Inspection on 08/08/06 for Eden Cottage

This inspection was carried out on 8th August 2006.

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

Eden Cottage 31/01/06

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

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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 Mrs Sue Gaskell Unannounced Inspection 8th August 2006 12:00 Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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.V299434.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 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. The fees are currently in the range of £1,122 per week. The provider, Lothlorien Community Ltd is a subsidiary of Parkcare Homes Ltd (Craegmoor), a major national provider. The registered manager, Ms Joanna Mulcahy is 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.V299434.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 8th August 2006 between 12.00am and 3.30pm. There are 3 people currently living in the home. The inspector spoke to the 3 residents, who showed her their bedrooms, and also spoke to the manager and 2 members of staff. One of the residents has limited communication and therefore the inspector also spent time with this lady in order to see whether she appeared relaxed and comfortable. The inspection process consisted of information collected before and during the visit to the home, and care management feedback after the site visit finished. Other information seen included incident report forms, assessment and care plans, medication records, duty rota and staff employment and induction paperwork. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 6 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.V299434.R01.S.doc Version 5.2 Page 7 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&6 Quality in this outcome area is good. . This judgement has been made using available evidence including a visit to this service. The statement of purpose, service user guide and individual statement of terms and conditions, clearly says what service will be offered. Prospective residents can be confident that their needs will be assessed and can be met EVIDENCE: There has been one admission to the home since the last inspection visit. That person’s file contained a detailed and comprehensive outcomes based preadmission assessment. The resident explained how she had made several visits to the home and that this had helped her to make a decision about whether or not she wished to live here. The home does not take emergency admissions. All residents have now been issued with a service user guide that is in a pictorial format. Although residents are issued with individual agreements stating their terms and conditions of residence these are not in a format likely to be understood by residents. The manager said that she has explained the contents to each resident but also said that she would look into other ways to make the agreement more accessible to residents Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 8 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. The service user plans are easy to use and descriptive. Residents’ choices are respected and their decision-making is well supported. Residents are supported in taking risks in the daily and social activities that form part of an independent lifestyle. EVIDENCE: The home uses a “person centred” care planning model that enables residents to have as much input as possible to any decision affecting their lives and clearly shows the individual resident’s views. All of the care plans include details on short and long term care needs, and there are detailed guidelines for how the home will assist residents in achieving any particular individual goals. Residents have key workers who monitor their individual needs and activities and help them understand the contents of their care plans. 2 residents said that they are asked about what they want from the home and how they would like staff to assist them. Comprehensive risk assessments have been prepared Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 9 for a variety of activities and situations. Care plans and assessments have been reviewed and included staff signatures to confirm that staff have read and understood the detailed guidelines. On the day of the inspection there was the registered manager and 2 support staff on duty. Issues relating to confidentiality are addressed during the induction period. All records are stored in a lockable office and there was no public display of confidential or personal information. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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): 12,13,15,16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Daily life generally meets the residents’ lifestyle preferences and expectations. Residents’ ability to engage in appropriate leisure activities could be compromised occasionally by lack of staff. Residents have regular contact with their families and friends and receive a nourishing and balanced diet. EVIDENCE: The residents are supported by the staff and management to participate in a range of activities and events for educational, recreational and therapeutic purposes. There is a weekly programme of activities and 2 of the residents said that they choose which activities they want to do. Residents may come and go as they please in the house and garden, subject to risk assessments. One resident said that she is expecting to go to college in September and also that she has applied for a job within the community. The manager and the resident Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 11 talked about how they would plan travelling to and from college. The residents also explained how they had looked at brochures and other information in order to choose and plan their holiday. The other resident’s holiday was planned by staff but with special attention to her likes and dislikes. Families and other visitors are encouraged and welcomed with restrictions placed only in accordance with specific requirements which have been previously identified in the care plan. Visitors may be received in the resident’s own room or in communal areas. One resident’s parents’ said that they are always made welcome and that the home keeps them informed of progress and changes. Staff said that meals are provided mainly based on residents’ likes, dislikes and choices, but also taking into account the need for a reasonably balanced diet. 2 residents said that they are regularly asked what they would like on the menu and that they accompany staff in shopping for food and other items. Residents also have the opportunity to prepare under supervision, or assist staff to prepare meals that they have chosen. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ choices over their care are respected. Residents’ care plans are reviewed and their health care needs are met. Residents are protected by the home’s policies and procedures for dealing with their medication EVIDENCE: All of the three residents who were either spoken to or around during the inspection were seen to be relaxed and comfortable interacting with staff. Staff referred to the importance of respecting residents’ privacy and dignity and how one resident has been supported in her personal relationships. Staff were also aware of issues concerning rights, choices and consent, and said they have had to be dealt with great sensitivity. Residents care plans and daily records referred to clear guidelines on providing support and monitoring health care and social care needs. There was evidence in residents’ files to show that residents’ needs have been closely monitored and that they have been referred for specialist help whenever necessary. The parents of one resident referred to the care and consideration shown by staff. The manager and two members of Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 13 staff spoken to showed a high level of awareness of residents’ needs and referred to various issues, such as medical, nutritional or communication assessments, being included in the care plans. One recently employed member of staff said that she had been instructed to read care plans during her induction period and that staff have to sign to acknowledge having read any important guidelines. The home has sound medication procedures. The manager and staff confirmed that all existing staff had recently undergone a 12 session medication training programme. One new staff said that only trained staff would administer medication unless under supervision, and that all staff have to read the procedures stored in the medication file. Medication was stored securely and appropriately. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 14 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 good. . This judgement has been made using available evidence including a visit to this service. Residents can be confident complaints will be listened to and dealt with appropriately and they will be protected from abuse. EVIDENCE: Although it was not possible to talk to all residents about how they felt, two residents said that they would feel comfortable telling staff about anything they are not happy with. Another resident’s parents also said the same. The manager and staff said that every effort is made to ensure that residents can communicate their feelings if they are not happy with something and that staff discuss how they can tell if someone is not happy. The home uses complaints forms that have been produced in a pictorial format and there was evidence to show that these have been used in the past by residents. The home has adult abuse procedures in place and staff confirmed that they have received training on adult protection. Staff were aware of the company’s “whistle blowing procedures” and each resident’s file also contained a copy of these procedures. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 15 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, 27 & 30 Quality in this outcome area is good. . This judgement has been made using available evidence including a visit to this service. Residents live in a homely,comfortable and safe environment. The home is hygienic and clean. EVIDENCE: The Home provides a comfortable and homely environment in which to live and work. All three residents showed me their rooms, which are well maintained, and furnished and decorated to a good standard. 2 residents said that they had helped choose their own colour schemes and the ornaments. The shared spaces are pleasant and appropriate for the activities of the home and there is an enclosed rear garden. The manager said that although the current residents do not have a need for adaptations or special equipment, this would be obtained if ever necessary. The home is well maintained but as the national minimum standard have developed, the existing toilet and bathroom facilities need to be improved and or extended in order to meet current safety, dignity and privacy considerations. Similarly, the current sleeping in facilities for staff do not meet current expectations as they involve the use of the residents’ facilities. The Manager explained that this issue has been looked at in the past, Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 16 and that an extension has been considered which would address these issues, but the plans have yet to be implemented. Maintenance certificates and records are up to date and there are no outstanding health and safety issues Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a team with a wide range of skills. Staffing numbers are appropriate to meet the service users’ needs and wishes. Recruitment practices are sound. Training provision and staff support is good. EVIDENCE: The manager and staff said that the current staff rota is adequate to meet residents’ care needs and ensure that residents can participate in any chosen activities. Night staffing also appears adequate and staff said that there are emergency on call systems in the event of an emergency. Staff confirmed that there are sound recruitment practices and that all staff have to be CRB checked and have verbal references prior to their employment, with subsequent written references. One recently recruited member of staff confirmed that she had received a comprehensive induction training with core issues covered initially and then further on-going training. Recent training has included medication and non aggressive crisis intervention. Staff said that they are encouraged to identify any particular training needs. Staff confirmed that Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 18 they receive regular supervision from the manager and there was a supervision programme on the notice board. The staff group has remained very stable over the years and staff described the ways that residents have benefited from this, eg in providing a stable and consistent environment. Staff also referred to the high level of team work, and on-going support from the Manager for work and personal issues affecting their work. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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. Residents are supported and protected by the effective management of the home. The company encourages input from residents and regularly reviews its procedures, thus benefiting the residents lifestyle and safety. Health and safety in the home is promoted. EVIDENCE: Staff said that residents’ views and feelings are regularly questioned and monitored, either through talking to them or through other forms of communication. One resident said that the home has residents’ meetings and that she and another resident enjoy talking about holidays and other activities. The manager said that quality assurance is given a high priority and any feedback from residents and/or their families is acted upon. The general Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 20 management of the home and completion of records are generally of a good standard. Staff said that the manager is very supportive. There were no obvious hazards around the home and there was evidence to show that health and safety issues are taken seriously eg restrictors on windows and staff ensuring that hazardous chemicals are locked away. The maintenance file also contained comprehensive risk assessments covering the premises, equipment and vehicles. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 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 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 4 X 3 X 3 X X 3 X Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA27 Good Practice Recommendations The current toilet and bathroom and sleeping in facilities need to be improved /extended to meet safety/dignity and privacy considerations. Eden Cottage DS0000023208.V299434.R01.S.doc Version 5.2 Page 23 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.V299434.R01.S.doc Version 5.2 Page 24 - 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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