Inspection on 20/03/07 for Keeper`s Cottage

This inspection was carried out on 20th March 2007.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Keeper`s Cottage 21/02/06

Keeper`s Cottage 15/09/05

Keeper`s Cottage 23/03/05

Keeper`s Cottage 22/06/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Keeper`s Cottage Rear Of 7 Gibraltar Lane Laceby Grimsby North East Lincs DN37 7AU Lead Inspector Stephen Robertshaw Unannounced Inspection 20th March 2007 09:30 Keeper`s Cottage DS0000002924.V334604.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 Keeper`s Cottage DS0000002924.V334604.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. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keeper`s Cottage Address Rear Of 7 Gibraltar Lane Laceby Grimsby North East Lincs DN37 7AU 01472 871017 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) thecliftons@keeperscottage.org.uk Mr Donald Ashley Clifton Mrs Andrea Gillian Clifton Mrs Andrea Gillian Clifton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st February 2006 Brief Description of the Service: Keepers Cottage is a care home providing personal care and accommodation for two adults with learning disabilities. The home is owned by Mr and Mrs Clifton and Mrs Clifton is the registered manager. The accommodation is provided in a large bungalow sited in a residential area in the village of Laceby. It is close to shops and local amenities with public transport links to the nearby town of Grimsby. The service users have their own bedrooms and share a lounge, kitchen/dining room, conservatory and bathroom facilities. There is a large, very well maintained garden and ample parking provided. The home does not intend to admit any new service users to the home. A copy of previous inspection reports are available to service users and visitors to the home. The current fees for care provided in the home £319 per week. The levels of care to be provided for this fee are detailed in the home’s statement of purpose and service user guide. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit took place on the 22nd March 2007. The home were given short notice of the inspection to allow for the service users to be at home at the time of the site visit. The evidence included in this report was provided through a pre-inspection questionnaire returned to the Commission by the management of the home, two family surveys, observation of documentation at the home, a tour of the premises, discussions with service users, management and staff. All of the key standards were inspected. The inspector was in the home for approximately four hours. What the service does well: What has improved since the last inspection? What they could do better: The manager of the home refuses to undertake the Registered Managers Award and none of the staff receive any of the mandatory training to make sure that they have the necessary knowledge and skills to care for the service users. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 6 Some of the documentation in the home could be improved to support the evidence that the service users’ needs can be met at the home. This included the daily diary records and the home also needs to develop their own individual care plans for the service users. 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. Keeper`s Cottage DS0000002924.V334604.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 Keeper`s Cottage DS0000002924.V334604.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): 1,2,3,4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that prospective service users would be provided with sufficient information about the home that would help them make a decision about if it was the right home for them. EVIDENCE: The home has an up to date service user guide and statement of purpose. At the time of the site visit there were two service users living at the home, and the proprietors confirmed to the inspector that they do not intend to admit any other service users to the home. Both service users had an assessment of their needs completed before they were admitted in to the home. The assessments had been completed through their placing authorities. There was evidence to support that the local authorities evaluate their assessments on a minimum of an annual basis with the home. The service users both confirmed to the inspector that the home is able to meet all of their needs and that they were ‘very happy’ there. The staff training records do not support that the staff have the necessary skills and knowledge Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 9 to care for the service users appropriately. However direct observation showed that they communicate with the service users very effectively and appear to understand all of their needs. The service users both told the inspector that they had been given the opportunity to visit the home before they made the decision to move there on a more permanent basis. Each of the service users care files included a tenancy agreement that had been provided through their placing authorities. Keeper`s Cottage DS0000002924.V334604.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): 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. Service users’ personal needs and choices are met at the home, however the lack of care plans and detailed daily records could compromise this particularly as the service users become more dependent on the staff due to their age. EVIDENCE: The service users’ care files included care plans that had been produced through their assessments of needs and had also been completed by the funding authorities. There was no evidence shown to the inspector that the home has developed individual care plans for the service users that determines how their care must be provided at the home. The service users have responsibility for keeping their own rooms tidy and although their washing is completed for them they are supported to complete their own ironing. