Inspection on 31/01/06 for Eden Cottage

This inspection was carried out on 31st January 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 no outstanding requirements from the previous inspection report, but made 1 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 03/11/05

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 Unannounced Inspection 31st January 2006 10:00 Eden Cottage DS0000023208.V279876.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 Eden Cottage DS0000023208.V279876.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. Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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 Mrs Joanna Margaret Mulcahy Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 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.V279876.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken on 31/1/06. 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 member of staff on duty and one of the 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? What they could do better: As noted at the last inspection; Staff training in safe handling, management and administration of medication needs to be undertaken by all staff involved and competency assessments completed. The toilet and bathroom facilities previously appeared to be adequate for the service users needs and provided appropriate privacy. As the support needs have changed it has become apparent that the current facilities need to be Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 6 improved /extended to meet safety/dignity and privacy considerations. The Manager reported at a previous inspection that approval and plans are in place to effect the improvements. These have yet to be implemented. Staff ratios need to be reviewed to ensure an appropriate level of safety, supervision and opportunities for choice and is maintained at all times. 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.V279876.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 Eden Cottage DS0000023208.V279876.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): 1-3 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. These need to be more robust to ensure that the placement will be compatible and needs can be appropriately met. EVIDENCE: It was noted at the last inspection that the Manager has 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 a clearer description of services offered and any limitations would prevent inappropriate referrals. This would ensure that admissions, when they occur, are within the scope of experience and expertise of the staff group and are compatible with the existing service user group and the environment. Eden Cottage DS0000023208.V279876.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): 6-10 Service user plans identify the needs of the resident group. Service users are enabled to make decisions affecting their daily lives. Risks are assessed positively . Staff are aware of issues of confidentiality and records are securely stored EVIDENCE: The Manager reported that there has been no significant changes to individual service user care plan documentation. This was seen to contain detail on aspects of need and delivery of services and included physical and social needs, health care, medical information and behavioural guidelines.. It was reported that service users family and representatives are encouraged to be involved in the formulation of care plans and participate in the regular reviews. One of the service users is able to verbalise opinions and is consulted whenever appropriate and possible. The other service user is non verbal but staff communicate with pictures and limited Makaton and have a good working knowledge of likes, dislikes and preferred routines. Service user response to any change in routine is noted and acted upon accordingly. There is a general structure to the weekdays but routines remain flexible. Decisions are made and choices determined on a daily basis relating to activities, mealtimes and any other issues requiring user participation. Staff were observed Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 10 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. The management undertakes and records where potentially hazardous activities are identified or planned in order that service users can participate in chosen activities with appropriate support. Eden Cottage DS0000023208.V279876.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): Not inspected at this visit EVIDENCE: Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 12 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): 20 The home needs to demonstrate that staff are trained to an appropriate level in the handling and administration of medication EVIDENCE: The home operates a monitored dosage system of medication administration. The storage and records appeared satisfactory and up to date. The number of staff and level of training in medication administration was not clear. The registered person was reminded at this and 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 incorporated a form of competence assessment before allowing care workers to administer medicines. This is again a requirement. Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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): 22,23. Family member, visitor and Service user views and concerns are listened to and acted upon. Systems are in place to promote and maintain protection from abuse. EVIDENCE: There is an ‘organisation’ complaints procedure on file and available.. The Manager reported that she endeavours to operate an ‘open door’ policy and service users, their families and representatives are encouraged to interact and voice concerns and ideas to staff at all levels. Policies relating to Adult protection and whistle blowing are in place and guidelines available to staff. The Manager reported that staff are given opportunity to attend Adult Protection and crisis prevention and intervention training, with updates as required. Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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): 24,25,27,30. 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 reportedly no requirements following the Environmental Health Officer’s most recent visit. Both service users’ private rooms seen appeared to be generally well maintained, and furnished and decorated to a good standard. 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 Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 15 Manager reported that plans are in place to effect the improvements but have yet to be implemented Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 Page 16 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): 33 The registered person needs to ensure that the staffing levels do not compromise safety of service users or staff or inhibit the opportunity for choice. EVIDENCE: The general rota pattern indicates one member of staff per shift plus the Manager during office hours. There are no staff specifically employed to undertake catering and domestic duties. It was reported that extra staff hours may be allocated for specific and planned evening activities. 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, evening and night do not compromise safety of service users or staff or inhibit the opportunity for spontaneity and choice. Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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): 37,39,42. The home is well run with an open and inclusive atmosphere. Policy and practice endeavours to ensure the health and welfare of service users is promoted and protected. EVIDENCE: It appeared from discussion and observation that the Manager is approachable and supportive. She operates an open door policy and frequently meets with staff individually and collectively on a formal and informal basis. An open and inclusive atmosphere appears to have been established within the Home. The Inspector was assured that the service users views are actively sought in all matters relating to their lifestyle and daily routine at the Home. Service users are encouraged to voice their opinions at any time. The home is regularly visited by a representative of the organisation and reports submitted in accordance with Regulation 26. The health, safety and welfare of service users, staff and visitors is addressed in induction and training, written guidance and routine maintenance and service checks. Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 2 3 2 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 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 2 34 X 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 x 3 X 3 X X 3 x Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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 12/05/06 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. (This was a previous requirement 31/01/06) Requirement 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 YA1 Good Practice Recommendations The statement of purpose needs to specify the target DS0000023208.V279876.R01.S.doc Version 5.1 Page 20 Eden Cottage service user group and limitations of the service. 1. YA3 YA2 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. The service aims to provide for a specific service user group and associated physical support needs. It has become apparent that the current toilet and bathroom facilities need to be improved /extended to meet safety/dignity and privacy considerations. 2. YA33 3 YA27 Eden Cottage DS0000023208.V279876.R01.S.doc Version 5.1 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.V279876.R01.S.doc Version 5.1 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. 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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