Inspection on 02/05/07 for Robben Cottage

This inspection was carried out on 2nd May 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Robben Cottage 14/03/06

Robben Cottage 26/04/05

Robben Cottage 07/12/04

Robben Cottage 28/07/04

Robben Cottage 01/03/04

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 Robben Cottage 9 Greenfield Terrace Portreath Redruth Cornwall TR16 4LY Lead Inspector Ian Wright Unannounced Inspection 2nd May 2007 13:45 Robben Cottage DS0000009023.V338649.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 Robben Cottage DS0000009023.V338649.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. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Robben Cottage Address 9 Greenfield Terrace Portreath Redruth Cornwall TR16 4LY 01209 843901 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) Mrs Lynn Whiting Mrs Lynn Whiting Care Home 2 Category(ies) of Learning disability (2) registration, with number of places Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th March 2006 Brief Description of the Service: Robben Cottage provides care for up to 2 younger adults with a learning disability. The home is shared with the registered provider’s family. The home is situated in the village of Portreath, on the north coast of Cornwall near Redruth. The registered provider provides care and support. No other permanent staff are employed. The home is a two storey, terraced domestic house near the centre of the village. The two residents have their own bedroom, their own sitting room and bathroom. The home has several pets. A copy of the inspection report is available from the registered provider, and can also be obtained free from CSCI (e.g. via our help line or website) The range of fees at the time of the inspection is currently between £300 to £310 per week, although this may vary for new service users according to their needs assessment. There are additional charges e.g. for a contribution towards the use of the home’s car, hairdressing etc. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in just under five hours. All of the key standards were inspected. The methodology used for this inspection was: • To case track both service users. This included meeting and discussing with them their experiences of living in the home and inspecting their records. • Discussing care practices with the registered provider. • Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. What the service does well: 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. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 6 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 Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 7 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, 5 Quality in this outcome area good. This judgement has been made using available evidence including a visit to this service. The registered provider has a suitable assessment procedure, which should ensure appropriate action is taken by the provider to assess potential service users’ needs. The registered provider also provides service users with suitable terms and conditions of residency so they are aware of their rights and responsibilities. EVIDENCE: The current service users have lived at Robben Cottage for a significant period of time and regard it as their permanent home. The registered provider is however planning to admit a third service user subject to the approval of a major variation of the home’s registration. The inspector was able to inspect the registered provider’s assessment policy, which appears suitable. The inspector and registered provider discussed the process that would be followed if a new service user were to be admitted to the home. This would include an assessment being completed, and the person being able to visit. It is advisable that a copy of the Cornwall Adult Social Care (social services) assessment is obtained if the person is referred by this agency. The registered provider said she would also consult with the current service users throughout the process. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 8 Copies of service users terms and conditions of residency were also inspected and these seem suitable. Service users are also issued with a social services contract of which copies were available on their files. Robben Cottage DS0000009023.V338649.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. All service users have a care plan and these are reviewed. The care plans ensure staff have suitable information to provide care. Service users are encouraged to make decisions about their lives with suitable assistance as required. The registered provider has a suitable approach to risk, so service users can be assured they will be supported to take risks as part of an independent lifestyle. EVIDENCE: Care plans were inspected for both service users. The registered provider said she ensures there is an annual review meeting to help service users plan for the future. Both service users were aware of their care plan, and are involved in drawing it up and reviewing it. The registered provider may find ‘Person Centred Planning’ training provided by Cornwall Adult Social Care useful, although the current process used by the registered provider incorporates the basic philosophy of this training. Both service users said they were involved in making decisions about all areas of their lives, with assistance from the registered provider and other professionals as required. On service user is involved in a self-advocacy group. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 10 Both service users said there were no unreasonable restrictions and they appear to be encouraged to pursue their life choices. The registered provider is not involved in the management of service user monies, and does not act as an appointee for service users financial benefits. Service users said they were encouraged to take reasonable risks so they can be as independent as possible. Where appropriate any risks are documented and the risk is assessed. Robben Cottage DS0000009023.V338649.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 good. This judgement has been made using available evidence including a visit to this service. Service users can participate in a suitable range of activities, and are able to mix with the wider community. Service users are encouraged to maintain relationships with friends and relatives. Service users rights are respected, and service users are enabled to take a suitable amount of responsibility in their daily lives. Suitable arrangements are in place so service users enjoy a healthy and varied diet. EVIDENCE: The inspector spoke with the registered provider and both service users regarding what activities are available. Both service users pursue active lifestyles such as attending the day centre, sheltered work placements, clubs, the pub etc. Both service users are able to use public transport and regularly go to Camborne, Redruth or Truro to the shops etc. One of the service users also goes to the local church. Service users use the shops / café / beach in the village and said they felt part of the local community. Both service users keep in regular contact with friends and family. Friends and family are welcome to visit the home, and the service users can receive their Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 12 visitors in their own lounge. Service users right to participate in personal relationships is respected and encouraged. Service users said they felt their rights are respected. The registered provider appears to have an encouraging attitude to enabling both service users to pursue their own wishes and aspirations. Service users are encouraged to take a reasonable amount of responsibility regarding household duties such as doing their laundry and helping with housework. Service users said they enjoyed the meals provided. Service users said there was always enough food and they have access to the kitchen if they wish to prepare a snack. Tea and coffee making facilities are available in the service users own lounge. Meals are decided on a day-to-day basis, and it was suggested a record of meals provided is kept (e.g. in the diary). Robben Cottage DS0000009023.V338649.