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 11 The home had completed some risk assessments in relation to the individual risks posed by the service users however the information recorded was very brief and basic. There is no restriction in the movement of the service users The management of the home completes daily records for the service users. These records are very basic and merely record if the service users had ‘been to town’ or similar events. They do not detail the feelings or emotional responses of the service users. This makes it difficult to identify if there are any patterns of behaviour for the service users or if they are happy with the care that they receive. The manager of the home stated that she believed that the diary records were sufficient as the service users were very settled at the home and there were no behaviour or other problems for them. The inspector re-confirmed that in their opinion the diary records should be more explicit and detail the events that the service users become involved in. The manager and staff at the home were observed listening to the service users and respecting their right to make decisions in relation to their daily lives at the home. The service users confirmed to the inspector that they are responsible for their own finances, although one of them said that they needed support from the staff to maintain their finances appropriately. Both service users have individual bank accounts at a local bank. Clear records were in place in relation to the service users individual bank accounts and all of their transactions and also of their Department of Work and Pensions allowances. All of the confidential records in the home were securely stored and limited access to them. Both service users understood that records were kept in relation to their care at the home and that they could access it if they wanted to, however both said that they did not wish to do this. The service users also have their own files that they keep all of the records of their personal achievements in. The service users confirmed to the inspector that they are involved in the decision-making processes in the home. This included what activities they wanted to become involved in and where they wanted to go on their annual holiday. Keeper`s Cottage DS0000002924.V334604.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): 11,12,13,14,15 and 16 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the service users are provided with the opportunity to develop their personal lifestyles at the home, this ensures that they have fulfilling social lives and have good access to the local community and facilities. EVIDENCE: The service users both have the capacity to use public transport by themselves, and use the local transport system on a regular basis. The service users have a full week of activities including work experience and education opportunities. The service users were very positive in relation to how free they are to follow their own interests. The manager of the home stated that if the service users want to try new activities in the community they will be offered appropriate levels of support until they are comfortable enough to attend the activities by themselves. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 13 Both service users also attend the barbers, local shops, public houses and banks by themselves. They said that they know all of the people in the local shops and pubs and ‘get on well’ with them’. Every Friday evening the service user go out for a meal and they have meals from local take away restaurants. Both service users have received training in horticulture and gardening and help to keep the homes gardens tidy free of weeds. The service users confirmed that they did this out of their own choice and added that they enjoyed gardening although one of the service users agreed with the manager that they at times needed encouragement to work in the garden. The service users also told the inspector how they enjoyed the annual holiday from the home. They said that they had been to Spain, Italy and France and that they were looking forward to this years holiday. Both of the service users have up to date passports to allow them to travel out of the country on holiday. The service users also told the inspector how they like to catch a bus in to Grimsby where they walk around the shops and amusements and have a meal in a café. Both service users also said that if they did not receive much encouragement to join in activities either in the home or in the community they would sit and watch television all day. The care files supported the evidence that the service users have regular contact with their families and friends. Mealtimes are relaxed and the service users help to choose the weekly menus. They both told the inspector that their favourite meal of the week was the ‘Sunday roast’. They said that they always enjoy their meals and although they had previously undertaken some independence training in relation to the preparation of meals, they both preferred not to continue with this in the home. The manager of the home stated that she tries to maintain a healthy diet for the service users and includes lots of fresh fruit and vegetables in their diets. Keeper`s Cottage DS0000002924.V334604.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): 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. This means that the service users personal and healthcare needs are met at the home. EVIDENCE: At the time of the site visit neither of the service users living at the home were in receipt of any prescribed medication. One of the service users had a slight cold and the manager of the home told them that they could have some homely remedies whilst he waited for an appointment with his GP. Both service users’ care files provided evidence that they receive an annual flu inoculation. The care files’ diary notes identified when service users saw any healthcare professionals including GP’s, dentists and opticians. The manager confirmed to the inspector that both service user remain in good health and this was confirmed in the inspectors discussions with the service users. Keeper`s Cottage DS0000002924.V334604.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users are protected from possible abusive situations at the home. EVIDENCE: There had been no complaints or concerns recorded in the home or with the Commission in relation to the service since the last inspection. The service users spoken to by the inspector said that they knew who to talk to if they had any concerns about their care or their personal lifestyles. There had been no reports to the local multi agency protection team and all of the staff had received protection of vulnerable adult training that had been provided through the local authority. The manager appeared to understand the protocols for the protection of vulnerable adults and was able to show that the home had a copy of the local multi agency agreement in relation to the protection of vulnerable adults. Keeper`s Cottage DS0000002924.V334604.