Inspection on 27/07/05 for Paddock Cottage

This inspection was carried out on 27th July 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 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

Paddock Cottage 05/10/06

Paddock Cottage 23/11/05

Paddock Cottage 07/02/05

Paddock Cottage 19/07/04

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Southfields

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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 Paddock Cottage Rusper Road Ifield Crawley, West Sussex RH11 0HL Lead Inspector Linda Riddle Announced Wednesday, 27 July 2005 V228243 th 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. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Paddock Cottage Address Rusper Road, Ifield, Crawley, West Sussex, RH11 0HL 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) 01293 611776 Alliance Home Care (Learning Disabilities) Limited Ms Alison Hunter Care home only (PC) 6 places 6 places Category(ies) of Learning disability (LD) registration, with number of places Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 6 persons in the registration category LD (learning disabilities) category aged 18-65, who may also have past or present mental disorder. Date of last inspection 7th February 2005 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. Currently residents cannot access the garden without staff being present as the unguarded swimming pool presents a hazard. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was carried out over a period of 5.75 hours by one inspector. Prior to the inspection the previous two inspection reports were read along with various correspondence and other documentation held on file. A pre-inspection questionnaire had been completed by the manager and returned to the Commission for Social Care Inspection prior to the inspection. Information provided in this contributed to the inspection process. Comment Cards were sent out by the Commission for completion by or on behalf of residents and also for relatives/friends. Comments in those returned were positive. The registered manager was unable to be present for the inspection but the deputy manager assisted the inspector with her enquiries. Records, policies and procedures were examined during the inspection, members of staff were spoken with and there was discussion with the deputy manager. A tour of the premises was undertaken. During the inspection only three residents were present in the home. Two of the three had little or no language skills but the third was able to communicate verbally on a simple level. Each of them was spoken with. They were observed at various times throughout the inspection to be relaxed, familiar with their surroundings and to relate well to the staff on duty. It was evident that staff understood their needs and methods of communication very well and were able to respond appropriately to them. Information held on file in respect of residents and staff members is comprehensive. Records were found to be up to date and in good order. Clear policies and procedures are in place to support good practice. The building was seen to be well maintained and in good decorative order. Some concerns were raised about the safety of the swimming pool and resident’s freedom to use the garden independently. The recent loss of two part- time care staff had created difficulties in providing the desired level of cover at all times. Staff training is on-going but a number of those who had previously achieved National Vocational Qualifications had left to work elsewhere. What the service does well: Care is focused on meeting the needs of residents. They are helped and encouraged to reach their potential both within and outside of the home. The home provides opportunities for them to participate in their local community. Their healthcare needs are well addressed. They live in a comfortable and cheerful environment. The home’s policies and procedures comply with current legislation and recognised professional standards upon which good practice is based. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 6 What has improved since the last inspection? 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 H60 H11 S14657 Paddock Cottage V228243 270705 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 Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 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) 2 3, 5, Resident’s individual needs are thoroughly assessed prior to permanent admission to ensure that the home will be able to meet their needs. EVIDENCE: The procedures for assessing residents prior to their moving into the home were seen to be thorough. Three files were examined and these included the joint Health and Social Services Assessments/Care plans. In addition the home has its’ own very comprehensive assessment tool. Every prospective resident has short stays in the home. During these periods the assessment process continues up to the time when a decision is made as to whether the resident is suitable for the home and the home suitable for and capable of meeting the needs of the resident. Staff spoken with were knowledgeable about the care needs of individuals. It was seen that each resident’s copy of the Statement of Purpose and Service User Guide included an individual costed contract/statement of Terms and Conditions. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 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, 8 Good arrangements are in place to ensure that the health, personal and social care needs of residents are met. Residents are offered opportunities to participate in the day to day running of the home within the limits of their abilities and understanding. EVIDENCE: Three care plans were examined and these showed that all aspects of physical, social, spiritual, and mental health needs are identified and planned for. The plans include robust risk assessments covering self-injury, vulnerability and risks associated with activities of daily living within and outside of the home, including recreational activities such as horse riding and swimming. Care plans would benefit by being in pictorial formats which some of the residents would be able to understand. A recommendation has been made in this respect. Meetings for residents are held four to six weekly which are chaired by a member of staff. Because of their disabilities residents are limited in the amount they can contribute. Suggestions are therefore put to them and those who can, confirm their choices. Examples of this were seen in the minutes of the meetings. Residents had been told about various venues they might want to visit for outings and based on their responses outings to their favoured places had been arranged. Similarly meals had been planned in a similar way. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 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, 17 Educational, social, recreational activities and meals are all well managed. They are creative and provide daily variation and interest for residents living in the home. EVIDENCE: Residents are dependent upon staff to accomplish daily living routines. It was evident however, from information in care plans, discussion with the deputy manager and staff and observations made during the inspection that staff actively promote independence and development of social/communication skills through support and guidance. The activity board showed that residents are accompanied on shopping trips. Where they are able residents help with simple tasks around the home such as tidying their rooms with staff support and guidance. One resident said that he likes to make a cup of tea. Another said “I love cooking and I make fairy cakes”. Those who are able and choose to, attend college or day centres. This enables them to participate in activities such as sensory stimulation, drama and cookery and/or in outdoor pursuits. