Inspection on 22/09/06 for Houndstone Cottage

This inspection was carried out on 22nd September 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 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 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 17/10/07

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 Ms Sue Hale Unannounced Inspection 22nd September 2006 09:30 Houndstone Cottage DS0000016215.V306702.R02.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.V306702.R02.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.V306702.R02.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 (0), registration, with number Mental disorder, excluding learning disability or of places dementia (0), Mental Disorder, excluding learning disability or dementia - over 65 years of age (0), Old age, not falling within any other category (0) Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. REGISTERED FOR 3 PERSONS IN CATEGORIES OP, LD (E), MD AND MD (E) 28th February 2006 Date of last inspection 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 thirteen 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.V306702.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and was undertaken in two visits to enable the inspector to meet the two people currently living at the home. The home is registered to accommodate three residents but is not planning to have any more admissions. The inspector was able to see and to speak with both residents. No relatives were at the home during the inspection but both residents have regular contact with family members. Mrs. Graham, the proprietor and registered manager was at the home and she spent time discussing home issues with the inspector. The inspector looked at records and looked around the home. What the service does well: What has improved since the last inspection? What they could do better: One requirement is made as a result of this inspection. Mrs. Graham has a friend who is involved with the home, who may start to assist the Grahams in Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 6 providing care for the residents. Mrs Graham must see the satisfactory CRB disclosure if this happens. 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. Houndstone Cottage DS0000016215.V306702.R02.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.V306702.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 The quality of this outcome group is adequate. 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. A statement of purpose and service user’s guide would need to be produced and provided for any new admissions in order for them to make an informed decision whether to move into the home. Current residents are cared for well, receiving individual care and close supervision of care needs. The residents say they value the care and attention given at the home. Each resident has a current contract between the placement authority and the home. EVIDENCE: Houndstone Cottage does not have a statement of purpose or service user’s guide. The residents 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 Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 9 to admit any new residents, although Mrs Graham has stated that new residents will not be admitted. Both residents have lived at the home for more than a decade. Both spoke of their satisfaction with the care they receive and of the kindness of the Graham family members. Current contracts were seen for both residents. Houndstone Cottage DS0000016215.V306702.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 The quality of this outcome group is adequate. The home has not developed written care plans for residents, but the value of such is limited when the Graham family provide the care. Care planning must be implemented if the home admits further residents or employs non-family care staff and is recommended now as a way of recording risk in managing the health and social care of residents. Assessing the risk of resident’s behavioural needs is not recorded by the home. Community health care reports of consultations and visits provide some records of risk management strategies. 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 has a friend who does some cleaning at the home. This person may assist with care in the near future. Mrs. Graham needs to consider Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 11 providing written care plans for residents should the carer be lone working in the home with residents. Residents have a role in the household and both re-confirmed during the inspection that their choices are respected and that they understand if they are not permitted to act in certain ways that is upsetting to others in the house. 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. Houndstone Cottage DS0000016215.V306702.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,13,14,15,16,17 The quality of this outcome group is good. The residents enjoy the activities and social contact at the day centre. Mrs. Graham provides home and community activities for rest of the time that residents are at home. Resident’s 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 attend a local day centre three times a week and both spoke highly of the time they spent there. Activities are provided both in and out of the home, although resident’s choices are currently self-limiting. Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 13 One resident has had a summer holiday in Dorset with Mrs. Graham. Mr. Graham remained at the home providing 1:1 support for the other resident. One resident chooses not to go on holiday and they find it difficult being away form the home any length of time. Both residents 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. The kitchen and dining room facilities at the home are of a high domestic standard. Houndstone Cottage DS0000016215.V306702.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The quality of this outcome group is good. 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. Resident’s confirmed the owners respect their privacy. In discussion with Mrs. Graham and both residents it was established and confirmed that community health care professionals have been contacted for advisory visits, reviews and treatment where necessary since the last inspection. Letters from community health professionals were seen stored in the individual residents’ personal file. Both residents said that they felt well and that they can discuss their problems with Mrs and Mr. Graham or their daughter who is involved in their care. Mrs. Graham manages the medication for the residents and both residents 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. Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 15 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 The quality of this outcome group is good. Residents said that they could express concerns to the Grahams at any time. Problems are discussed in the home daily, if needed. 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: Residents said that they could talk about any problems or concerns to the Grahams. The CSCI local office telephone number is displayed in the home for residents to contact if they need to speak to an alternative person. The CSCI has received no complaints concerning to the home since the writing of the previous inspection report. The home has a copy of Somerset’s multi-agency Vulnerable Adults policy. Both residents have an allocated social worker to whom concerns can be raised. Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 16 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): 24,25,26,27,28,29,30 The quality of this outcome group is good. Residents live 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 says that they are 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. There is one ground floor bathroom, separate first floor shower room and separate toilet. All are decorated pleasingly and all were clean. Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 17 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.V306702.R02.S.doc Version 5.2 Page 18 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): 31,32,34,35 The quality of this outcome group is good. Family members and a family friend, who know the residents well, currently staff the home. This provides continuity of care by a familiar face. If Mrs. Graham employs a part-time care worker this will mean that care plans will need to be devised for residents so that an audit trail of care delivery can be monitored and that the staff member has clear guidelines to the needs of the residents 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. Mrs. Graham said that she had considered involving a friend in the home for some part time care duties in addition to occasional cleaning duties. This may not happen as the persons circumstances have changed. This person has known both residents for some time. They do not have a written job Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 19 description but Mrs. Graham has explained the job role and the person has known both residents socially for several years. This person has obtained a CRB disclosure but Mrs Graham has not yet seen this. Houndstone Cottage DS0000016215.V306702.R02.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,40,42,43 The quality of this outcome group is good. Mrs. Graham manages her home and the needs of residents in an effective way without formal qualifications. Residents spoke highly of the personal qualities of Mrs and Mr Graham. The home produces very few records but this is in keeping with the type of family run service. 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 effectively. To date she has sourced appropriate health care support for her residents as their needs fluctuate. An extended training course in mental Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 21 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. 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. Mrs. Graham reported verbally that the care home is financially viable. Mrs. Graham should consult with her insurer to the additional employer’s liability cover required for a part-time care worker if a worker is employed. Houndstone Cottage DS0000016215.V306702.R02.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 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 3 25 3 26 3 27 3 28 4 29 3 30 4 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 3 2 X LIFESTYLES Standard No Score 11 3 12 N/A 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 N/A 3 3 3 2 X 3 3 Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 23 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. Standard YA34 Regulation 19 (1) (b) (i) Requirement The registered provider must ensure that they see the CRB of the part-time cleaner/carer. Timescale for action 30/10/06 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 Mrs. Graham consult her insurer to the additional employer’s liability cover required for a parttime care worker. 2. YA42 Houndstone Cottage DS0000016215.V306702.R02.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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. Extracts may not be used or reproduced without the express permission of CSCI Houndstone Cottage DS0000016215.V306702.R02.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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