Inspection on 23/11/05 for Paddock Cottage

This inspection was carried out on 23rd November 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Paddock Cottage 05/10/06

Paddock Cottage 27/07/05

Paddock Cottage 07/02/05

Paddock Cottage 19/07/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Paddock Cottage Rusper Road Ifield Crawley West Sussex RH11 0HL Lead Inspector Mrs L Riddle Unannounced Inspection 23rd November 2005 12:45 Paddock Cottage DS0000014657.V267629.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 Paddock Cottage DS0000014657.V267629.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. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Paddock Cottage Address Rusper Road Ifield Crawley West Sussex RH11 0HL 01293 611776 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) Alliance Home Care (Learning Disabilities) Limited Ms Alison Hunter Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 persons in the registration category LD (learning disabilities) category aged 18-65, who may also have past or present mental disorder. 27th July 2005 Date of last inspection Brief Description of the Service: Paddock Cottage is a care home registered to provide accommodation and personal care for up to 6 residents between the ages of 18 and 65 years who have learning disabilities. Additional conditions of registration provide for any of those 6 residents who might also have past or present mental disorders. The service is privately owned by Alliance Home Care Ltd, for whom the Responsible Individual is Mr A Dahya. The Registered Manager in charge of the day to day running of the home is Ms Alison Hunter. The home is situated on a main road in a residential area a few miles from the centre of Crawley town with local amenities and transport nearby. The detached two storey property provides accommodation on both floors in six single bedrooms. Communal rooms are on the ground floor and there is an activity room in a separate building in the grounds. The garden to the front of the home provides a driveway and parking area but residents are unable to access this due to the danger of it opening onto a busy main road. The good sized garden to the rear of the propery contains a swimming pool. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a period of three and three quarter hours by one inspector between the hours of 12:45 and 16:30 as part of the yearly inspection process. Prior to this inspection the previous inspection report was read along with other documents and correspondence relating to the home. Some records and documents were examined during this inspection and a tour of the premises was undertaken. Due to the limited communication abilities of most residents it was not possible to have in-depth discussion with the majority about the home, the services and the care they receive. However, five were spoken with in a general manner so as not to distress or agitate them by questioning. Three residents were able to make some simple comments about the home. Observations were made of the way staff approach and interact with residents and the way in which care is delivered. Three staff members were spoken with and there was discussion with the deputy manager, the registered manager not being present in the home on the day of inspection. Six residents were being accommodated at the time of inspection. What the service does well: What has improved since the last inspection? Staffing levels have improved allowing three support staff to be on duty during most daytime shifts. The process of putting the complaints procedure, parts of the care plans and the Service User Guide into pictorial formats which can be more easily understood by residents, has commenced. All staff who handle medications have received training appropriate to the tasks they perform. Some staff members have undertaken training relating to Adult Protection and more will be doing so in December 2005. The morale of staff has improved and the registered provider has given staff opportunities to air their grievances. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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. Paddock Cottage DS0000014657.V267629.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 Paddock Cottage DS0000014657.V267629.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 Good information is provided in the Home’s Statement of Purpose to enable prospective residents and/or their representatives to make an informed choice about the home. EVIDENCE: The Statement of Purpose contains information about the home including its aims and objectives and general philosophy. Staffing details are included and there is a description of the accommodation and what the home is able to offer residents in relation to health, personal and social/recreational provision. The Service User’s Guide is currently being reproduced in pictorial format to make it more easily understood by residents. Paddock Cottage DS0000014657.V267629.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): 7,8, 9 There are strategies for consulting with residents to help them make informed choices and to participate in all aspects of home life as far as their individual abilities will allow. They are supported to take some assessed risks in the course of their daily lives. EVIDENCE: Three care plans were examined. These were found to be very comprehensive. Care notes, risk assessment and monthly reports provide good evidence of decisions, choice and risk taking. For example, residents are helped to choose their breakfasts from several types of cereal. Those who cannot verbalise are able to point to the one they want. Similarly they are asked what sort of things they want for snacks and dinners prior to the weekly shop being done. Two residents accompany staff on this shopping trip to help select. Two or three residents are able to state exactly what they want. Residents are able to take only minor risks because of their disabilities, but these have all been assessed and recorded and residents are under close observation by staff. It was noted that residents are able to participate in such activities as swimming and horse riding where there are risks but safety precautions are built in to the risk assessments. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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): 15, 16 Residents are helped and encouraged to maintain relationships with families and friends and to take some responsibilities in their lives. EVIDENCE: When residents talk about friends they have made at their college or day centres staff encourage them to invite those friends to the home for tea or similar. Two have regular established routines in relation to family contact/visits. One goes home for alternate weekends for example. Where contact is less regular staff make sure that those relatives are informed of important events such as care reviews, hospital appointments and medication reviews in order to try and encourage visits or contact. The deputy manager confirmed that key workers try to enable and assist where there are difficult relationships. Care plans identify resident’s needs concerning relationships and what action is needed by staff to help them maintain these. An example of this stated ‘to be encouraged to phone parents, to visit and to write letters’. This is good practice and places some responsibility on the resident. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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 the following standard(s): 18 Staff provide personal support to residents in a way that meets each one’s assessed needs and wishes. EVIDENCE: Care plans were seen to provide clear and detailed information concerning what help and support each resident needs and the way it should be given to suit the individual. They detail what residents are able to do for themselves and what staff need to do to help them towards greater independence. Individual programmes are in place for each resident to help them achieve potential, such as small tasks they may assist with around the home and/or external college or day centre attendance. Plans cover personal hygiene support, behavioural guidelines and self-help skills. A ‘star profile’ in each resident’s file provides an overview of how all care needs should be met. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 The home has a complaints procedure and residents/representatives can be sure that their concerns will be listened to, taken seriously and acted upon. A Vulnerable Adults procedure is in place to ensure a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a detailed complaints procedure to be followed in the event of any complaints being made. A recommendation was made in the last report that the complaints procedure be produced in pictorial format so that some of the more able residents may be able to understand it. The deputy manager confirmed that this is in the process of being done. It will be followed up at the next inspection. Each resident has access weekly to an advocate who can complain on their behalf if needs be, as can any other relative or representative. A procedure for responding to any allegations of abuse was seen to be in place and the home has the West Sussex Procedures for Adult protection. Records showed that some staff have undertaken Adult Protection training and further training was seen to be arranged for December 2005. Staff spoken with were aware of their responsibilities in relation to reporting bad practice. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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 the following standard(s): 24, 25, 26 The home is well maintained and comfortably furnished throughout but there remains some restriction in relation to residents being able to use the gardens independently because of a safety issue. EVIDENCE: All parts of the home are furnished and maintained to a good standard, providing a homely and cheerful environment for residents. The gardens were seen to be tidy but the swimming pool still has no safety wall around it as required in the previous report in July 2005. The deputy manager said that quotes from contractors are in the process of being maintained but this is slow progress given the time that has elapsed since the last inspection. The timescale for action to be taken by the registered provider was 31st October 2005. Residents bedrooms are, in the main, attractively decorated in styles and colours which, where possible have been chosen by the residents. They were seen to reflect their different personalities and interests. One resident for example has many toys and wall murals, another has numerous videos whilst another likes his room to be very minimal in terms of furnishings and walls. This particular room is in need of redecoration but the deputy manager said, that to prevent upset to the resident, this will be done when he goes away for a short break in the near future. Most residents were happy to show their Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 14 rooms and comments from them included “I like my room” and “I like living here”. Two residents are able to lock their rooms if they wish but the remainder are unsafe to do so. Risk assessments were seen to be in place in relation to this. The privacy of all residents is respected and it was noted that each resident was asked permission before any of the rooms were visited for inspection purposes. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 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): 33, 35, 36 Suitable numbers of staff and an active training programme means that residents are cared for in a way which meets their needs by staff who are competent and knowledgeable. EVIDENCE: Duty rotas examined, observations made and discussion with the deputy manager and staff confirmed that staff are deployed in numbers which are adequate to meet the varying needs of residents. During most daytime shifts three support staff are available and at night there is one on awake duty and a second asleep on the premises to assist if required. The home has a good training programme which covers all work related topics such as epilepsy, physical intervention, medication handling and working with vulnerable adults etc. In addition mandatory training is provided to keep staff up to date with fire safety, first aid, food hygiene and health and safety. Three staff were spoken with during the inspection. Two said that they had undertaken a lot of training whilst working in the home including National Vocational Qualifications. One said that he is currently doing level 3 and hopes to complete it early next year. A new member of staff said that he has completed part of his induction training. Staff confirmed that meetings are held fortnightly and since the last inspection when morale was noted to be low, a member of the company’s human resources department had attended a staff meeting to discuss problems. The staff felt that this had been very positive. The responsible individual had also visited the home to see any staff who Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 16 wished to speak with him. Staff confirmed that they receive formal supervision from the registered manager four to six-weekly. It was observed that residents enjoyed close and relaxed relationships with staff. They were in and out of the kitchen/dining room where a support worker was preparing the supper. There was friendly chat between both parties as they watched him, cups of tea were made, other staff were also in and out and there was a happy and cheerful atmosphere. Two residents had recently had birthdays, one said he had a birthday cake and the others sang happy birthday to him. One resident pointed to the support staff who was cooking and said “he is the best cook”. Another resident said “I like it here, we have nice food. Jingle Bells is my favourite song and I like Christmas. The staff are nice”. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 17 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): 40, 42 The home has policies, records and procedures in place to safeguard the interests of residents and the health, safety and welfare of residents and staff are, in the main, promoted and protected. EVIDENCE: The home’s written policies and procedures were seen and these are regularly updated to ensure that they comply with current legislation and recognised professional standards. Staff have access to these and are required to sign acknowledgement of having read them each time they are updated. The home has a comprehensive health and safety policy. As previously mentioned staff have regular training in all topics related to health and safety as was seen on record and confirmed by staff. There was documentary evidence to show that hot water temperatures are monitored and recorded regularly and checks made on all electrical and other equipment. Restrictors are fitted to windows above ground floor level. It was noted that the testing of fire bells and emergency lighting was overdue and this needs attention. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 18 All accidents and incidents are recorded appropriately and notified to the Commission for Social Care Inspection and other agencies as required. Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 19 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 3 x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x 3 3 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 3 x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x 3 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Paddock Cottage Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 x 3 x DS0000014657.V267629.R01.S.doc Version 5.0 Page 20 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 YA24 Regulation 13(4)(a) Requirement The registered person shall ensure that all parts of the home to which residents have access are, so far as is reasonably practicable, free from hazards to their safety. Timescale for action 30/04/06 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 Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Paddock Cottage DS0000014657.V267629.R01.S.doc Version 5.0 Page 22 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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