Inspection on 07/03/06 for Freehold Cottage

This inspection was carried out on 7th March 2006.

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

Freehold Cottage 05/02/09

Freehold Cottage 28/02/07

Freehold Cottage 28/09/05

Freehold Cottage 07/12/04

Freehold Cottage 27/04/04

Freehold Cottage 16/01/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Freehold Cottage 452 Market Street Shawforth Rochdale Lancashire OL12 8JB Lead Inspector Mrs Marie Dickinson Unannounced Inspection 7th March 2006 10:30 Freehold Cottage DS0000009524.V276105.R02.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 Freehold Cottage DS0000009524.V276105.R02.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. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Freehold Cottage Address 452 Market Street Shawforth Rochdale Lancashire OL12 8JB 01706 853384 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) kiaran@gmail.com Mr Kiaran Desmond Burke Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/09/05 Brief Description of the Service: Freehold Cottage is registered to provide accommodation and personal care for six adults with a mental illness. The home is a large detached cottage style building with a garden area to the rear of the house. It is situated on the Market Street a short distance by car /public transport to all local amenities such as shops, post office, library, pubs etc and is situated on a main bus route to neighbouring towns such as Manchester, Rochdale, Bury and Bacup. The home is owned and managed by Mr Kiaran Burke with the support of senior staff. Residents accommodation is in six single bedrooms on the first floor. Ground floor living arrangements include a lounge, dining area, laundry and kitchen for residents use. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on 7th and 17th March 2006. It is the second statutory inspection carried out this year. During the inspection, time was spent talking to the people who live at the home and staff on duty. Information was obtained from staff records, care records and policies and procedures. A tour of the premises was also carried out. What the service does well: People are admitted to the home properly. Professional people helped arrange the care that was needed and staff were trained to support people with daily living, as they required. One new resident said she visited the home on a number of occasions and ‘couldn’t wait to live there’. Residents benefited from a good standard of care planning. This enabled them to receive the correct support from medical and social professionals. Care staff had clear guidance in what each person needed. Residents lived their lives in a meaningful way that suited them and helped them with personal development. Activities were also personal to them and they had the opportunity to make important decisions about their lives. They learned new skills. Resident’s views on daily living were positive, comments included ‘I can do what I want’ and ‘I like living here’ and ‘staff help’. Relatives were kept informed of progress residents made where needed and were invited to take part in care reviews if the resident wished. Relatives and other visitors were made very welcome. Residents living at the home benefited having their own policies and procedures. They also had information on their rights. They received guidance in how to keep safe and had their own house rules to follow. Sufficient staff were employed who were supervised in their work. Teamwork was noticeable and staff employed said they enjoyed their work and chosen career. Residents viewed carers as treating them well. They felt ‘safe.’ Staff were trained in caring for people with mental health problems, and given other training as part of their professional development. This included important topics such as abuse of vulnerable adults and health and safety. The home was very well managed and run in the interests of the residents. They had their say in how the home was managed. What they said mattered. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 6 The home was nicely decorated and residents accommodation suited them. 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. Freehold Cottage DS0000009524.V276105.R02.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 Freehold Cottage DS0000009524.V276105.R02.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): 1,2,3,4,5 Information about the home was available. Procedures were in place for residents to be admitted in a proper manner. Proper use of assessment information planned for resident being admitted. Sufficient information was recorded to write a plan of care. People living at the home had a written contract. EVIDENCE: There had been one new admission since the last inspection. The new resident explained how she knew about the home and the process of planning her admission. Her social worker had been involved in helping her. She had visited the home and met with the other people living there. These types of contact such as short visits were encouraged and if the placement is agreed a settling in period of stay is offered. The new resident said she liked the room that was vacant and decided herself she wanted to live there. She said she had meetings with the owner of the home to discuss how staff would help her. She also said she talked to her family as well. A copy of the new residents assessments completed by health and social care professionals and a care plan for mental health needs were available to look at. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 9 Together these documents provided a clear and detailed picture of what approach to meeting identified needs were required. There was more evidence in other residents completed assessments; people are visited prior to their admission. Assessments had taken into account the resident’s needs in relation to the type of home environment, staffing levels and current residents living at the home. Contracts were given to residents. Staff were long serving and had received training to care for people with mental health problems. Records showed they worked with other professional people in caring for residents, such as community psychiatric nurses, psychologists and psychiatrists. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 10 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): 6,7,8,9 Residents assessed needs were recorded in detail. Being involved in writing their own care plans meant residents personal goals were recognised and staff knew how to help them achieve these safely. Essential information, policies and procedures and regular contact with Mr Burke, helped residents to be involved in important issues of life in the home. A confidentiality policy informed them of the principle of keeping their records private. EVIDENCE: The standard of residents’ care records was very good. Assessment of needs was reviewed regularly and completed over several meetings. Residents discussed their care plans. There were clear directions for staff as to the type and amount of support each resident needed. Specialist help required for residents was identified, and details of this support was recorded. Restrictions on residents doing what they liked that may cause them problems was recorded and agreed with them. Residents understood how these agreements helped them. Issues around having any restriction were Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 11 discussed with the new resident. She said she understood how these were important to her to ‘manage her life’. Residents benefited from being involved in writing their own care plans. They had meetings with staff and the owner to discuss what they would like to achieve and set goals to reach. The care plan written for the new admission had been written to combine health and social care. Information included strengths and needs, and showed who had a particular responsibility to help reach the desired outcome. In addition to this a contingency plan was written to support staff in taking the right action if the resident was ‘not well’. Residents benefited from this level of support from staff. Residents looked after their own money with the help of staff. This was recorded in their files showing how support was to be offered. When residents are admitted to the home they are given their own handbook with information such as policies and procedures. Everything residents needed to know was outlined in the book, which was easy to read. Decision-making was encouraged and residents were given time to consider the individual choices they made. Information that showed how people might be at risk was clearly written. Action required to reduce the risk was also recorded and agreed with each resident individually. A crisis plan was in place for staff to follow if needed. During the inspection it was clear staff considered confidentiality of resident information and records to be important. This was included in induction training and the staff handbook. Individual records were kept secure in the office. Residents had information on confidentiality given to them. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 12 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): 11,12,13,14,15,16,17 Residents were given opportunities to live a lifestyle that suited them. This included social activities and learning new skills for personal development. Residents were helped to keep in touch with their families and friends. Residents were provided with a nutritious and varied diet. EVIDENCE: Care planning was used to help people living in the home have opportunities to learn and use practical skills. Records showed how support networks were identified such as counsellor, community psychiatric nurse, staff and other residents. Resident’s views about their opportunities to take part in activities remained positive. The did what they wanted to do and what they were comfortable going to clubs, day centres, swimming or just going out for shopping. Residents were able to make full use of community facilities if they wished. To get out and about residents used public transport or staff took them out in their cars. One resident set off to a day centre on the bus during inspection. He Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 13 said he knew the times they passed the home and which one would get him to where he was going. The resident most recently admitted to the home said she enjoyed baking, tapestry work and looking after her new pet rabbit. Activities were definitely people’s own choice. Written into their contract was the option of a seven-day holiday they could choose and plan. Records showed family links and friendships were kept up for residents. The resident recently admitted said her mum and dad visited. In addition to this the owner of the home had arranged a friend to visit and go out with. Visitors to the home were made welcome and visits could be made in private. The home was managed in a manner to avoid any institutional routines. Letters were delivered unopened and during the course of the inspection, staff working in the home treated residents with respect. Residents had their preferred name stated on their plan. They had locks on their doors and managed their own keys. They said they spent time in their bedroom when they wanted, and had agreed flexible times for going to bed and getting up. Meals and meal times was a relaxed event. During inspection one resident made her own sandwich for dinner. The kitchen was being refurbished and residents discussed how they were managing their cooking. Everything was working out well and one resident said ‘he enjoyed the curry he had the other night’. Residents decided their own menus and staff helped to prepare and cook food. Residents learning independent skills made meals. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 14 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 Individual preferred routines likes and dislikes allowed residents to enjoy personal care in a dignified way. The healthcare of residents was monitored and medication practice and procedures protected residents. EVIDENCE: All the residents were involved in the inspection. They discussed general living in the home. They said routine was special to them. Individual records were kept, outlining what each person liked doing and the encouragement given from staff. Residents said they liked the staff and were happy with how they helped them. This included staff helping with personal care. The range of support varied for each resident. This was recorded in care plans and daily records Part of residents care included links with other professionals for example mental health care. Residents confirmed staff spoke to other professional people about their care with them. This included healthcare and part of the staff role was to help them attend medical appointments. Routine health care was evidenced in records. All service users were registered with a General Practitioner. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 15 Records also included information about service users medication, and what staff should be aware of if someone was not well. Residents could self medicate following an assessment to make sure this would be safe. Medication was recorded correctly. Staff had attended training with the supplying pharmacist. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 16 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 Residents felt their interests were protected. They were confident Mr Burke and staff dealt with complaints properly. Adult protection procedures were in place. EVIDENCE: Residents in the home were aware they had the right to make a complaint should the need occur and were confident Mr. Burke or the staff would listen to them. The complaints procedure assured residents their ‘complaints would be taken seriously’. Residents had the opinion their rights were protected and they felt safe living at the home. Records showed how the adult protection procedures were followed for example, as part of staff recruitment staff are not allowed to gain financially from residents. Staff were familiar with protection issues, clearly recording any area of vulnerability residents had and how to protect them. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 17 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): 24,25,28,30 Residents lived in a homely environment, which they said they liked. Their rooms were private. The home was furnished and decorated to a good standard. Standards of hygiene were also good. EVIDENCE: Freehold cottage is a detached property situated just off the main Road running through the town of Whitworth. It is located near to a bus route that services towns such as Rossendale Valley, Rochdale and Bacup. Improvement needed in the residents’ accommodation had been made. This included decoration of all resident’s bedrooms, lounge, staircase and bathrooms. Residents were very pleased with the outcome and had helped in choosing colour schemes. The kitchen was currently being completely refurbished and dining room furniture met with residents needs. The home was clean and residents felt ‘at home’ and were ‘happy’ with their accommodation. They had their own bedrooms. In addition to these being re decorated, they had been provided with new beds and carpets in their rooms. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 18 To complete the upgrade of the premises a games room was being created for the residents. They said they were ‘pleased’ about this and were going to play pool when it was ready. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 19 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): 32,33,34, Good staff recruitment procedures were in place. Resident benefited the right support from staff they liked. EVIDENCE: The home was fully staffed during the inspection. The current level of staffing hours provided was linked to the needs of the residents currently living at the home. Staff were clear about their roles and responsibilities. There had been no new staff employed since the last inspection. One position was vacant and residents were involved in the recruitment process. This included interviewing staff over a period of time to make sure residents had an opportunity to meet with them and give an opinion if they thought the applicant would be right to work at the home. Recruitment policies and procedures and practice showed how residents were protected. Residents were very happy with the staff in the home. They said they had time for them, and were involved in ‘home life’. They knew them well as they had worked in the home for a long time. Both staff on duty discussed their role as support workers and what was involved in caring for people with mental health problems. They had relevant Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 20 training to help them. It was clear they had a good positive relationship with the residents. In their discussions with residents during inspection, both staff showed they were knowledgeable about individual needs and were sensitive and respectful to them at all times. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 21 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): 37,39,41,42 Residents and staff were happy with the way the home was managed. Guidance and support was given to staff. Residents and staff had regular contact with the owner and had their say in running the home. The health, safety and welfare of residents, was promoted and protected. EVIDENCE: Mr Burke has many years experience looking after people with a mental health problem. He runs the home with the help of carers. He works in the home and has regular contact with the people who live and work there. Staff and residents share in the running of the home. They discuss issues on a regular basis and everyone knows their particular responsibilities. Staff said they had meetings and had supervision. In completing quality monitoring an audit on how the home was run is carried out. The results of these are available for people to look at. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 22 Records required in managing the home and those belonging to residents and staff were kept safe. Policies and procedures had been updated and made available for staff and residents. The health and safety of residents was safeguarded. Policies for safe working practices and staff instructions in fire safety were available. New fire procedures had been written for residents to place in their bedrooms as a reminder what to do to keep themselves and others safe. Routine servicing and testing of essential household services and safety equipment was carried out. Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 23 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 3 2 3 3 3 4 3 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 2 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X 3 3 X Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 24 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. Refer to Standard Good Practice Recommendations Freehold Cottage DS0000009524.V276105.R02.S.doc Version 5.1 Page 25 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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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