Inspection on 10/08/05 for Nowell Cottage

This inspection was carried out on 10th August 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Nowell Cottage 28/09/07

Nowell Cottage 07/08/06

Nowell Cottage 24/01/06

Nowell Cottage 07/03/05

Nowell Cottage 06/07/04

Nowell Cottage 27/02/04

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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 Nowell Cottage Aldington Road Lympne Hythe, Kent CT21 4LH Lead Inspector Geoff Senior Unannounced 10 August 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. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Nowell Cottage Address Aldington Road, Lympne, Hythe, Kent, CT21 4LH 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) 01303 269879 David Charles Uden Care Home only 3 Category(ies) of Learning Disability x 3 registration, with number of places Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Nowell Cottage is a registered care home for 3 Service Users with a learning disability. It is the family home of Mr and Mrs Uden who are the registered providers. No other staff are employed. Family members offer additional support. The premises are situated on the edge of the village in a rural location surrounded by fields. There are other buildings on the site where the Registered Owners aim to provide an activity workshop and a large summerhouse within the extensive, mature gardens. Mr and Mrs Uden’s stated aim is to provide a good quality of lifestyle within a rural family network where personal and life skill development are encouraged during the structured but flexible daily routines. The three Service Users have lived at the Home for approx 20 years Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Proprietors have several years experience working with people with a learning disability in a residential setting, as employees in a large home and as the proprietors of Nowell Cottage for approx 20 years. The home provides a welcoming, comfortable and varied environment for the service users. Communal areas and bedrooms appeared well maintained and adequately furnished. The Registered Owner stated that the Service Users are able to communicate their views clearly to them and that they are well aware of the individuals’ needs.They do not employ any staff and therefore consider that more detailed care plans or contracts were not required. The Inspector was informed that Care management contact is limited but Day Centre placement reviews are undertaken and documentation updated. for all three service users. There were three Service users present at this inspection. Two were in the lounge and one was in the garden with members of the Uden family. The inspector spoke briefly with one service user and observed family interactions with the others. The Registered Owners told the Inspector that the aim of the Home is to create a family atmosphere and to consider and include the Service Users as part of the family. They do not intend to take any other Service Users as and when vacancies occur. Because of this statement some of the standards are not applicable in this report What the service does well: What has improved since the last inspection? Little changes within the general routine of the house. Mr and Mrs Uden recognise however, the value of good support and communication and to this end is in regular contact with external agencies for ongoing health and social care of the service users. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 6 What they could do better: 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. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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 standard(s) Not inspected EVIDENCE: Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,10. The proprietors have a good understanding of residents’ rights to make decisions and to be consulted on matters affecting them. Service users are encouraged to participate in the day to day running of the home. EVIDENCE: The home maintains individual case files for each service user. These contain detail pertinent to the personal, health and social care of the individuals. Care plans and targets have input from care management, day centre staff and from the home. Service users have signed their care plans. Risk assessments have been undertaken and recorded. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 10 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) 11,12,13,14,16. The Proprietors have a good understanding of the service user’s needs and offer support and opportunity to develop where appropriate. EVIDENCE: Service users needs are such that employment was not seen to be a viable proposition. They are however helped to access appropriate facilities according to their individual needs. They are encouraged to participate in family functions and gatherings. Service users attend the local day opportunities centre on a number of weekdays and a social club on Thursday evening. Service Users are supported to attended events in the area and, as it is a small village, they are relatively well known in the local community. Service users are encouraged but not compelled to participate in the varied activities on offer.. Service Users are, in the main, free to determine their own routine around the necessary daily schedules, for example getting up in the morning, attending the D.O.C. and going to bed at night. Individuals’ access to their private space is unlimited and movement inside and without the home is restricted only on safety grounds. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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) 18,19 Service users are receiving personal support in accordance with their individual need and their healthcare is monitored and promoted EVIDENCE: The Registered Owner discussed the ongoing healthcare arrangements with the Inspector who was pleased to note that incidents, accidents and health care appointments are regularly monitored and recorded. The Service users require limited personal care. They may be prompted in relation to matters of personal hygiene and help may be offered in choosing suitable clothes for the time of day and season There is no nursing care undertaken Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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) Not inspected EVIDENCE: Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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) 24,25,26,27,28,30 The standard of the environment is good and provides the service users with homely and comfortable surroundings. EVIDENCE: The home appeared to be clean, tidy and well maintained. Service users private bedrooms were not seen at this visit but were previously noted to be comfortably furnished. The service users have been encouraged to personalise their rooms according to individual choice and preference. There is one recently refurbished WC./bathroom available for Service Users and the private bathroom of the Registered Owner that is available at any time. There is a choice of communal space in which to sit and socialise There are two comfortable sitting rooms and a garden room as well as a dining room offering a variety of day space and private areas should they be required Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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) Mrs and Mrs Uden are sole proprietors and do not employ staff. Nowell Cottageis their home. They are available 24 hrs per day. Standards not inspected. EVIDENCE: Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 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) 41 The records maintained in the home need to be reviewed to ensure compliance with the regulatory requirements. EVIDENCE: The Service Users have lived as part of the Uden family for 20 years. It is Mr and Mrs Uden’s stated intention not to admit any more Service Users as and when vacancies occur. It is acknowledged that, given the circumstances under which care and accommodation is offered, a number of records required by regulation are not applicable. The Registered Persons need, however, to review the regulation (17) and schedules (3 and 4) to ensure they have in place those that are relevant to the current situation. Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 16 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 x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Nowell Cottage Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x 1 x x x H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 17 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 41 Regulation 17 Requirement The registered persons need to review current documentation in the light of requirements of Regulation 17 Timescale for action 31.7.05 now 31.12.05 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 Good Practice Recommendations Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford, Kent TN23 1HU 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 Nowell Cottage H56-H05 S23233 Nowell Cottage S226371 100805 Stage 4.doc Version 1.30 Page 19 - 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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