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 11 There was a detailed and varied activities programme for each resident which included a range of recreational activities undertaken in the community such as swimming, ladies club, horse-riding and others according to their interests and abilities. Residents are taken out for meals and to local pubs and other venues to enable them to integrate into the community. Menus are planned for the week ahead with input from those residents who are able to communicate their likes and dislikes. Where they cannot, staff make an informed choice on their behalf based on their knowledge of that person. Menus showed that a varied and balanced diet is provided which includes fresh produce. During weekdays residents who are at home have a snack lunch and they all eat together with staff in the early evening when they have the main meal. Records showed that the majority of staff had undertaken food hygiene training, just two were still in need of this. The deputy manager said that based on residents wishes they are all taken out to eat on Saturday evenings. They used to have takeaways but had opted for a change. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 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 standard(s) 19, 20 The healthcare needs of residents are assessed and recognised and arrangements are in place to address them. Residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Information in the files examined showed that residents are registered with GPs in the locality. Care plans stated clearly what the individual needs are in relation to dental, optical and other aspects of their healthcare and how and where these are met. Residents are taken by staff to attend practitioners in the community. Further support for their physical, mental and specialist healthcare needs are provided through the Community Team for People with Learning Disabilities. Policies and procedures were seen to be in place for the safe receipt, recording, storage, handling administration and disposal of medicines. Medication administration records were examined. These were up to date and correctly completed. All medicines were seen to be in date. A monitored dosage system of administration is used. None of the residents is able to take control of his/her own medications and this was stated in each care plan. The majority of staff have received training in the safe handling of medicines. A recommendation has been made that the small number who have not should undertake such training. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 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 standard(s) 22, 23 Complaints are handled objectively and resident’s representatives can be confident 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 has been made that the complaints procedure be produced in pictorial format so that some of the more able residents may be able to understand it. Each resident has access weekly to an advocate who can complain on their behalf if needs be, as can any other relative or representative. The complaints record seen showed that no complaints had been received since 2003. 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 the majority of staff have undertaken Adult Protection training and it is recommended that those who have not, do so. Staff spoken with were aware of their responsibilities in relation to reporting bad practice. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 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 standard(s) 24, 28, 29, 30 Whilst the home provides residents with cheerful, clean, comfortable and well maintained surroundings there is some restriction in relation to their being able to use the gardens independently due to safety issues. EVIDENCE: Resident’s rooms were seen to reflect their interests and personalities. The deputy manager said that wherever possible residents are helped and encouraged to choose the colour schemes in their rooms. All were seen to be furnished appropriately and provided comfortable and pleasant personal space. There is ample communal space consisting of a lounge and separate kitchen/dining room. A separate building in the grounds provides an activities area. A well equipped laundry is situated on the ground floor. Staff have received training and policies and procedures were seen to be in place relating to the control of infection. The swimming pool is covered by a safety cover when not in use. Currently residents cannot go into the main back garden without staff present although it is a secure area away from the busy road. The reason for this is the unguarded swimming pool. A requirement is made that a secure and sufficiently high wall be erected around it with a lockable gate. This will enable residents to access the garden independently at all times in safety. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 Training is provided which means that residents are supported by a competent and effective staff team. The number of staff available at weekends in particular, is not always sufficient to meet the needs of the residents. The procedures for recruitment are robust and provide the safeguards which offer protection for residents living in the home. EVIDENCE: Records showed that there has been a high level of training provided for staff including National Vocational Qualifications (NVQ). At the time of the last inspection 21 of the staff had achieved NVQ at level 2 or above. Now only two members of the support staff with this qualification remain working in the home. One member of staff is currently doing level 2 and two more will be commencing it. Staff said there is no incentive for people to stay once they obtain it as they receive no recognition from the organisation. Two part- time staff who worked at weekends had recently left and the rotas showed that there are difficulties providing suitable cover for some shifts. Three staff on each shift enables the home to be flexible in its approach to service provision. It means that if some residents want to go out and others do not, this can be accommodated. With just two staff members on duty as was seen to be the case for some shifts, such flexibility is not possible. This affects resident’s quality of life. A requirement has been made in respect of this matter. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 16 Six staff files were examined. They contained comprehensive documentation including references and Identification for each member of staff. There was evidence of Criminal Record Bureau checks having been obtained for all employees. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 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 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) 39, 41 Resident’s representatives can be confident that their views and the best interests of the residents form the basis of the self monitoring and continuous review and development of the home. EVIDENCE: A system for measuring quality had been implemented since the last inspection and is being developed as was seen. Questionnaires had been sent out to residents, relatives/representatives and staff and the deputy manager said that the results of these will be analysed and published in due course. Inspection of records showed that there is regular testing of fire bells and equipment. All accidents and incidents are recorded. Detailed records of resident’s finances are in place. Records were seen to be securely stored, were in good order and up to date. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 18 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 3 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 2 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x x 3 Standard No 31 32 33 34 35 36 Score x 3 2 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Paddock Cottage Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x 3 x x H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 19 NO 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 24 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 reasonably practicable free from hazards to their safety. The registered person shall ensure that at all times persons working at the care home are in such numbers as are appropriate for the health and welfare of residents. Timescale for action 31st October 2005 2. 33 18(1)(a) 31st August 2005 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. 2. Refer to Standard 6 and 22 20 and 23 Good Practice Recommendations The care plans and complaints procedure should be in pictorial formats to aid residents understanding of these. Training in respect of safe handling of medicines and adult protection should be provided for those staff who have not undertaken it. Paddock Cottage H60 H11 S14657 Paddock Cottage V228243 270705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 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. 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