Inspection on 21/10/05 for Moss Cottage

This inspection was carried out on 21st October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moss Cottage 12/05/06

Moss Cottage 31/01/06

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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 Moss Cottage 7 Western Road Liss Hampshire GU33 7AG Lead Inspector John Vaughan Unannounced Inspection 21st October 2005 11:10 Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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 Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Moss Cottage Address 7 Western Road Liss Hampshire GU33 7AG 01730 894 242 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) www.c-i-c.co.uk Community Integrated Care Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4), Physical disability (1), of places Physical disability over 65 years of age (1) Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users admitted to the home must have a Learning Disability. Date of last inspection Brief Description of the Service: Moss Cottage is a small residential service providing care and support to four adults with a learning disability. Community Integrated Care provides the care and support and the building is owned by the health authority who are responsible for the maintenance of the property. The home is located in a residential street and is indistinguishable from the other houses in the street. The home is close to the shops in the small village of Liss in a rural part of Hampshire. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector met with service users and staff in the home and toured the building assisted at times by service users. A sample of records was examined during the visit. This is the first inspection of the home since the new provider, Community Integrated Care took over on 1st July 2005. What the service does well: What has improved since the last inspection? What they could do better: The manager has been asked to put information in place about the home and what service users will be provided with if they live in the home. The home needs to put clear plans for how the support service users and put clear information in place on how they will keep people safe. The manager needs to have clear information in place to show how service users monies are being managed and that each person receives their personal allowances from their benefits. The inspector has asked that the home makes sure enough staff are available to support service users to meet each persons needs. The manager needs to make sure staff who take charge of the home have the right skills and abilities to do so. The manager has been asked to make sure that the fire safety checks in the home are carried out to keep people safe Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 6 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. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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 Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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 and 2 The lack of information and a clear approach to assessing service user’s needs mean that the home cannot demonstrate how they will assure service users that they can meet their needs. EVIDENCE: The home was unable to provide the inspector with a Statement of purpose or a service user’s guide to the home. The inspector could see no evidence that any work was taking place to develop these documents and staff were unaware of any work being carried out. The inspector was unable to examine assessment documentation for service users, as there was nothing in place except for the previous providers care plan and risk assessments. Care manager’s assessments were not available. The inspector could not assess how the home will support service users or assess their needs as a format for carrying out this task was unavailable and the manger was not available to discuss what approach is to be taken Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 9 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 and 9 The lack of service user plans and clear risk assessments mean the home cannot demonstrate that they can meet service users needs and have the potential to place service users at risk. EVIDENCE: The inspector examined the documentation in place in the home following the change to a new provider on 1st July 2005. The home is currently using information left by the last organisation and no care plans or responses to service users needs could be provided for inspection. The home could not provide any evidence that they have carried out any assessment of service user’s needs to determine the service required. The staff could not provide any plans for service users and they did not have any information on what is happening to put care plans and risk assessments in place. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 10 The previous provider put the current risk assessment strategies in place and none of these have been reviewed and replaced with a response from Community Integrated Care. The manager has been required to take action to develop a service user plan for each person, which documents the support required, and how they intend to meet these needs. They must also update the risk assessment strategies for each person. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 11 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): 12 and 13 Service users benefit from activities outside of the home. The lack of a service user plan means that the home cannot demonstrate how the are providing support to access appropriate activities. EVIDENCE: A record of daily events has been re-established in the home from October 2005 onwards. A member of staff told the inspector that no record was maintained prior to this. From discussions with the member of staff on duty the inspector was able to confirmed that service users are going out of the home shopping, for drives in the country or for meals in pubs and restaurants. The inspector was told that trips out have been difficult due to staffing shortages and a lot of weekends have had only one staff on duty, which have meant that service users could not go out. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 12 Key-worker days were each service user spends one to one time with their key staff member have stopped and there is no structure to activities at present. The absence of a service user’s plan makes it difficult to for the inspector to determine how the home is meeting the needs of individuals and responding to their leisure and recreational needs. One service user continues to attend day services four days a week and on the day of the inspection another service user went out with a member of staff. Two service users have been on holiday to Amsterdam this year and staff are looking to arrange a holiday for one other person involving their favourite type of transport, a ferry. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 13 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): Not assessed at this visit EVIDENCE: Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 14 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 and 23 Complaints procedures are in place demonstrating that the views and concerns of service users, their families and representatives would be recorded and responded to. The lack of full information on service users finances means that the home cannot demonstrate that the service is managing their finances appropriately EVIDENCE: The home has a clear complaints procedure, this included details on how to contact the commission. The complaints procedure is on display in the home. The inspector discussed the complaints procedure with the staff member on duty and advised that the manager will need to set up a file to monitor any complaints made. The inspector was able to confirm that no complaints have been made. Service users are supported with their finances and monies are held on behalf of service users. Each person has a building society account and the inspector checked two of the accounts with assistance from a member of staff. A record of all transactions is maintained and balances matched these records. