Inspection on 07/08/06 for Nowell Cottage

This inspection was carried out on 7th August 2006.

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

Nowell Cottage 28/09/07

Nowell Cottage 24/01/06

Nowell Cottage 10/08/05

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 Inspection 7th August 2006 09:30 Nowell Cottage DS0000023233.V303546.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 Nowell Cottage DS0000023233.V303546.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. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Nowell Cottage Address Aldington Road Lympne Hythe Kent CT21 4LH 01303 269879 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 David Charles Uden Mrs Roslyne Irene Joan Uden Mr David Charles Uden Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 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 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 more than 23 years. The reported weekly fees are £323. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and was undertaken on 7th August 2006. During the course of the visit the inspector met and spent time with Mr and Mrs Uden the Providers. He also spoke with two of the three service users, observed interactions with the family and viewed the property and a number of records. 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 more than 23 years. The home provides a welcoming, comfortable and varied environment for the service users. Communal areas and bedrooms appeared well maintained and adequately furnished. Mr and Mrs Uden 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. 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 employ any staff or 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 are in regular contact with external agencies for ongoing health and social care of the service users. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 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 DS0000023233.V303546.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The Providers have a good understanding of the service users support needs and aspirations. This is evident from discussion with the Udens, the service users and observations of the lifestyle offered and routines established. EVIDENCE: Mr and Mrs Uden have provided care and accommodation for the three current service users for approx 23 years. Nowell Cottage is their home and the service users live very much as part of the extended family. Continuing needs are monitored through daily life and routine and more formally by regular review. The needs and aspirations are well known and supported by the family. It is Mr and Mrs Uden’s stated intention not to take any more clients as and when vacancies arise. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 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): 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service Care plan information is subject to regular review and remains relevant. 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: Care plan documentation is formulated in conjunction with Day centre staff and Care Management. It is subject to regular review. There are few activities undertaken by the service users within or outside the home without the direct supervision of the providers or Day centre staff. It was noted that, where risk is perceived, appropriate actions are discussed with the care manager and the steps taken to manage the risk noted in the individual’s case notes. Service users are encouraged to take part in any decision making process and their choices and preferences are respected. Any restrictions are placed only in the interests of safety. As the home is ‘staffed’ by Mr and Mrs Uden only. they do not feel the need for a number of the required written policies or procedures. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 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 the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a full and varied programme of activity and Service users’ days are, for the most part, meaningfully occupied. Service users are involved in the choice and occasionally the preparation of a varied and balanced menu EVIDENCE: Service users are encouraged and helped to maintain family links wherever possible. Mr and Mrs Uden maintain contact with service user’s families to ensure they are up to date with progress and news. Visitors are welcomed without restriction and may be received in the resident’s own rooms or in the communal areas. A phone is available for private use. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 11 It was reported that all three service users take their main meal of the day in the evening together with Mr and Mrs Uden. There is no set menu as Service Users decide daily what they wish to eat. One resident’s special dietary needs are catered for, as is time to complete the meal at his own pace. The Registered Owner records meals taken by Service Users. Weekdays are occupied with a range of activities and pastimes: 2 days plus club night are spent at the Day Centre in Ashford; Monday is house day; Wednesdays and Fridays are spent out with Udens on outings, shopping and pub lunch. Weekends are for family activities around the house or visiting and helping at the Stables and swimming at one daughter’s house. One service user often chooses to go to other daughter’s next door. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 12 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): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive personal support in accordance with their individual need and their healthcare is monitored and promoted. EVIDENCE: Mr and Mrs Uden discussed the ongoing healthcare arrangements with the Inspector It was noted that incidents, accidents and health care appointments are monitored and recorded. Mrs Uden reported that there was limited personal care support required by the service users. There is no nursing care undertaken It was understood that no service users keep or administer their own medication. Where the arrangements for the storage and administration of medicines were previously allied to that of a domestic environment the medication is now more appropriately stored in the proprietor’s private accommodation. There was a written record of medication administered. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 13 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): 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users may speak freely with Mr and Mrs Uden and, if the need arises, to express opinions and concerns to the proprietors. Mr and Mrs Uden have previously indicated an awareness of issues relating to protection of vulnerable adults EVIDENCE: Mr and Mrs Uden have stated that they have undertaken a Criminal Record Bureau check. There are no separate staff employed at the home. There is no separate written policy regarding protection of vulnerable people but the Registered Owners have obtained a copy of the local multi agency policy and procedures for the protection of vulnerable adults. Service users may raise issues with Mr and Mrs Uden and their family members. They may also approach Day Opportunities Centre staff to advocate on their behalf. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 14 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the accommodation is good and provides the service users with an attractive and homely place to live. EVIDENCE: Nowell Cottage is the family home of Mr and Mrs Uden. At the time of inspection visit the home appeared to be clean, tidy and free of undue odours. There is a good standard of décor and furnishings in the communal and private areas. Nowell Cottage has a homely feel, observation at this and previous inspection visits noted that service users to be comfortable in their surroundings. There are adequate laundry, bathroom and kitchen facilities. There is an extensive garden with a patio and seating. The Inspector was accompanied by service users to view the bedroom accommodation. Each room was personalised to suit the individual occupant. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 15 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): 32,35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are no staff employed at the home, thus a number of standards are not applicable. Mr and Mrs Uden have a good understanding of the service users’ needs and offer a consistent level of care within the home. EVIDENCE: Mr and Mrs Uden have a good understanding of the service users’ needs and offer a consistent level of care within the home. They liaise closely and regularly with other agencies and professionals to ensure the support they offer remains appropriate and relevant. They have completed CRB checks. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 16 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): 39,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service The service users benefit from a well run home. They appear to be content with their life at Nowell Cottage and feel safe in their surroundings. EVIDENCE: Nowell Cottage is the family home of Mr and Mrs Uden who are the registered providers. No other staff are employed. The Inspector was informed 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. From observation and from discussion with two of the service users they appear to be content with their life at Nowell Cottage and feel safe in their surroundings. Mr and Mrs Uden endeavour to ensure that measures are taken to promote the health, welfare and safety of everyone living at the Cottage. It is recommended that they review their competencies relating to basic safety training. For example; First Aid, fire safety and food hygiene. Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 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. 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 3 3 X 3 X X 3 X 3 X Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 18 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 Nowell Cottage DS0000023233.V303546.R01.S.doc Version 5.2 Page 19 Commission for Social Care Inspection Kent and Medway Area Office 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. 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