Inspection on 29/11/05 for Field Cottage

This inspection was carried out on 29th 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Field Cottage 26/01/09

Field Cottage 31/01/07

Field Cottage 01/08/05

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Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

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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 Unannounced Inspection 29th November 2005 4pm Field Cottage DS0000063859.V255775.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 Field Cottage DS0000063859.V255775.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. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 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 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) East Sussex County Council Vacant Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is seven (7). Service users must be aged between eighteen (18) and sixty-five (65) years on admission. Service users with a learning disability only to be accommodated. Date of last inspection 1st August 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 toilet 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. East Sussex County Council Social Services Department is the Registered Provider of Field Cottage. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 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 unannounced inspection took place over two and a half hours on 29 November 2005. This is the second inspection of this year and therefore this report should be read in conjunction with the report from the announced inspection carried out on 01 August 2005. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. A tour of the premises took place, menus, activity timetables and medication records were inspected. The Inspector met with all seven tenants and had longer conversations with five of them. The Team Leader and staff member on duty were spoken with throughout the inspection and the Inspector joined all parties in the kitchen/dining room for the evening meal. The home does not currently have a Registered Manager. A Team Leader has been in post now for five months and it is a requirement from this inspection that a Manager for this service is put forward for registration. What the service does well: Field Cottage continues to be a relaxed and friendly home which is run completely for the benefit of the people who live there. The inspection occurred over the early evening period and it was observed that the tenants lead busy, fulfilling and exciting lives. The way day services are structured for the tenants at Field Cottage, enable them to participate in the running of the home and maximise opportunities for social inclusion. The Inspector was particularly impressed with the way the home had developed activity timetables for both day and evening periods. It was again evident that tenants are given choice about their lives at the home. This is especially true for mealtimes. The weekly menu is devised by a different tenant choosing the evening meal each day. One tenant had requested to join ‘slimming world’ and it was encouraging to see a separate menu had been drawn up with this individual to enable full participation in this diet. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 6 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. Field Cottage DS0000063859.V255775.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 Field Cottage DS0000063859.V255775.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): 2 Tenants benefit from an ongoing assessment and reviewing process that ensures their needs and aspirations can be met. EVIDENCE: Field Cottage has not admitted any new tenants since the last inspection, therefore this Standard was assessed in respect of the way the two tenants who moved to the home at the beginning of 2005 have settled in. The review records for both these tenants were inspected and there was documentary evidence that both people had settled in well at Field Cottage. For one tenant, the progress made had led to a reduction in the medication they had previously needed to take. It was observed throughout the inspection that both individuals were comfortable at the home and had positive interactions with the other people who live and work at Field Cottage. One of these tenants told the Inspector that “he liked living here”. Field Cottage DS0000063859.V255775.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): 10 Tenants benefit from the knowledge that their information is handled appropriately and that their privacy is respected. EVIDENCE: Throughout the inspection process it was observed that staff respected tenants’ rights to confidentiality and privacy. Written information is stored appropriately. Field Cottage DS0000063859.V255775.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): 14, 16 & 17 Tenants benefit from the opportunity to lead active and fulfilling lives, where their rights and responsibilities are recognised each day. Tenants enjoy a variety of healthy, balanced and nutritious meals. EVIDENCE: The tenants at Field Cottage continue to lead busy and fulfilling lives. There was documentary evidence that activities are planned both during the day and evening. On the day of inspection, six tenants had accessed formal day services provided by a variety of local day centres and colleges. One tenant informed the Inspector that “Tuesday is my home day and I chose to go out”. At the start of the inspection, tenants were choosing their evening activity, with one going to a music and drama club and two going bowling in Brighton. All tenants have recently been on holiday to Cornwall. This was arranged in two groups of two tenants and one group of three. Each group spent a week away and the feedback was positive from all parties. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 11 Throughout the inspection, tenants were observed moving freely around the home and their involvement in domestic tasks has generated a feeling of ownership over the environment in which they live. One tenant provided the Inspector with a tour of the home and it was noted that this person was respectful of other tenants’ bedrooms. The Inspector joined the tenants and staff for their evening meal, which was observed to be a relaxed and friendly occasion. Each day a different tenant chooses the evening meal and on this day, one tenant had chosen spaghetti bolognaise. Two dishes had been prepared, one using minced meat and the other a vegetarian option to reflect individual preferences. The meal was plentiful, well presented and enjoyed by all. The home continues to support one tenant with a healthy eating diet and a separate menu has been produced with this tenant, although they always have the choice of eating the meal selected by other tenants if preferred. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 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 Tenants are protected by the individualised system in place for managing medication. EVIDENCE: The storage and administration of medication were found to be satisfactory. Records are accurate and current. Each tenant has 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. It was noted that on one occasion correction fluid had been used on the Medication Administration Record (MAR Sheet) where a signature had been placed in the wrong place. This was discussed with the Team Leader, who has agreed to introduce another system for indicating errors. Field Cottage DS0000063859.V255775.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): EVIDENCE: These Standards were not assessed at this inspection, although requirements made at the inspection in respect of complaints and adult protection procedures were found to have been complied with. Field Cottage DS0000063859.V255775.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): 24 & 30 Field Cottage is an appropriate environment for the people who live there. The home would be significantly more homely if the bathroom facilities were refurbished. 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 toilet 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 previous inspections and it was pleasing to note that the new lounge furniture has arrived which greatly improves this room. The Team Leader has taken personal responsibility for the re-decoration of the kitchen/dining room and this area looks considerably better. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 15 It is disappointing that the promised upgrade of the bathroom facilities is still outstanding. The Team Leader has confirmed that numerous requests have been made to the Housing Association who own the property, but that the work has again been delayed until the next financial year. These facilities are now not only visually uninviting, but also malodorous. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 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): 31, 34 & 36 Tenants benefit from a committed and competent team of staff. Tenants would be further protected if the Team Leader could evidence that staff had been appropriately recruited. EVIDENCE: The Team Leader informed the Inspector that all staff had received copies of their job descriptions, along with their contracts of employment upon entry to the service. Throughout the inspection, it was observed that tenants received the support they needed from the staff on duty. Staff recruitment files are still 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 two inspections and is reaffirmed in this report, that evidence be available in the home to demonstrate that correct recruitment procedures have been followed. The Team Leader confirmed that she provides monthly supervision to all staff. A record of when these sessions had been conducted were viewed. The Team Leader has received training in providing effective supervision and reported that the sessions were going well. Field Cottage DS0000063859.V255775.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): 37, 38, 39 & 42 Tenants benefit from an inclusive and well-managed home, but would be further protected if the Manager was registered. Tenants would be better protected if fire safety issues were addressed. EVIDENCE: Field Cottage does not currently have a Registered Manager in post. A Team Leader has been in post for five months and there was evidence that the home is being effectively managed and that the service continues to improve. Field Cottage has had a number of leaders in the last 12 months and the home has now achieved some stability in respect of management. It is therefore required that the Registered Provider formalise the managements arrangements at Field Cottage and put forward an application for the registration of a manager. The home has a number of systems in place to gain feedback about the service and include all stakeholders in the running of the home. Regular tenants’ meetings are held and these are chaired by an external advocate. Satisfaction Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 18 questionnaires are carried out on an annual basis with each tenant and the results published for all interested parties. Monthly monitoring visits are carried out on behalf of the Registered Provider, however these are not always being forwarded to the Commission and this needs to be addressed. During the inspection it was identified that a number of communal doors were propped open with door wedges. The Team Leader explained the reason for this and that appropriate door fittings were due to arrive in the next few weeks. An Immediate Requirement was left in respect of fire safety and it has been required that a risk assessment be undertaken and advice from the Fire Brigade be sought in the interim period. Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 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 X 3 X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score 3 X X X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Field Cottage Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 2 3 2 X X 2 X DS0000063859.V255775.R01.S.doc Version 5.0 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 YA20 YA24 Regulation 13(2) 23(2)(b)(d) 16(2)(k) 19 &Sch 2 as amended Requirement The administration of medication to be appropriately recorded. All areas of the home to be maintained in a good state of repair. (Previous timescale of 01 October 2005 not met) 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 timescales of 30 May 2005 and 01 October 2005 not met) The CSCI to receive an application for the registration of a Manager. Copies of monthly visits in accordance with Regulation 26 to be forwarded to the CSCI without delay. The home to liaise with the Fire Brigade and compile a risk assessment in respect of the fire doors propped open in the interim period before door gurads are fitted. Timescale for action 05/12/05 01/03/05 3 YA34 20/01/06 4 5 YA37 YA39 8(1)(a) 26 01/01/06 01/01/06 6 YA42 23(4) 29/11/05 Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 21 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Field Cottage DS0000063859.V255775.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Sussex Area Office 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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