Inspection on 11/01/07 for Perry Cottage

This inspection was carried out on 11th January 2007.

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

Perry Cottage 26/01/06

Perry Cottage 22/09/05

Perry Cottage 08/12/04

Perry Cottage 07/07/04

Perry Cottage 20/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Perry Cottage Lower Cotley Farm Fluxton Ottery St Mary Devon EX11 1RJ Lead Inspector Belinda Heginworth Unannounced Inspection 11th January 2007 08.40 Perry Cottage DS0000022008.V311129.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 Perry Cottage DS0000022008.V311129.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. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Perry Cottage Address Lower Cotley Farm Fluxton Ottery St Mary Devon EX11 1RJ 01404 814961 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 Simon Charles Knight Mrs Nicolette Knight Mr Simon Charles Knight Mrs Nicolette Knight Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th January 2006 Brief Description of the Service: Perry Cottage is a rural cottage near the town of Ottery St. Mary, East Devon. On the top floor there is a separate flat where a member of the Registered Providers family lives, and takes some responsibility for the residents safety at night. On the lower two floors live three young men who have a learning disability. The cottage has a beautiful conservatory and veranda, which was built by the providers and the residents. The Registered Providers live and work at a farm within walking distance of Perry Cottage. Residents assist with the farm work, which they all enjoy. They are supported to live in Perry Cottage by the Registered Providers who visit the cottage frequently. Residents are included in all aspects of family life. Fees range from £300 to £420 per week. Residents’ contribute towards the cost of transport through their disability allowance. Currently only personal items are charged in addition to the fees and transport. Reports from the Commissions are available upon request to residents, relatives and care managers. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over 2 hours and 20 minutes during a week-day. The providers were present throughout the inspection. Prior to the inspection the provider completed a questionnaire, which provides information about residents, fees and confirms that necessary policies and procedures are in place. Surveys were sent to residents prior to the inspection but none were returned. Residents said they preferred to speak with the inspector on the day. Telephone contact was made with 3 relatives who all gave positive feedback about the home. Comment cards were sent to 2 GPs and two health professionals, none were returned. Telephone contact has been tried with one care manager but this has been unsuccessful. The majority of this inspection was spent with the residents until they left to work on the farm. Residents files were “case tracked”, this means their records were read and residents were consulted about their care. The inspector looked around parts of the building and read other records, these included, medication and quality assurance policies. What the service does well: The providers are caring and respectful and have created a warm, friendly, fun and inclusive home. The environment is homely and meet residents’ needs and is situated in a beautiful setting. Perry Cottage is very much the residents’ home and is run in a person centred way, focusing on the needs and wishes of each person. They are consulted about all aspects of their lives, including the food they eat and live as part of the family. It was clear through talking with residents that their life at the home is very happy and very fulfilling. Relatives are delighted with the care their dependants receive, comments included “ wonderful”, “thoughtful”, brilliant”, “couldn’t wish for better care”, “provide a great social life”. Residents help on the farm and spoke proudly of the work they do. They are very much part of the local community and lead a busy social life attending local events and are in a local football team. They attend and carry out many activities both in and out of the house, including the horizon club, run by the providers. Good information is kept on residents’ needs and risks with clear action recorded to help to meet needs and reduce risks. All needs and risks are regularly reviewed and involve residents, relatives and professionals when necessary. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Perry Cottage DS0000022008.V311129.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 Perry Cottage DS0000022008.V311129.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assured their needs can be met with good assessment and admission practices. EVIDENCE: The residents have been living at the home for many years. The assessment process prior to admission ensured the home could meet their needs. Relatives and residents confirmed their involvement. Although the providers do not intend to admit any new service users, they are fully aware that full assessments of need would need to be completed before admission. Perry Cottage DS0000022008.V311129.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. 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. Good information is provided to help meet and monitor residents’ needs safely and consistently. Decisions made on behalf of residents are done so in consultation with residents, their representatives and in their best interests. EVIDENCE: Residents spoke about how they are involved in all decisions about their care and the running of the home. Regular meetings are held in the home where the providers ensure residents are happy with their lives and together they come up with ideas on how to improve things. Each resident has a detailed plan of care that highlights social, care and health needs. Some have care managers who visit and fully consult residents in reviews of their care. All care plans are reviewed regularly with residents. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 10 Assessments of hazards are identified and detailed action is recorded on how to reduce the risk. In some cases actions to reduce risks are discussed and agreed with other professionals and relatives. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 11 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 benefit from accessing the local community and taking part in appropriate activities. Residents’ rights are respected at all times and relationships with families are maintained. Service users benefit from a varied and healthy diet which they help to choose and prepare. EVIDENCE: It was clear through talking with residents and making observations that residents lead a very active, independent and full life. The home is run in a person centred way that takes into account residents’ wishes and needs. Residents spoke fondly of the providers saying they were kind, fun and caring. Throughout the inspection the atmosphere was relaxed and residents were spoken to in respectful and caring manner. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 12 Residents help out each day on the farm and said they enjoyed doing this. There are many photographs displayed throughout the home of a busy but fulfilling life, some of which are taken by the residents themselves. These ranged from hot air balloon trips, holidays in France, family events, parties and clubs they attend and many more. They were photographs of some of the work they enjoyed doing on the farm. These included vegetable growing and keeping chickens and cattle. On the day of the inspection residents were carrying out some chores at the farm before going off to do some artwork locally. Residents said weekends are either visiting relatives, relaxing, watching TV, shopping or going to the pub. One resident has a particular interest in jigsaw puzzles and has plenty of room in the lounge to complete them. The providers run a weekly club in Exeter called the Horizon club. People from other homes and settings attend. The residents have made good friends there and said how much they enjoyed going. The residents use the local pub and are very much part of the local community. They are also part of a local football team and enjoy playing weekly. Relatives spoken with said the providers were “brilliant” and one said “I could not give my son the social life the providers give”. The residents said they are supported to maintain contact with family and friends. They talked about their recent visit home at Christmas and their regular telephone contact. Relatives spoken with said the providers are “wonderful and thoughtful”, one relative said “they couldn’t wish for better care and always keep us up to date with everything”. In the summer the providers held a barbecue at the home where relatives and friends attended. The home does not use menus but residents said they are able to choose what to eat and often help to prepare the main meal. The residents live independently from the providers and make their own breakfast and snacks and drinks. The provider makes the main meals, which are served in the main farm or the home, depending on what they are doing each day. Residents said they had a wide range of fresh vegetable and fruit and the meals were “lovely”. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 13 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 are supported in a way they prefer and their health needs are well met. Medication practices protect service users health and welfare. EVIDENCE: Residents are independent with personal care but would talk to the providers if they were worried about anything. Residents said they felt they were well taken care of and the providers demonstrated a good understanding of residents’ health needs. Care plans provided further evidence that health care needs were assessed, monitored and met. This included information about regular chiropody, dental and eye checks as well as appointments with other professionals such as GP, psychiatrists and psychologists. These regular visits ensure residents’ health and mental health needs are monitored closely. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 14 Residents do not have regular medication but homely remedies are available if required. A homely remedy policy is in place and such medicines are stored appropriately, therefore protecting residents’ health, safety and welfare. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 15 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. Relatives and residents are assured they are listened to and complaints are dealt with appropriately. Residents are protected from potential abuse. EVIDENCE: The home has a complaint’s procedure and relatives are also provided with a copy. Residents said if they were unhappy they would talk to the providers, their family or care manager. Residents said they have discussions together at meetings where they will talk about any issues they concerned about. They said they felt listened to and said the providers will act on any concerns or requests they have. The providers have a copy of the Department of Health’s No Secret document to ensure they understand how to protect residents from abuse, neglect and self-harm. They also have a copy of the local Alerters Guide, which provides information on how and who to contact in cases of suspected abuse. Residents have their own bank accounts, which they said they enjoyed using. Benefits from funding authorities are paid directly to the providers where a standing order is then set up to pay the residents’ weekly allowance into their individual bank accounts. All accounts, including the providers are fully auditable. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 16 Residents also receive disability benefits that are paid to the providers to help contribute towards the cost of the transport they use. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a clean, comfortable and homely environment. EVIDENCE: Perry Cottage is situated in a rural setting with beautiful views of the hills from the lounge, kitchen, veranda and some bedrooms. The house is cosy and clean, creating a lovely warm atmosphere. The home is very much the residents’ house with their belongings and hobbies displayed throughout. Bedrooms are decorated and furnished to individual tastes, preferences and needs. Residents said they keep their bedrooms clean and tidy and help with some cleaning around the house. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 18 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 & 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by experienced and competent people who help them to lead a safe and fulfilling life. Practices regarding recruitment need to improve to ensure residents are fully protected from potential abuse. EVIDENCE: Residents said they thought the providers did a “good job” of caring for them. Although the providers have attended training courses in the past, they have not done so recently. They agreed that they needed to up date themselves on health & safety training and training that may help them to meet residents’ needs. The providers said they would look into this and arrange this soon. The providers do not employ staff as residents lead a fairly independent life and the providers are able to meet their needs. However, the providers do not live on the premises but their son lives in a flat within the home. He is there as a first point of call should the residents have an emergency at night. The providers accepted that full recruitment procedures should be carried out for Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 19 their son, including a CRB check to ensure residents are fully protected. The providers said they would complete this immediately. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 20 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a well run and safe home that takes into account their views and wishes. EVIDENCE: One of the providers began training in NVQ 4 in management but has recently given this up saying it took too much time away from the residents. Residents said they were happy the provider was no longer at college. The providers understand the need to receive suitable training and qualifications and may consider starting it again in the future and accept it will be a recommendation to do so. However, the home is well run, residents live a full, safe and comfortable life and are cared for by providers who are respectful, kind and enthusiastic. Relatives spoke highly of the providers and the care their Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 21 dependants received. Care managers reviews are positive with the outcome for residents being excellent. The providers monitor the quality of care to residents through care plan reviews, listening to the residents’ views at meetings and general day-to-day conversations and updating policies and procedures. A quality assurance plan has been drawn up that includes all health & safety updates necessary to keep the home safe, but did not include details about the above mentioned meetings and reviews. In addition there were no details about how relatives and outside stakeholders would be consulted on how the home is run. The provider agreed to include this and said a more formal system would be set up to seek the views of relatives, GPs, care managers and so on. Relatives spoken with said they speak to the providers each time they pick their dependant up for home visits and keep up to date with any issues. The CSCI obtains information prior to inspections. The information includes conformation that all necessary policies and procedures are in place and are up to date. These are not inspected on the day but the information is used to help form a judgement as to whether the home has the correct policies to keep residents safe. These along with risk assessments are reviewed regularly and are up dated where necessary, to ensure they are appropriate and reduce risks to residents. The fire authority recently visited the home and has made recommendations, which the providers intend to complete as soon as possible. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 22 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 X STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19 Requirement The registered person shall allow a person to work in the care home unless the employer has obtained in respect of that person the information and documents specified in paragraphs 1- 7 of Schedule 2 of the Care Home Regulations. (This refers to CRB, references and identification) Timescale for action 13/02/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA37 Good Practice Recommendations The registered provider should take NVQ 4 in management and care. The registered person should undertake periodic training and development meeting TOPSS specifications, to maintain and update their knowledge, skills and competence while managing the home. The registered providers should up date their knowledge and skills by attending relevant training. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 24 2. YA39 The views of family, friends and advocates and of stakeholders in the community (egg. GPS, teachers, chiropodist, audiologist, and voluntary organisation staff) are sought on how the home is achieving goals for service users. Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Perry Cottage DS0000022008.V311129.R01.S.doc Version 5.2 Page 26 - 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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