Inspection on 05/10/06 for Paddock Cottage

This inspection was carried out on 5th October 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

Paddock Cottage 23/11/05

Paddock Cottage 27/07/05

Paddock Cottage 07/02/05

Paddock Cottage 19/07/04

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Thorndene

Insight - Eastchurch

Southfields

Magenta

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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 Ms J Hartley Unannounced Inspection 5th October 2006 11:15 Paddock Cottage DS0000014657.V315945.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 Paddock Cottage DS0000014657.V315945.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. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 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.V315945.R01.S.doc Version 5.2 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. 23rd November 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. There is a good-sized garden to the rear of the property, which is accessible to residents. Fees range from £11450.02 to £1334.42 Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced key inspection took place over nearly four hours. The Registered Manager Ms Alison Hunter was present throughout most of the inspection and provided the information required. The inspector examined information held on the service file since the last inspection in November 2005, and read the previous two inspection reports, the Service User Guide and the Statement of Purpose. During the inspection the inspector spoke to two service users, and two members of staff. 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. The inspector undertook a tour of the premises and looked at all six care plans and three staff files. Various record books, policies and procedures were also examined. What the service does well: What has improved since the last inspection? At the previous inspection it was noted that some residents were unable to access the garden unsupervised due to the dangers posed by the swimming pool. Since the last inspection the pool has been removed and the area made safe. A bedroom and the large hall have been redecorated and refurnished. Paddock Cottage DS0000014657.V315945.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. The summary of this inspection report can be made available in other formats on request. Paddock Cottage DS0000014657.V315945.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 Paddock Cottage DS0000014657.V315945.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Information is provided in the Home’s Statement of Purpose and Service User Guide to enable prospective residents and/or their representatives to make an informed choice about the home. 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 homes’ latest Statement of Purpose and Service User Guide were both seen during the inspection. Both documents are up to date and include the required information. All of the residents’ files were examined during the inspection. Each file contained Health and Social Services Assessments as well has the homes’ own comprehensive assessment. Care plans included details of any restrictions of choice and freedom and the reasons they were in place. Each file included thorough risk assessments. Paddock Cottage has thorough procedures for assessing residents prior to their moving into the home. The manager said that when someone is referred to the Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 9 home they obtain background information and an assessment from the referrer. Then someone from the home will visit the prospective resident and do his or her own assessment. The prospective resident is then invited for a visit to the home followed by an overnight stay. Following this the resident moves into the home for a six to eight week further assessment and trial period. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 10 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. 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. Residents know their assessed and changing needs and personal goals are reflected in their individual plan, they are able to make decisions about their lives with assistance as needed. Residents are supported to take risks as part of an individual lifestyle. EVIDENCE: All the residents’ files were inspected. They were all found to contain comprehensive care plans. Individual procedures and guidelines were seen to be in place for residents who may be aggressive, cause harm or self harm. Each resident has a simplified version of his or her individual care plan called a “Communication Passport”. This is a very good personalised document that is useful for residents, staff at the home and any other professionals involved in the residents care. It was clear that residents have taken part in producing these. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 11 Evidence was seen that care plans are reviewed at least every six months within the home and also yearly by the referring authority. The manager said that residents are invited to their reviews. Staff confirmed this and said that keyworkers work alongside residents prior to a review to support residents in putting their views forward. Evidence of decisions, choice and risk taking was seen in care notes, risk assessment and monthly reports. Regular residents meetings are held to enable residents to air their views. The home has also arranged for an advocate to meet with residents once a month. Residents are supported in taking risks that are appropriate to their abilities. For example some residents attend horse carriage riding and trampolining. All individual files seen included relevant and comprehensive risk assessments. The home has a policy in place regarding unexplained absences that clearly sets out the action to be taken by staff if the circumstance should arrive. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are able to take part in a wide range of age, peer and culturally appropriate activities and are given a lot of support in being part of the local community and to maintain relationships with their families. Residents’ rights are respected and responsibilities recognised in their daily lives. The home actively promotes independent living through support and advocacy. Residents are offered a healthy diet and enjoy their meals. EVIDENCE: Residents each have an individual activity plan on file. It was evident from this and the daily records seen during the inspection that they take part in a wide variety of activities including attending college, church group, horse riding, trampolining, bowling, shopping and visiting local community activities such as car boot sales and village fetes. Residents are taken out for meals and to local pubs and other venues to enable them to integrate into the community. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 13 It was evident from the daily records that residents are supported and encouraged to maintain family links through visits to their family, having family visit them at home and through telephone contact. During the inspection staff were witnessed interacting positively with residents. All the bedrooms have locks but the current residents are not able to hold their own keys. The manager said that they are encouraged to ask staff to lock their doors for them when they are away from their rooms to prevent people entering them without their permission. Care plans and daily records show that residents are supported in maintaining and learning independence skills. Where they are able to, residents help with simple tasks around the home such as making their beds, tidying their rooms and putting washing away with staff support and guidance. Residents are able to help plan menus and shop for food. One resident said that she likes what she had for lunch on the day of the inspection. Menus showed that a varied and balanced diet is provided which includes fresh produce. Records showed that the majority of staff had undertaken food hygiene training. Evidence was seen that the home monitors nutritional needs and the weight of residents. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 14 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. 