Inspection on 17/10/08 for Houndstone Cottage

This inspection was carried out on 17th October 2008.

CSCI found this care home to be providing an Adequate service.

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

Houndstone Cottage 17/10/07

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 31/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Houndstone Cottage Houndstone Cottage Brympton Yeovil Somerset BA22 8TF     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Justine Button     Date: 1 7 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 23 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 23 Information about the care home Name of care home: Address: Houndstone Cottage Houndstone Cottage Brympton Yeovil Somerset BA22 8TF 01935421236 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Hilary Mary Graham care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Registered for 3 persons in categories OP, LD (E), MD and MD (E) Date of last inspection Brief description of the care home 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 user has lived at the home for approximately fourteen years and regards it as her 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. 0 3 0 Over 65 3 3 3 Care Homes for Older People Page 4 of 23 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We conducted the Key Inspection visit over one day. At the time of the inspection the care home providing a service to one person. The providers are currently considering if they are going to fill the remaining vacancies at the home. 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 has yet to be completed and returned to us, although it should be appreciated that this document does not fit well with the service provided at this home. Surveys were also sent to people living at the home and care managers and Care Homes for Older People Page 5 of 23 GPs of people using the agency. The last key inspection of Houndstone Cottage was on the 17th October 2007 . What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 7 of 23 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 23 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Houndstone Cottage does not have a Statement of Purpose or Service Users Guide. The individual living in the home was admitted prior to the Care Standards Act 2000 and the requirement to produce these documents. A Statement of Purpose and Service Users Guide would be advised if the home intends to admit any new residents in order for them to make an informed decision whether to move into the home. Given the small nature of the home, however, any admission would be person centered and the potential individual would be able to visits the home prior to moving in. Any person considering moving into the home would have to be relatively mobile as the bedroom is on the first floor and no stair lift is available Fee levels at the home are accepted at social services rates. Care Homes for Older People Page 9 of 23 Evidence: Residents know the home well and are involved in the daily routines. A Statement of Purpose and Service Users 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. Care Homes for Older People Page 10 of 23 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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, formalized care plans. Mrs. Graham was able to give a full and detailed verbal account of management of care for the person at the home over the last 12 months. This included sourcing relevant community health and social care support for ongoing chronic or acute health needs for people at the home. Members of the Graham family provide care at the home. Assessing risk of harm to the residents is done by thinking about issues and talking through strategies with them. 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. Mrs. Graham has managed the medication for the residents since their admission and residents have previously said that they are happy for her 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 peoples prescribed medicines over the Care Homes for Older People Page 11 of 23 Judgement: last 12 months. Evidence: 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. Care Homes for Older People Page 12 of 23 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The residents enjoy the activities and social contact at the day center a couple times a week. Mrs Graham provides home and community activities for rest of the time including shopping and trips to Cafes and pubs. Activities are provided both in and out of the home, although residents choices are currently self-limiting. Regular days out are offered 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. Evidence: 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 Care Homes for Older People Page 13 of 23 Evidence: residents in maintaining their independence. Care Homes for Older People Page 14 of 23 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: 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. Care Homes for Older People Page 15 of 23 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. The quality of furnishings in bedrooms and throughout the property is high. All registered bedrooms include seating and televisions. 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. Care Homes for Older People Page 16 of 23 Evidence: 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. Any person considering moving into the home must have moderate to good mobility as the only room available is on the upper floor and there is no stair lift available. Care Homes for Older People Page 17 of 23 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. Evidence: Family members who know the residents well currently staff the home. This provides continuity of care by familiar faces. Care Homes for Older People Page 18 of 23 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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 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. 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. Care Homes for Older People Page 19 of 23 Judgement: Evidence: 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. Care Homes for Older People Page 20 of 23 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 21 of 23 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 It is recommended that if any person is being consider for admission to the home that written information is made available to them. It is recommended that Mrs. Graham works with the residents social worker in formalizing a written plan of care for the individual based on a risk assessment approach to current health and social care needs. 2 7 Care Homes for Older People Page 22 of 23 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 23 of 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!