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 15 The inspector noted that service users do not appear to be receipt of their personal allowances at present. The staff member stated that they have queried this and been told that benefits have been received and have been placed in a bank account. The inspector advised that detailed records of this need to be maintained and that the provider must demonstrate that service users are in receipt of their personal allowance entitlement. The member of staff on duty said that they have had training in protection of vulnerable adults from his previous employer. The staff member was unable to locate the Hampshire policy for the Protection of Vulnerable Adults. They were advised that a copy of this policy must be available in the home. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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 and 30 Service users benefit from a comfortable and well-maintained home and personal spaces that reflect their likes and tastes. Documenting good hygiene practices will demonstrate the homes approach to maintaining the health and safety of service users. EVIDENCE: The inspector toured the home. The home was found it to be in a generally good stated of repair, clean and tidy and free from any unpleasant smells. The home has a lounge and a separate kitchen/dining room. A service user pointed out to the inspector that the downstairs bathroom has had a new shower installed. The laundry is accessed through the kitchen and the staff were able to demonstrate good practice in relation to preventing contamination and cross infection however this practice needs to be clearly documented in the home. The inspector had the opportunity to see two service user’s bedrooms and the individuals both indicated that they were very happy with their room and they have lots of personal items including models, pictures and photographs Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 17 displayed in their room. Each person can have a key to their room and staff were observed knocking and waiting for permission to enter service user’s bedrooms. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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): 33 The home cannot demonstrate that an effective staff team is supporting service users. EVIDENCE: The inspector examined the homes staffing rota and spoke to the staff member in charge of the home on the day. Two staff were on duty during the inspection one person is on the homes bank staff list however they worked previously as a permanent member of staff in the home. The rota indicated that at the end of July an agency member of staff worked a long day in the home on their own and therefore were in charge of the home. The inspector was told that this was the first shift they had worked. No information was available in the home to indicate that this person had an induction into the home and access to confidential records was not possible during this visit to determine what checks had been carried out on this individual. The inspector was concerned that a new agency staff was left in charge of the home and made contact with a senior manager of the organisation during the inspection to raise this concern. They said that this is not an acceptable practice and would look into this with the manager. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 19 The rota also indicated that over the past three months a number of shifts only had one staff on duty and the staff member confirmed this. The inspector advised that the home must ensure that any staff member who takes charge of the home is fully inducted and has been assessed as competent to take charge of the home. The home must also ensure that the level of staff is maintained to meet service user’s needs at all times. The inspector was told the a new support worker started two weeks ago and a senior staff member starts next week this has improved the overall staff numbers and future rotas indicate higher staffing levels. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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): 42 The lack of appropriate responses to the prevention of fire has the potential to place service users at risk. EVIDENCE: The inspector examined the homes records related to servicing of equipment and confirmed that the fire alarm system was serviced in August 2005. The electrical appliances were tested in November 2004 and are due for retesting shortly. The gas boiler servicing and electrical wiring certificate could not be found and the inspector advised that these should be located or servicing and inspections should be arranged. The home does not have a fire risk assessment and cannot demonstrate their approach to risk analysis and fire prevention in the home. The fire alarm system has not been tested since 02/10/05 and this must be completed weekly. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 21 The inspector could not find any evidence that staff have been trained in fire prevention and this should be carried out every six months. There is also no record that a fire drill and practice has been carried out since the organisation took over. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 X X X Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X X X 2 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Moss Cottage Score X X X X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000064988.V260614.R01.S.doc Version 5.0 Page 23 N/A 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 2 Standard YA1 YA1 Regulation 4 5 Requirement The registered person must ensure that a statement of purpose is in place in the home. The registered person must ensure a service users guide is produced and made available to each service user. The registered person must ensure that each service user has a full assessment of their needs in place The registered person must ensure that each service user has a plan, which fully documents their assessed needs and includes clear methodologies for supporting these needs. The registered person must ensure that service users are supported by clear risk assessments for daily activities. The registered person must ensure that service user’s monies are fully documented in the home. The registered person must ensure that staffing levels are in place to meet service users assessed needs. The registered person must DS0000064988.V260614.R01.S.doc Timescale for action 21/01/06 21/01/06 3 YA2 14 21/01/06 4 YA6 15 21/01/06 5 YA9 13 21/12/05 6 YA23 13 21/12/05 7 YA33 18 21/11/05 8 YA33 18 21/11/05 Page 24 Moss Cottage Version 5.0 9 YA42 23 10 YA42 23 ensure that staff taking charge of the home are competent to do so. The registered person must ensure that a fire drill and practice is carried out in the home. The registered person must ensure that a fire safety checks are carried out including the weekly alarm system tests. 21/12/05 21/11/05 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 YA30 Good Practice Recommendations The manager should document the current practices in the home related to Laundry and the prevention cross infection. Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Moss Cottage DS0000064988.V260614.R01.S.doc Version 5.0 Page 26 - 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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