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. Residents receive personal support in the way they prefer and require. Their health needs are assessed as part of the care planning process and on an ongoing basis. The home has established links with relevant health professionals in the community to ensure health and emotional needs are met. The current residents are unable to administer and control their own medication due to the level of their learning disabilities. Residents are protected as far as possible by the homes’ policies and procedures for dealing with medication. EVIDENCE: Care plans seen show that daily routines for residents are tailored to meet individual needs and preferences. The home has enough staff on duty each shift to ensure they are able to meet individual requirements. Daily records provide evidence that staff provide care in line with care plans that are reviewed on a regular basis. Residents all wear their own clothes, which reflect Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 15 their personality and taste. Each service user is allocated a key-worker and co key-worker, which enables continuity of care for individuals. Files examined showed that residents are registered with doctors, opticians and dentists. Further support for their physical, mental and specialist healthcare needs are provided through community health services and the Community Team for People with Learning Disabilities. Each resident’s file includes a comprehensive record of health appointments and the outcomes. Clear policies and procedures were seen to be in place for the safe receipt, recording, storage, handling administration and disposal of medicines. Medication records were examined. They were seen to be up to date and recorded accurately. None of the residents are able to take control of their own medication and this was stated in each care plan. Staff records seen show that staff who administer medication have received training in this area. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 16 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. 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. There is a clear complaints procedure in place and any complaints that are received are dealt with in a timely fashion. The home has robust policies and procedures in place that as far as possible protect residents from abuse. Staff receive training in Adult Protection. EVIDENCE: The home has a clear complaints procedure that is included in the Service User Guide. The manager said that they have not been able to produce the procedure in a pictorial format that is understandable to the current residents at the home, however they have the resources to do this if a new resident came into the home who could understand pictorial information. An advocate visits the residents at the home each month. If residents feel they are unable to approach a member of staff with a complaint or concern they are able to speak to the advocate. Paddock Cottage keeps a record of any complaints made. There have been three since the last inspection. Two were from neighbours complaining that a resident was throwing things from an upstairs widow, and one was also from a neighbour concerning the hedge round the property being overgrown. All three complaints were resolved within the required timescales. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 17 The home’s procedures on abuse, Adult Protection and whistle blowing were seen. They are robust and include descriptions on different types of abuse. Staff training records show that staff have received training in Adult Protection. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely, comfortable and safe environment that is clean and hygienic. EVIDENCE: Paddock Cottage is a detached house situated in its own grounds near to the town of Crawley and all its amenities. A tour of the house found it to be accessible, safe and well maintained. Communal rooms are comfortable and homely with good quality furnishings. Residents’ bedrooms are personalised and decorated according to individual tastes. One resident said that she had chosen the colours in her room that had recently been decorated. One resident’s bedroom was found to be quite bare, as he doesn’t like having lots of things in his room. This was recorded in his care plan. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 19 The home has a planned maintenance programme. On the day of the inspection Paddock Cottage was clean, tidy and free from offensive odours. Some of the gloss paintwork on the stairs has become chipped. This is being addressed in the coming year and is part of the homes’ planned maintenance programme. Since the last inspection a bedroom and the large hallway have been redecorated. Radiators throughout the home have been covered and windows have restrictors fitted. The laundry is sited in its own room adjacent to the kitchen. Walls and floor surfaces are easy to clean. Paddock Cottage has policies and procedures in place regarding the control of infection. The home has a large, accessible well-stocked garden that has tables, chairs, a trampoline and a swing chair in it. There is a summerhouse situated in the grounds that is used for art activities for the residents. At the last inspection it was noted that not all of the residents were able to access the garden unsupervised due to the possible dangers posed by the swimming pool. The swimming pool has now been removed and the area made safe. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents individual and joint needs are met by competent, appropriately trained and qualified staff. Residents are supported and protected as far as possible by the home’s recruitment policy and practices. EVIDENCE: Records seen show that the home follows its thorough recruitment procedure when employing new staff. A sample of three staff files was inspected and found to include all the required paperwork including two written references and Criminal Records Bureau checks. Staff at Paddock Cottage are able to access a wide range of mandatory Health and Safety training and other training that is relevant to their role. Courses available to staff include various Health and Safety courses, Autistic Spectrum Disorder, Epilepsy, Conflict Management and Makaton. The home has not reached the target of having fifty percent of staff with an NVQ 2 by 2005. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 21 Throughout the inspection staff were seen to be approachable and patient. They listened to residents and communicated with them verbally and using Makaton when required. Staff spoken to showed a good level of understanding of residents’ individual needs, care plans and behavioural guidelines. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by a competent and qualified manager. The home has policies, records and procedures in place to safeguard as far as possible the interests of residents and the health, safety and welfare of residents and staff. EVIDENCE: Evidence held on file shows that the manager, Ms Alison Hunter, is qualified and competent to run the home. Ms Hunter says that she has the opportunity to undertake training to maintain and update her knowledge skills and competence. Allied Homecare has a Quality Assurance manager in post and has set up a quality monitoring system, which seeks the views of residents, staff and Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 23 relatives. Residents’ views are also sought during house meetings and through the monthly Regulation Twenty-Six reports. 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. Evidence was seen that the home has a comprehensive health and safety policy and staff have regular training in all topics related to health and safety. Documentary evidence was seen to show that hot water temperatures are monitored and recorded regularly and checks made on all electrical equipment and gas boilers. Restrictors are fitted to windows above ground floor level. Evidence was seen that the home has a regular Legionella test. All accidents and incidents are recorded appropriately and notified to the Commission for Social Care Inspection and other agencies as required. Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 24 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 3 2 3 3 X 4 3 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 2 33 X 34 3 35 3 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 4 13 4 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 3 X X 3 X Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 25 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 Paddock Cottage DS0000014657.V315945.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V315945.R01.S.doc Version 5.2 Page 27 - 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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