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users live in a home that is well maintained and provides a homely atmosphere. EVIDENCE: The inspector toured the premises and found them to be very clean and they were free of any offensive odours. The service users stated that they helped to keep the home ‘clean and tidy’ and they ‘enjoyed’ doing this. The home was well decorated and this helped to create a friendly and homely environment. Both service users showed the inspector their personal rooms and they appeared to be very proud of them. The rooms had been decorated and furnished to their individual tastes and preferences. Appropriate safety certificates were in position for the gas and electrical systems in the home. The fire system is also regularly serviced and maintained Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 17 to make sure that the home is safe for the service users to live in. The washing machine was domestic in character and was programmable to disinfection and sluicing standards. There is a sitting room and a dining room that the service users can use to socialise, however they both enjoy having their own company for much of the time in their own rooms. One of the service users has chosen to have a television and games machine in his room. In the sitting room the manager provided a new DVD player for the service users to watch their favourite films and programmes on. The manager also stated that she hopes to be able to provide a personal computer for the service users in the near future. Keeper`s Cottage DS0000002924.V334604.R01.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This means that there are sufficient staff to care for the service users, however there is no evidence to support that they receive appropriate training to make sure that they can appropriately care for the service users. EVIDENCE: The home does not employ any other staff except for the proprietors. There are two members of staff that cover any holiday periods for the proprietors and they have both received Criminal Reference Bureau clearances. This helps to ensure that health and safety of the service users. Although the staff at the home appear to understand the needs of the service users and are able to support them, they do not receive any of the mandatory training that would support the care that they offer in the home. The service users stated to the inspector that the manager and staff at the home support them with all of their needs. Surveys returned to the Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 19 Commission by the service users families also supported that the staff have the necessary skills and knowledge to care for the service users. There are no formal recorded supervision sessions for the staff to make sure that they understand the needs of the service users and to identify any training that they may require to help to support the service users living at the home. Keeper`s Cottage DS0000002924.V334604.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): 37,38,39,41,42 and 43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This means that the manager of the home understands the needs of the service users but refuses to update her knowledge and skills in caring for individual service users. EVIDENCE: The registered manager of the home holds a formal social work qualification the Certificate in Social Services. She has over twenty years’ experience of social work both in the field and in residential settings. The manager of the home refuses to undertake the Registered Manager’s Award. This award is the basic award that the government has set for all residential and nursing home managers. The manager of the home stated that her social work qualification Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 21 was far above the Registered Manager’s Award and therefore did not understand why she should have to undertake this training. The management approach to the home is open, positive and inclusive The service users appeared to be very comfortable with the manager of the home. The atmosphere between them was very relaxed and informal and there was a lot of friendly banter between them. There was evidence that the home takes into account other peoples views in relation to the services that are provided there, however there did not appear to be any formal quality assurance and monitoring system at the home. All of the appropriate maintenance and safety records for the home were up to date and in position. This included the maintenance and servicing of the fire system, the gas appliances and the water system to ensure that the home was safe for the service users to live in. Keeper`s Cottage DS0000002924.V334604.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 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 4 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 2 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 4 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 3 2 X 3 3 3 Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 24 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 YA6 Regulation Requirement Timescale for action 30/05/07 2. YA6 3. YA33 YA35 4. YA36 Keeper`s Cottage 15.1,2a,b,c The management of the home and d must develop individual care plans for the service users that detail how their needs must be met through the homes services. These care plans should be evaluated on a regular basis to make sure that they are still appropriate to the needs of the service users. These care plans should be supportive of the needs identified in the care plans provided through the funding authorities. 17.1a The registered person must 30/05/07 develop the service users diary records further to identify any patterns of behaviour and to support the care provided to the service users on a daily basis. This would also help to provide supporting evidence that the service users care plans are being followed. 18.1a,b,c, The registered person must 30/08/07 i, ii make sure that the staff working in the home receive the appropriate mandatory and service specific training to make sure that they can meet the needs of the service users. 18.2 The registered person must 30/05/07 ensure that any staff working in the home receive appropriate levels of recorded supervision to make sure that they are able to meet the needs of the service DS0000002924.V334604.R01.S.doc Version 5.2 Page 25 users, and their personal and training needs are identified. 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 YA37 Good Practice Recommendations As previously recommended the registered manager of the home should refresh and update her training including the Registered Managers Award to make sure that she has the necessary knowledge and skills to care for the service users and manage the home. Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 Keeper`s Cottage DS0000002924.V334604.R01.S.doc Version 5.2 Page 27 - 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!