Inspection on 24/05/05 for Linden Cottage

This inspection was carried out on 24th May 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Linden Cottage 10/10/08

Linden Cottage 13/10/06

Linden Cottage 16/01/06

Linden Cottage 11/01/05

Linden Cottage 01/09/04

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

CARE HOME ADULTS 18-65 Linden Cottage Linden Chase Uckfield East Sussex TN22 1EE Lead Inspector Paul Endersby Unannounced 24 May 2005 9:30 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 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 Stationary 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. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Linden Cottage Address Linden Chase Uckfield East Sussex TN22 1EE 01825 763872 01825 763787 None Elizabeth Fitzroy Support Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Graham John Jerrom Care Home 6 Category(ies) of Learning Disability (LD), 6. registration, with number of places Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. The maximum service users to be accommodated is 6 2. Up to 4 residents may also have a physical disability Date of last inspection 11 January 2005 Brief Description of the Service: Linden Cottage provides care and accommodation for six people with a learning disability; up to four of them may also have a physical disability. The house is a detached property set in a quiet residential area of Uckfield. The High Street with its shops and access to bus and rail routes are a short level walk away. The building is a converted bungalow; ground floor accommodation is adapted to accommodate people who have a physical disability and require using a wheelchair. First floor accommodation is allocated to those service users who can manage stairs. There is a large rear garden with a patio and lawn area, most of which can be accessed by wheelchair users. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place during the morning and early afternoon in May 2005. The Inspector met with the registered manager and other staff plus most of the six residents living in the home. However due to their limited communication skills, it was not possible to have any conversations with them. The Inspector did however spend time with the residents observing them with members of staff. The Inspector also reviewed some of the care plans and other documentation including some records. The inspection lasted 5 hours. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 6 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 Standards Statutory Requirements Identified During the Inspection Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 7 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 standard(s) 2 & 4 The pre-admission procedure includes the assessment process and visits by prospective residents which provide information to ensure that the home is suitable for the needs of the resident and that these can be met by staff. EVIDENCE: No new residents have been admitted for over four years. However it is possible that a vacancy will occur in the coming months. In the event that this occurs, the manager demonstrated that he is aware of the standard requiring that a new resident should only be admitted after a full assessment involving both social services, or other placing/funding agencies, and relatives or other relevant parties. Relevant policies and procedures in regard to the preassessment and admission process are already in place. Within the home comprehensive assessments are undertaken out of which care plans are developed. The manager also confirmed that prospective residents would always make an introductory visit to the home prior to admission. These visits would range from short visits to overnight stays and would be part of the planned transition into Linden Cottage. The period after admission is looked upon as a trial period. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 8 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 standard(s) 7 & 9 The relationships developed by staff with residents and their experience and knowledge of individual residents ensures that decisions are in keeping with the wishes of residents. The risk assessment framework contributes to the safety of residents. EVIDENCE: The manager and staff try at all times to respect the right of residents to make decisions and providing them with choices in all areas of their daily lives. The staff team includes a core group who are experienced and long serving. The focus is on building relationships with residents and their families and friends. This includes understanding residents likes and dislikes through staff observation and experience. These are included in the care planning documentation. All but one of the residents have family involvement and contact. Due to lack of availability is there is no regular advocate/befriender for the one resident who has no family contact. The manager is the nominated ”appointee” for their benefits. A record of monies held was inspected at random and found to be in order with balances tallying with records. Detailed risk assessments that enable residents to take responsible risks in their daily lives are in place. A selection of these were inspected and were found to be of good quality. The practice is for action to be taken to address identified dangers and hazards. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 9 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 standard(s) 12, 13, 15 & 16 The culture and ethos of the home ensures that residents are able to participate in a range of activities both in house and in the community. Likewise, respect for residents and their rights is implicit in the ethos of the home. EVIDENCE: Several residents attend courses at local colleges. From discussions with staff and the examination of records the Inspector ascertained that residents are enabled, with staff assistance, to participate in activities in the local community. These include, local shops, pubs, restaurants, the swimming pool and cinema. In addition outings to places further afield using the home’s minibus are undertaken. The manager confirmed that staffing levels permit this at both evenings and weekends. Encouraging and enabling family contact is an integral part of the culture of the home. Visitors to Linden Cottage are made welcome and offered refreshments, including meals as appropriate. Care plans and reviews confirmed that routines of daily living encourage residents to retain their independence and learn new skills. Respect for residents is implicit in the ethos of the home and staff were observed to include residents in conversations. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 10 All rooms and bathrooms and WCs are fitted with locks to encourage privacy. Residents choose when to be alone or in company. Residents are also encouraged to contribute to the running of the home and within their capabilities undertake some household tasks. The approach taken by staff is to provide routines of daily living which encourage residents to retain their independence and to learn new skills. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 11 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 standard(s) 19 & 21 The arrangements made by staff ensure resident’s health needs are met. As far as possible appropriate action has been taken to respect residents wishes in the event of their death. EVIDENCE: All residents are registered with local GP surgeries. Records included in individual care plans confirmed that staff of the home liaise regularly with a wide range of healthcare professionals and that appropriate steps are taken to meet the healthcare needs. District nurses and other learning disability support services provide good support when required. Other agencies such as the Community Learning Disability Team and SENSE are accessed to help meet individual residents needs as required. Where possible staff discuss residents wishes or those of their representatives regarding arrangements to be made after death and record these appropriately. A policy on dying and death has been prepared for the guidance and instruction of staff. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 12 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 standard(s) 23 Arrangements for protecting residents from abuse and managing residents who self harm are satisfactory. EVIDENCE: The home has a policy on adult protection and whistle blowing. Appropriate training in adult abuse and adult protection is provided for staff. Written guidance is also in place for staff to follow should they encounter physical or verbal aggression from residents, or as is currently an issue with one resident, preventing a resident from self harm. All staff are subject to checks with the Criminal Records Bureau (CRB) prior to commencing work. The manager is aware of the requirements in regard to the Protection of Vulnerable Adults (POVA) lists. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 13 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 standard(s) 24, 26 & 30 The overall layout and décor of the building including bedrooms and shared space provides a safe and comfortable environment for residents. EVIDENCE: The premises are suitable to meet the stated purpose of the home. The building has been adapted to a high standard to provide care for adults with physical disabilities. The environment is comfortable, well maintained and safe. The home is positioned within easy reach of local facilities and shops. All areas of the ground floor and garden are accessible to service users who use wheelchairs. The two service users who live on the first floor are able to manage stairs. Furniture and fittings are good quality. There are regular inspections by the Fire Brigade and Environmental Health Department. There is a planned maintenance schedule. All bedrooms have adequate furniture and fittings, including specialist equipment for people with physical disabilities. Residents can bring in their own possessions and bedrooms are furnished in a way which reflects their needs and interests. The premises were clean and hygienic throughout. The laundry is well sited, away from food preparation and serving areas. It has an impervious floor and hand washing facilities. The washing machine can wash foul linen at appropriate temperatures. No policies in regard to infection control were available. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 14 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 & 36 The staff training and supervision programme together with the collective experience of the team provides effective support to residents. The recruitment procedures need improvements to ensure maximum safety for residents. EVIDENCE: One staff member has completed NVQ2 and NVQ3 and four others are currently studying NVQ 2 or above. Over and above this there is a comprehensive induction and foundation training programme available to staff. This is then supplemented by regular training focused on the needs of individual residents. Staff undertake the Learning Disability Award Framework Induction and Foundation levels. All this contributes to staff knowledge of the disabilities and specific conditions of service users. Staff have professional relationships with a wide range of other disciplines who are included in the quality assurance surveys. The examination of staff records regarding recruitment procedures showed that generally correct recruitment procedures are followed when new staff are employed. This includes the use of application forms, the following up of two references and the issuing to staff of contracts of employment. However gaps in employment records are not always explored and recorded. Staff have been issued with the code of conduct and practice set by the General Social Care Council (GSCC). Staff receive formal supervision at least six times a year by the manager or one of the assistant managers all of who have undertaken specific training on supervision. All staff have annual appraisals with their line manager. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 15 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 39 & 40 The senior management of the home ensure the home is well run and for the benefit of residents. Evidence for this includes the quality assurance system and the relevant policies and procedures. EVIDENCE: The manager has been registered since November 2003. He has been studying for the Registered Manager’s Award (RMA) and hopes to complete the training very shortly. The manager has previously qualified as an NVQ Assessor. The two assistant managers have some specific responsibilities. One oversees health and safety matters and the other day care issues. Staff meetings are held on a monthly basis, and minutes are kept and are available to staff. There is an active quality assurance process which includes sending questionnaires to residents, relatives and professionals who are involved in meeting service users needs. The purpose is to ascertain their view of the service provided by the home. However the results have not been published and made generally available. Whilst an external manager makes regular monthly visits, these visits are normally pre-arranged. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 16 A selection of policies and procedures required by the national minimum standards were inspected, and with the exception of the lack of a policy in regard to infection control, all were found to be satisfactory. All policies and procedures are accessible to staff. They are regularly reviewed at the organizations head office and updated as required. Current residents would not be able to participate in the formulation of new policies and procedures. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x 3 x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Linden Cottage Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score 3 x 2 3 x x x H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 18 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 34 Regulation 19(1)(a) (i)& Schedule 2(1-6) 26(2)(3) Timescale for action Recruitment of staff must comply 24.05.2005 with the Care Homes Regulations 2001 and the National Minimum Standards. The monthly visits made on 24.05.2005 behalf of the registered provider must be unannounced. Requirement 2. 39 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. 2. 3. Refer to Standard 30 32 39 Good Practice Recommendations A policy on infection control should be prepared for the guidance and instruction of staff. That 50 of care staff achieve a care NVQ2 by 2005. (Recommendation from the last two inspections). Results of quality assurance surveys should be published. Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 19 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Linden Cottage H59-H10 S21403 Linden Cottage V225721 240505 Stage 4.doc Version 1.20 Page 20 - 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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