Inspection on 17/10/07 for Houndstone Cottage

This inspection was carried out on 17th October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Houndstone Cottage 17/10/08

Houndstone Cottage 22/09/06

Houndstone Cottage 28/02/06

Houndstone Cottage 26/08/04

Similar services:

2 Perhaver Park

The Vicarage

Fairfields Country Rest Home

St George`s

5 Seafield Road

Credence House

Poldhu

Queensmount

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Houndstone Cottage Brympton Yeovil Somerset BA22 8TF Lead Inspector Judith McGregor-Harper Unannounced Inspection 17 October 2007 10:00 th Houndstone Cottage DS0000016215.V351332.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 Houndstone Cottage DS0000016215.V351332.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. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Houndstone Cottage Address Brympton Yeovil Somerset BA22 8TF 01935 421236 NA 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) Mrs Hilary Mary Graham Mrs Hilary Mary Graham Care Home 3 Category(ies) of Learning disability over 65 years of age (3), registration, with number Mental disorder, excluding learning disability or of places dementia (3), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3), Old age, not falling within any other category (3) Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION 3onditions of registration: 1. Registered for 3 persons in categories OP, LD (E), MD and MD (E) Date of last inspection 22nd September 2006 Brief Description of the Service: Houndstone Cottage is a family home providing up to three places for adults with mental health related needs. Mr and Mrs Graham, with support from their daughter, provide all the care and support. The service users have both lived at the home for approximately fourteen years and regard it as their home. The home is situated on the Western fringes of Yeovil within walking distance to shops and amenities. Houndstone Cottage is an old building of pleasing character, which is well maintained and decorated. The home also provides pleasant garden space for service users to access. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. We conducted the Key Inspection visit over one day. At the time of the inspection the care home providing a service to two people. There is one vacancy at the home, although the proprietors have no plans to admit into this bed. One registered room is below size requirements for national minimum standards. Prior to the inspection an Annual Quality Assurance self-assessment was sent to the home to complete. This was completed in parts and returned to the Commission. Surveys were also sent to people living at the home and care managers and GPs of people using the agency. The last key inspection of Houndstone Cottage was on the 22nd of September 2006. What the service does well: What has improved since the last inspection? There have been no physical changes to the home since the last inspection or changes in staffing or persons living at the home. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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 Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 1 and 3. Standards 2 and 4 are not currently applicable. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents know the home well and are involved in the daily routines. A Statement of Purpose and Service User’s Guide would not provide additional information about the home for them. Current residents are cared for well, receiving individual care and close supervision of care needs. EVIDENCE: Houndstone Cottage does not have a Statement of Purpose or Service User’s Guide. People living in the home were admitted prior to the Care Standards Act 2000 and the requirement to produce these documents. A Statement of Purpose and Service User’s Guide will need to be produced if the home intends to admit any new residents in order for them to make an informed decision whether to move into the home. Fee levels at the home are accepted at social services rates. The residents say they value the care and attention given at the home. Both residents have lived at the home for more than a decade. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 9 Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 6, 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home does not have written records in relation to risk taking or care planning. Although the value of such is limited when the Graham family provide the care having no written care plans may place service users at risk, if care has to be provided by additional staff, for example as a result of illness at the home. Written records would demonstrate professional accountability and provide an audit trail of care delivery at the home. EVIDENCE: Each resident has a file containing relevant letters and other pertinent care information such as consultant Doctor reviews or social worker correspondence. There are no structured, formalised care plans. Mrs. Graham was able to give a full and detailed verbal account of management of care for the people at the home over the last 12 months. This included sourcing Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 11 relevant community health and social care support for ongoing chronic or acute health needs for people at the home. A feedback card from the GP for residents indicated satisfaction with care management by the home. Members of the Graham family provide care at the home. One person who resides at the home is currently receiving hospital treatment as an in-patient. The residents are consulted daily regarding their participation for the routine of that day. Assessing risk of harm to the residents is done by thinking about issues and talking through strategies with residents. Community health care specialists are also consulted if a problem arises or a review is needed. Community health care reports of consultations and visits provide some records of risk management strategies. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 11, 12, 13, 14, 15, 16, and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in the daily routines and day planning for the home. This provides self-esteem and value to them. Mrs. Graham works hard to support her residents in maintaining their independence. EVIDENCE: The residents enjoy the activities and social contact at the day centre a couple times a week. Mrs. Graham provides home and community activities for rest of the time that residents are at home. Both spoke of their satisfaction with the care they receive and of the kindness of the Graham family members. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 13 Activities are provided both in and out of the home, although resident’s choices are currently self-limiting. Regular days out are offered and one person chooses to take an annual holiday. One person chooses not to go on holiday and they find it difficult being away from the home any length of time. Both people have regular contact with family members living locally. Residents have a private lounge, although they are treated as family members. They have unrestricted access to shared areas in the home and grounds. Meals are home cooked and residents choose meals that they like, this included the preparation of specialist meals to accommodate swallowing difficulties. The kitchen and dining room facilities at the home are of a high domestic standard. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 18, 19, and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents value the care and support provided at the home. They feel in safe hands. Health care needs are monitored by Mrs. Graham and she has sought appropriate community health care support where needed. EVIDENCE: The owners provide care support and residents can express preference to whom delivers care. Residents confirmed the owners respect their privacy. In discussion with Mrs. Graham and from a recent care management review it was established and confirmed that community health care professionals have been contacted for advisory visits, assessment of care needs and treatment where necessary since the last inspection. Letters from community health professionals were seen stored in the individual residents’ personal file. Mrs. Graham has managed the medication for the residents since their admission and both residents have previously said that they are happy for her Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 15 to do so. Medication is stored securely. It is managed in the same way as in a domestic situation. Mrs. Graham has arranged for appropriate review of people’s prescribed medicines over the last 12 months. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 22 and 23. Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The atmosphere at the home is relaxed and open to suggestions or expression of concerns by people living there. Residents reported that they could express concerns to the Grahams at any time. Problems are discussed in the home daily, if needed. EVIDENCE: No formal complaints have been made to the home since the last inspection. Mrs. Graham has a local policy on the Protection of Vulnerable Adults, should she need to refer to a procedure manual in ensuring the safety of residents. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 24, 25, 26, 27, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residential care is delivered in a home where the owners have pride in the quality of accommodation provided for all who live there. There have been no changes to the premises since the last inspection. EVIDENCE: Houndstone Cottage is a property of character on the western fringes of Yeovil. It is specifically used for physically able residents and affords a very high quality of accommodation. Of the three registered rooms, one is situated on the ground floor with two others on the first floor. One of the three rooms is small, but the resident who occupies this room is happy to remain in this room. The quality of furnishings in bedrooms and throughout the property is high. All registered bedrooms include seating and televisions. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 18 There is one ground floor bathroom, separate first floor shower room and separate toilet. All are decorated pleasingly and all were clean. Residents have choice of exclusive use of one lounge or to share other communal sitting spaces, including a conservatory. The garden is well maintained and is fully accessible for residents. The home currently meets the physical needs of residents without adaptations. The home was presented to an excellent domestic standard on the day of the inspection. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 31, 32 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Family members who know the residents well currently staff the home. This provides continuity of care by familiar faces. EVIDENCE: Mrs and Mr. Graham are the primary care givers with their daughter assisting occasionally. This is a family run business where residents are part of the family arrangements. None of the family has formal care qualifications but have years of experience with working with a range of residents. Individual attention is provided for residents and at least one family member carer always provides support for residents when they are at home. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): We inspected standards 37, 38, 39, 40, 41 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Mrs. Graham manages her home and the needs of residents in an effective way without formal qualifications. Residents have spoken highly of the personal qualities of Mrs and Mr Graham. The home produces very few records in keeping with the type of family run service. However from 2007 we have expected all registered services to adopt a more formal approach to quality assurance processes. EVIDENCE: Mrs. Graham has many years experience in the running of her care home. She demonstrates an open and honest approach to the management of her service. She is not formally qualified but is managing the current needs of her residents Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 21 effectively. To date she has sourced appropriate health care support for her residents as their needs fluctuate. An extended training course in mental health or a professional mental health qualification would give her additional skills and confidence in caring for residents with mental health needs; but Mrs. Graham has previously said that she has not any plans to undertake this level of commitment to a training course. The home does not have written policies and procedures. The home holds a copy of the Somerset guidance document on safeguarding vulnerable adults. On request the home returned an Annual Quality Assurance Assessment to the Commission. This document was completed in part. Due to ill health there have been periods during 2007 when the registered person has not been fit for work. We must be notified in writing if there are period beyond 28 days when this occurs with details of contingency care and management plans at the home. Smoke alarms are fitted and tested appropriately by Mr and Mrs Graham. The environment is clean and the standard of fixtures and fittings is high. Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 22 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 1 2 N/A 3 3 4 N/A 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 25 26 27 28 29 30 1 2 3 2 3 3 3 3 3 4 X 4 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 STAFFING Standard No Score 31 3 32 3 33 X 34 X 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000016215.V351332.R01.S.doc 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Houndstone Cottage Score 3 3 3 N/A 3 3 2 2 1 3 X Version 5.2 Page 23 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. 1 Standard YA41 Regulation 38 (4) (a) Requirement We must be informed in writing if the registered person is absent from the home or unfit for work for a period exceeding 28 days with details of contingency care and management plans for the home. Timescale for action 31/12/07 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 YA6 Good Practice Recommendations It is recommended that Mrs. Graham works with each resident’s social worker in formalising a written plan of care for each resident based on a risk assessment approach to current health and social care needs. It is recommended that the home develop a formal quality assurance system. This will assist in the completion of the Annual Quality Assurance Assessment required by the Commission. 2. YA39 Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Taunton Local Office Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Houndstone Cottage DS0000016215.V351332.R01.S.doc Version 5.2 Page 25 - 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. 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