Version 5.0 Page 19 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 YA20 Regulation 18 Timescale for action The registered manager and staff 31/01/06 comply with the home’s policy and procedure for the receipt, recording, storage, handling, administration and disposal of medicines. It is for the provider to evidence that they have invested in training care staff who handle medicines and have incorporated a form of competence assessment before allowing care workers to administer medicines. The home has an effective staff team with sufficient numbers and complementary skills to support service users’ assessed needs at all times. Staff numbers/hours relating to the needs of service users are based on guidance recommended by the Department of Health. Staff levels to be reviewed to reflect service users changing needs. 31/12/05 Requirement 2 YA33 18 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA1 YA3YA2 Good Practice Recommendations The statement of purpose needs to specify the target service user group and limitations of the service. The pre admission process should be further explored to ensure that the judgements made are based on all available information and ensure that the placement will be compatible and that needs can be appropriately met. The number of staff available to address the current needs of the service user group may at times compromise the opportunities for choice. As demands on the service have changed it has become apparent that the current toilet and bathroom facilities need to be improved /extended to meet safety/dignity and privacy considerations. 3 4 YA16 YA27 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 Eden Cottage DS0000023208.V258765.R01.S.doc Version 5.0 Page 22 - 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. 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