Inspection on 16/06/08 for Maple Cottage

This inspection was carried out on 16th June 2008.

CSCI found this care home to be providing an Excellent 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

Maple Cottage 31/08/06

Maple Cottage 05/08/05

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Maple Cottage Maple Cottage 208 Send Road Send Surrey GU23 7EN Lead Inspector Suzanne Magnier Unannounced Inspection 16th June 2008 10:00 Maple Cottage DS0000013711.V365442.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 Maple Cottage DS0000013711.V365442.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. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Maple Cottage Address Maple Cottage 208 Send Road Send Surrey GU23 7EN 01483 772168 01483 740100 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) Mr G Enderby Mrs W A Enderby Mrs W A Enderby Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st August 2006 Brief Description of the Service: Maple Cottage is a Victorian cottage in the village of Send near Woking. Maple Cottage is a family home and has a domestic atmosphere. The home provides care to one service user, who has their own bedroom and access to a range of areas around the home. Parking is available on a nearby street, and the home is near to the village shops. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the person who uses this service experiences excellent quality outcomes. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the care home was an unannounced ‘Key Inspection’. Some additional standards have been assessed and the outcomes included within the report. Ms S Magnier Regulation Inspector carried out the inspection and the registered persons Mr and Mrs Enderby represented the service. For the purpose of the report the person using the service is referred to as the service user. The inspector arrived at the service at 10.00 and was in the home for two hours. It was a thorough look at how well the home is doing. It took into account detailed information provided by the home and any information that CSCI has received about the service since the last inspection. The service user does not use formal speech to communicate, so responses were assessed by observing facial expressions, body language, listening and requesting the registered persons to interpret the service users own way of communicating. The Commission received responses to the Annual Quality Assurance Assesssment (AQAA) sent prior to the inspection which reflects some comments made during the last inspection in August 2006. The inspector looked at how well the service was meeting the standards set by the government and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the service users care plan, and risk assessments, support plans and medication procedures, documents relating to fire safety precautions and a document sent by the Commission for Social Care Inspection (CSCI) to the home the regarding publication of reports. The commission have not received or been made aware of any notifications of complaints or safeguarding vulnerable adults referrals since the previous inspection. From the evidence seen by the inspector it is considered that the home is able to provide a service, which promotes diverse religious, racial or cultural needs of the service user. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were made as result of this inspection. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 7 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. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 8 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 Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 9 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): 2. The service user who uses the service experiences good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The homes records demonstrate that the service users needs are well monitored, changes identified and actions implemented in order to ensure and promote their welfare and wellbeing. EVIDENCE: The home continues to offer a service to one service user. Records within the care plan demonstrated that the home continues to make sure that the service users needs are met on a daily basis. Written documentation, in the form of reviews, was available to evidence that changes in the service users care and support needs were clearly documented and any actions following the review to ensure the individuals welfare and well being were also clearly recorded. The Annual Quality Assurance Assessment (AQAA) advises that no new individuals have been or are planned to be taking up residence at the registered premises. Maple Cottage DS0000013711.V365442.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, 9. The service user who uses the service experiences excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The service users support and personal care needs are well documented. The care being provided is reviewed to ensure that their needs continue to be met. The management of risk assessments promotes the service users rights to safety and best interests. EVIDENCE: During the inspection the registered persons demonstrated a good understanding of the service user and reinforced that the home is run as a family home with the emphasis being person centred towards the individual in their care. It was observed that the service user using the service had control over their life and moved freely around the home. The care plan was clear in setting out goals and achievements, which included developing skills with their own personal care and building and maintaining personal relationships that the individual chose to participate in. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 11 The care plan was up to date and was based on a full holistic assessment. The documentation included the service users strenghts and preferences as well as references to their diversity. The care plan included a lot of documentaion regarding the service users health care needs and it was evident that the registered person and the service user have maintined strong links with healthcare professionals in order to promote the service users health and well being. There was evidence that a see-read co-ordinator has supported the service user with their communication abilities and the individuals preferred communication style was clearly recorded within the care plan. It was observed that the consistent individualised support from the providers has had positive outcomes for the individual. As reported in previous inspections undertaken by the commission the standard of care planning has been maintained at a high level and therefore the home has continued to exceed this standard. Some risk assessments were available and were sampled by the inspector and the provider advised that the assessments were developed alongside the support from a healthcare professional and were reviewed as part of the individual’s annual review. The care plan documented ways to reduce particular hazards which were documented positively within the service user’s care plan, which promoted their best interests and safety. The providers have maintained close and supportive links with healthcare professionals and other people within the local community and demonstrated an ability to recognise when to seek support from others to continue to meet the service users needs. Maple Cottage DS0000013711.V365442.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): 12, 13, 15, 16, 17. The service user who uses the service experiences excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The service user is able to exercise choice about their lifestyle and is supported to develop their life skills through a consistent and predictable routine. Meaningful relationships are promoted and maintained. The individual’s rights are central to the care and support being provided. A healthy and balanced diet is available. EVIDENCE: During discussion with the registered persons they explained that the service user is supported throughout a twenty- four hour period and thus support is available when the individual requires it. The home has continued to exceed the National Minimum Standards for younger adults in that the daily routines of the home have been sustained to promote the service users right to live an ordinary and meaningful life in a way that is directed by them. