Inspection on 01/08/05 for Field Cottage

This inspection was carried out on 1st August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Field Cottage 26/01/09

Field Cottage 31/01/07

Field Cottage 29/11/05

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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 Field Cottage 17 Harrisons Lane Ringmer East Sussex BN8 5LL Lead Inspector Lucy Green Announced 1 August 2005 14:00 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. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Field Cottage Address 17 Harrisons Lane Ringmer East Sussex BN8 5LL 01273 814016 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) East Sussex County Council Vacant Care Home 7 Category(ies) of Learning Disability (LD) 7 registration, with number of places Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum number of service users to be accommodated is seven (7). 2. Service users must be aged between eighteen (18) and sixty-five (65) years on admission. 3. Service users with a learning disability only to be accommodated. Date of last inspection 08 February 2005 Brief Description of the Service: Field Cottage is registered to provide residential care to seven younger adults with a learning disability. The home is a two-storey property situated in a quiet residential area of Ringmer. The location of the home offers easy access to village shops and other local amenities. The home has a vehicle and public transport links are within easy walking distance. Tenant accommodation is provided by seven single rooms, which have been individually decorated and furnished. One bedroom provides ensuite facilities. Communal areas comprise of a lounge and kitchen/dining room. A large garden is situated to the rear of the home. Tenants access a range of leisure and day services offered by local colleges and organisations. Since the last inspection, East Sussex County Council Social Services Department have become the Registered Provider of Field Cottage. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The reader should be aware that the Care Standards Act 2000 and Care Homes Regulations 2001, uses the term ‘service user’ to describe those living in care home settings. For the purpose of this report, those living at Field Cottage have requested to be referred to as ‘tenants’. This announced inspection took place over three and a quarter hours on 01 August 2005. This is the first statutory inspection of this year. The purpose of this inspection was to meet with residents and staff and to generally monitor care practices at the home. A tour of the premises took place, rotas and care records were inspected. Six of the seven residents, a staff member on duty, the Team Leader and Resource Officer were spoken with. Comment cards were left for residents, visitors and General Practitioners and seven had been returned at the time of writing this report. The home does not currently have a Registered Manager. A Team Leader has been appointed who is responsible for the daily running of the home with support from a Resource Officer. It is anticipated that this person will be put forward for registration in due course. What the service does well: What has improved since the last inspection? The home has made a number of improvements since the last inspection, of particular importance is the recruitment of a Team Leader. A lot of work has gone into the updating of documentation and records and the plans in place to support tenants are greatly improved. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 6 The Team Leader was able to demonstrate that other areas identified at the last inspection are currently being dealt with. As such, new furniture for the lounge has been ordered and there are plans in place to refurbish the bathroom. Fire safety awareness in the home has been improved through the updating of risk assessments and door closers being ordered for those doors which were previously propped open. 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. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 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 Field Cottage H59-H10 S63859 Field Cottage V226018 010805 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) 1 The documentation in place enables both current and prospective tenants to know what they can expect from a placement at Field Cottage. EVIDENCE: The home has a comprehensive Statement of Purpose in place which provides the reader with a synopsis about the services provided at Field Cottage. This document has recently been reviewed and updated to reflect changes to service. A Licence Agreement now provides prospective and current tenants with accessible information about life at the home and incorporates the rights and responsibilities attached to living at Field Cottage. The Licence Agreement has been produced using pictures and photographs which are meaningful to the people who live at the home. A copy of the Licence Agreement is contained in each tenants’ care plan and the Team Leader confirmed that staff have explained this document to each tenant. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 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, 8 & 9 Tenants are protected and enabled by the documentation in place to support them. Tenants are encouraged to take measured risks in order to develop skills and lead active and fulfilling lives. EVIDENCE: The Inspector tracked the care provided for two tenants living at Field Cottage. As part of this process, the care plans for these tenants and other supporting documentation were viewed. There was documentary evidence that a lot of work has been done on developing the plans of care since the last inspection. The two care plans viewed, had recently been compiled in the format of a ‘Lifestyle Plan’. There was evidence that the tenants had been involved in producing the plans with their keyworker. Both care plans viewed included a pen portrait of the person outlining their strengths, needs, likes and dislikes. The plans contained comprehensive information about how each tenant should be supported, with guidelines in place explaining how care should be delivered. The plans were individually focused and it was possible to track how daily support was linked to developing goals and working towards independence. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 10 Each tenant had a range of risk assessments in place which outlined the safety of a range of activities and the controls in place to manage any risk. The Team Leader was able to demonstrate that an enabling approach to risk assessment is taken. There was evidence to reflect that care plans are regularly reviewed with all relevant parties. The review minutes inspected confirmed that information is reviewed at least every six months. The documentation available highlighted that tenants are actively involved in the running of Field Cottage. Activity and support plans showed that tenants are involved in all domestic areas including; the preparation of meals, shopping, cleaning of the home and the laundering of clothes. The philosophy at Field Cottage is that the home belongs to the tenants and therefore they each share the responsibility for the running of the home. The home holds regular tenants’ meetings where all parties have the opportunity to discuss issues within the home and make decisions about menus, decorating the home and the success of outings and holidays. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 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 standard(s) 11, 12, 13, 14, 15 & 17 Tenants benefit from a flexible plan of activities which enables individuals to choose how to spend their time. Tenants enjoy a variety of well-balanced meals. EVIDENCE: The tenants at Field Cottage continue to lead active lives. The activity timetables for two tenants were viewed and found that they both participate in a range of appropriate and fulfilling activities. Both tenants attend courses at local day services. The tenants are involved in the running of the home and consequently time is built into their schedules for undertaking household tasks. Each tenant has one day each week where they are supported with household tasks and a chosen 1-1 activity. The tenants at Field Cottage also participate in a range of evening activities, including swimming, slimming world and other social outings. Field Cottage does not provide staffed holidays however, holidays to a specialist venue, where staffing is provided has proved a successful alternative. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 12 The care plans focus on maximising opportunities for social development and this is reflected in the way tenants spend their time. During the inspection, one tenant was supported by a staff member to prepare the evening meal. The home has a positive approach to supporting tenants to maintain relationships with both families and friends. Tenants have regular home visits and staff support tenants to send cards and letters and arrange meetings with friends and families. Comment cards were sent out to relatives and three had been returned at the time of this report. The consensus of opinion was that relatives were satisfied with the overall care provided at Field Cottage, with one relative commenting; “I am very happy with the way staff look after my relative”. Tenants are supported to plan and prepare meals. The menus are arranged on a weekly basis following consultation with the tenants. The menu displayed showed a range of varied and balanced meals. It was observed that tenants who wish to have something different to the menu are offered an alternative. Specialist diets, including healthy eating diets are catered for. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 Staff have the knowledge and experience to ensure healthcare needs are fully met. Tenants are protected by the systems in place to manage medication. EVIDENCE: Tenants are encouraged and supported to manage their own personal care. The role of staff is primarily to prompt tenants as necessary. There is evidence in the care plans that staff support is offered in a sensitive and respectful manner. Risk assessments are in place to ensure the safety of residents at all times. Staff support residents to ensure their health needs are met. Care plans contain a record of any visits or contact with healthcare professionals. The Inspector received two completed comment cards from local General Practitioners which highlighted satisfaction with the way staff support tenants with their healthcare needs. The storage and administration of medication were found to be satisfactory. Records are accurate and current. Each tenant has a their own medication file which contains information about the potential side affects of their medication and the criteria for when each medicine should be administered. Staff receive appropriate training in the management of medication. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 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 standard(s) 22 & 23 Tenants benefit from a culture where their views are sought and listened to. Systems are in place to protect tenants from abuse. EVIDENCE: The home has a standard complaints procedure compiled by East Sussex County Council. There have been no logged complaints about Field Cottage since the last inspection. Tenants are regularly visited by an external advocate who could support them to make a complaint if necessary. Two comment cards received from relatives stated that they were not aware of the home’s complaint policy and it is therefore required that the home consider how this issue can be addressed. The home has a number of systems in place to protect tenants from abuse, including obtaining satisfactory checks from the Criminal Records Bureau prior to staff commencing employment in the home. Tenants are supported to manage their finances and the records are maintained. The receipts and logging records for two tenants were viewed and found to be accurately maintained. The home has a copy of the East Sussex, Brighton & Hove Multi-Agency Policies and Procedures for the Protection of Vulnerable Adults, however it is required that the home draft its own policy on adult protection to include the updated roles and responsibilities and contact details for the relevant agencies. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 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 standard(s) 24 & 30 Field Cottage is an appropriate environment for the people who live there. Tenants will benefit from the planned refurbishment of the bathroom and delivery of new lounge furniture. EVIDENCE: Field Cottage is a two-storey property situated in a quiet residential area of Ringmer. The location of the home offers easy access to village shops and other local amenities. Tenant accommodation is provided by seven single rooms, which have been individually decorated and furnished. One bedroom provides ensuite facilities. Communal areas comprise of a lounge and kitchen/dining room. A large garden is situated to the rear of the home. A number of maintenance issues were raised at the last inspection and these were discussed with the Team Leader and Resource Officer for the home. It was confirmed that there is a plan in place for the upgrading of the bathroom and new furniture for the lounge was awaiting delivery. When these are completed, Field Cottage will be a more homely environment. At the time of the inspection, the home was found to be clean and hygienic throughout. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 & 35 Tenants benefit from a committed and competent team of staff. Tenants would be further protected if the Manager could evidence that staff had been appropriately recruited. EVIDENCE: At the time of the inspection, the Team Leader confirmed that with the exception of one part-time vacancy, the home was fully staffed. The rota indicated that staffing levels reflected those outlined in the Statement of Purpose. Two comment cards received from relatives stated that there were not always sufficient staff on duty and this issue was raised with the Team Leader. It was stated that whilst the home had recently experienced staffing shortages, posts had now been filled and the home was now operating on correct staffing levels. The rota allows flexibility for staffing levels to be increased or reduced according to activities and the number of tenants at the home. Minimum staffing levels provide three staff in the morning, two in the afternoon and one sleep-in person at night. The home was calm and relaxed on the day of the inspection and there were sufficient staff to meet the needs of the tenants. Staff training is ongoing at Field Cottage and at the time of the inspection three staff members had completed National Vocational Qualifications and the Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 17 Team Leader confirmed that other staff would be soon commencing this qualification. New staff to Field Cottage have undertaken appropriate induction and foundation training. Staff recruitment files are currently stored at East Sussex County Council Personnel department and therefore it was not possible to view these documents at this time. It was a requirement of the last inspection and is reaffirmed in this report, that evidence be available in the home to demonstrate that correct recruitment procedures have been followed. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 18 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) 42 Tenants benefit from a safe and well managed home. EVIDENCE: Field Cottage does not currently have a Registered Manager in post. A Team Leader was however appointed in April of this year, who is being overseen by a Resource Officer. There was evidence throughout the inspection that a lot of work has been undertaken since the last inspection to meet the required standards. The outcome of this inspection, is that the home is being appropriately managed. Various systems are in place to ensure the Health and Safety of the home are maintained. Several safety audits were viewed and found to be accurately maintained. A designated staff member has completed appropriate fire training which is now being cascaded to other team members. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 19 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 3 x x x x Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 3 2 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Field Cottage Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 22 23 Regulation 22 13(6) Requirement The home to ensure all stakeholders are aware of the complaints procedure. The adult protection policy and procedure to be developed to reflect current local guidance on protecting vulnerable adults. (Previous timescale of 01 April 2005 not met) All areas of the home to be maintained in a good state of repair. Staff files to contain the information required by the Care Homes Regulations.The information as listed in Schedule 4 to be available at the home for inspection at all times. (Previous timescale of 30 May 2005 not met) Timescale for action 01 October 2005 01 October 2005 3. 4. 24 34 23(2)(b)& (d) 19, Schedule 2 as amended and Schedule 4 01 October 2005 01 October 2005 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. Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 21 Refer to Standard Good Practice Recommendations Field Cottage H59-H10 S63859 Field Cottage V226018 010805 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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. 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