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 13 A purpose built sensory/relaxation room with large settees and floor cushions continues to be available for the service user and during the inspection they took time to be in the room. The room is well decorated in neutral colours to offer a calming and relaxing atmosphere and has a large television screen, bubble tube and access to the enclosed secluded rear garden. The registered persons advised that the service user is seen as part of the family and has continued to maintain relationships with their own family, friends and family members and a range of health professionals, and other professionals and these links and opportunities remain a positive experience for the service user. The registered providers explained that the homes gas cooker was not functional and they were waiting for an engineer to visit the home. This had resulted in the kitchen area being disorganised as worktops and drawers had been emptied to accommodate space for the engineer to undertake the work. Meals continue to be prepared and taken in a domestic manner. It was observed that the service user had access to the homes fridges and was able to communicate in their own way that they wanted to have a drink, which was readily made available. Due to the flexibility of the service the service user is enabled to make their own choices about when they wish to take meals and the registered providers give assistance and support when necessary. The service is aware of and appreciate the need for a balanced and healthy diet and the service users body weight is measured regularly to support general good health. Maple Cottage DS0000013711.V365442.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, 20. The service user who uses the service experiences excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The service users physical, emotional and health care needs are robustly monitored and met and their choice and dignity is consistently promoted. Medication procedures ensure that medication is administered in a safe and appropriate way. EVIDENCE: Whilst sampling the service users care plan and related documents it was observed that the registered persons have maintained clear written guidelines that give information about how the service user likes to be supported and how they will communicate their preferences regarding personal and healthcare support. The guidelines demonstrated that care is provided in a flexible and consistent manner with gender preference being if the service user preferred. It was evident through sampling the care plan that the registered providers continue to support and encourage the service user to develop and maintain their independence skills, with personal support being offered as required. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 15 During the inspection there was evidence of flexibility and due to other occurrences in the home it was observed that the registered providers were alert to the changes in mood, and behaviour of the service user and how they should respond and take action. As previously documented a range of health professionals continue to be involved in the ongoing health care support needs of the service user and visits to the local General Practitioner (GP) and domiciliary services have been maintained and records of visits sampled during the inspection. The inspector sampled the secured orderly medication cupboard in the home. The local chemist supplies the home with the service users medication. The home’s records evidenced that the ordering, returns and stock taking of medicines were robust. During the sampling of the medication administration charts it was observed that there were no gaps in any of the medication administration sheets. The AQAA indicates that no controlled medicines are stored in the home. There was evidence, through sampling some documents relating to medication reviews from health care specialists, that changes made to the service users medication are closely monitored and the parameters of the use of prescribed as required medicines would continue to be closely monitored by the registered providers. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The service user who uses the service experiences excellent quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The ethos of the home promotes the service user to express their concerns, which are listened to and acted upon and their rights to be protected from harm and abuse are robust. EVIDENCE: During the inspection it was evident that the registered providers in their response to the service user take their views seriously and the providers are clear when an incident needs to be referred to the local multi agency safeguarding team. The registered providers are committed to the continual promotion of the service users human rights in order to safeguard and protect the individual. The AQAA advises that no complaints or safeguarding concerns have been received since the last inspection and the commission have not received information regarding these topics from external sources. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27,30. The service user who uses the service experiences good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The physical design and layout of the home enables the service user to live in a safe, well maintained and comfortable environment which encourages their independence. EVIDENCE: The registered providers home continues to offer the service user a familiar, safe, clean and comfortable environment where the individual can be supported as part of the family and have access to all parts of the home. The home is cosy and a secluded garden is available for the service user to safely use. The home has several pets, which the registered providers explained the service user engages with on their terms. During the tour of the home the inspector was shown the service users bedroom, which was personalised, clean and contained items of interest and Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 18 leisure, appropriate furnishings, furniture and bed linen. A bed leaving alarm has been fitted in order to ensure that when the individual leaves their bed during the night the registered providers are alerted in order to offer support should the individual need assistance. The bathing/toilet facilities, which the service user can access are a shower room which also includes a deep shower tray. Facilities for washing and drying clothes were available and were observed to be in working order. The service user has free access to all areas of the home. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. The service user who uses the service experiences good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The registered providers are the sole members of staff and are competent, and effective in providing support to the service user to ensure the smooth running of the service. EVIDENCE: The home’s staff comprise of the registered providers. The AQAA advises that no staff have been or will be recruited to the home. The service user has been living at the home for several years and the providers are proactive in planning for the individuals needs. There was evidence throughout the inspection that the registered providers demonstrated a good understanding of the particular needs of the service user and provided effective person centred care. The registered manager confirmed that they had achieved their National Vocational Qualification (NVQ) Level 2 and 3, which incorporated the statutory training. Maple Cottage DS0000013711.V365442.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, 39, 42. The service user who uses the service experiences good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The management and administration of the home is robust. The home is run in the best interests of the service user and their views and opinions and those of others associated with the home are taken into account. The service users general health, safety and welfare is promoted within the safe environment. EVIDENCE: As previously documented throughout the report the home is run by the registered providers and the service lives as a member of the family. The person centred approach to care has assisted the service user to live a life that reflects their individuality and offers freedom of choice. Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 21 The commission acknowledge that the service user would not be able to complete a quality assurance questionnaire in writing yet it was observed throughout the inspection that they were capable of communicating their needs to the registered persons and getting those needs met. There are maintained links with a variety of healthcare professionals, friends and relatives associated to the service user and the registered provider advised that these visitors to home spoke favourably about the service offered. The home continues to maintain the health and safety and welfare of the service user and the inspector was assured that health and safety checks were completed by the home. Following the previous inspection in August 2006 the fire department have confirmed in writing to the home that the home follow the premises fire precautions laid out within the Government publication for Adult Placement Schemes even though the premises are registered as a care home. Maple Cottage DS0000013711.V365442.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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 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 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 3 X 3 X X 3 X Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Maple Cottage DS0000013711.V365442.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. 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