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. Personal care is delivered to a good standard, and there are suitable links with medical professionals. Currently the registered provider does not administer medication, although arrangements regarding self-medication appear suitably managed. EVIDENCE: At the moment, current service users only require limited assistance with personal care. Care plans offer suitable guidance where staff do have involvement in this area of people’s lives. Service users said their general practitioners were supportive and they were happy with any medical assistance they had received. Access to dental treatment is, as in many areas of the country limited, although dental care is accessed via the hospital. There is suitable access to opticians. No specialist health services are currently required although these are accessible if required. Service users currently self-administer their own medication. The registered provider provides suitable assistance with ordering service user medication. If in future service users do require more assistance with their medication, the registered provider will need to attend a suitable course e.g. from a pharmacist. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 14 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. The registered provider has suitable policies regarding complaints and prevention of abuse / adult protection. These should ensure any complaints or allegations are treated suitably if they occur. EVIDENCE: Copies of the registered provider’s policies on complaints and the prevention of abuse are suitable. There have not been any complaints or allegations regarding this service. Service users said they had no concerns or complaints. Service users said other members of the household always acted appropriately in any interactions with them. The inspector suggested to the registered provider that it would be suitable for her to attend the county council’s adult protection training. The registered provider said she had tried to gain a place on this but it has been difficult due to oversubscription. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 15 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. Robben Cottage provides a pleasant, homely and clean environment for service users. EVIDENCE: Robben Cottage provides shared accommodation for two service users, the registered provider and her family. Service users have their own bedroom, their own bathroom and their own lounge. They are able to use the family kitchen, and sometimes use the main lounge to socialise with the family, have meals etc. The home is very homely and comfortable, and does not appear to meet any ‘stereotypes’ of being a ‘care home’. The home was clean, well decorated and well maintained at the time of the inspection. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 16 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, 33, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users receive suitable support from the registered provider. However improvements are required to staff records and training. This will help to ensure suitable checks are performed on any carer, and staff are suitably trained to meet service user needs. Equal opportunities issues regarding recruitment and work practices seem appropriate. EVIDENCE: Robben Cottage is a small ‘family style’ care home where, apart from the registered provider, no staff are employed. The service users live along side the registered provider, her partner and the registered provider’s children. Although no staff are employed, at times, for example if the family go away, the registered provider has a ‘bank’ of people who will provide day/ sleep in support at the home. The registered provider keeps basic records on any other carer who may provide support at the home. However these occasions may be few and far between, and the registered provider said she does not employ the carers. Records show that the ‘bank’ of carers are all employed in the social care field. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 17 However some of the evidence of background checks is limited. For example for some of the carers the registered provider has recorded she has seen references and a CRB check, but these are not available for inspection. Information as outlined in Schedule 2 of the Care Homes regulations 2001 (revised 26/7/2004) regarding background checks and training needs to be maintained. The registered provider has obtained her Registered Manager’s Award, and is currently completing a National Vocational Qualification in Care at level 4. The registered provider does require some training updates for example by law she should have a food hygiene certificate. Ms Whiting agreed her partner- Mr McDonald, would obtain an approved persons first aid certificate so one member of the household is a first aider. No service users requires any manual handling, but carers need to be trained in this area if service users needs change. If staff are employed in future they would need to at least receive training in moving and handling inanimate objects in line with the manual handling regulations. Although infection control standards are to a good standard, it is advisable the registered provider has a look at infection control guidelines published by the Department of Health. These are available free via the internet at: http:/www.dh.gov.uk/assetRoot/04/13/63/84/04136384.pdf These are written for all care homes irrespective of size. Subsequently a proportionate response, in liaison with CSCI, should be adopted for this small family type home, rather than adopting the guidance wholesale. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 18 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 generally good although some improvements are required to improve health and safety precautions. This judgement has been made using available evidence including a visit to this service. The registered provider has suitable skills, experience and knowledge to manage the home so service users benefit from a home that has strong leadership. The registered provider has a suitable approach to quality assurance. Subsequently service users can be assured that their views, and the views of other stakeholders, will be sought to improve the quality of the service. Health and safety standards need some improvement to ensure suitable checks take place. EVIDENCE: The registered provider appears to be caring and aware of the needs of the service users who live in the home. She has completed her Registered Managers Award, and is currently completing a National Vocational Qualification in care at level 4. Service users were positive about the registered Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 19 provider’s approach and said they would approach her if they had any problems or concerns. The registered provider has a suitable approach to quality assurance. For example there are regular household meetings to discuss how the home operates and provide a forum to iron out any problems or difficulties. An annual survey system is in operation to ascertain the views of service users and their representatives. The registered provider has a suitable health and safety policy. Gas appliances were tested in December 2006 and a gas safety certificate was obtained. An electrician also visited the home in December 2006 and checked and tested the electrical system. The registered provider said some remedial work was required. Once this is completed the registered provider needs to obtain an electrical hardwire certificate, which needs to be available for inspection. Portable electrical appliances need to be tested preferably every year and at least every two years. Again documentation needs to maintained regarding this. Health and safety risk assessments have been completed, but an additional risk assessment regarding the prevention of legionella needs to be completed. Information regarding the legal requirements to prevent legionella can be obtained from the Environmental Health Department at Kerrier District Council. There is a smoke detector fire alarm system, checks were regularly performed until December 2006, and then the registered provider has not recorded these checks. Weekly testing needs to be recorded in the home’s fire book The registered provider said the alarms are regularly set off, and she would remember to record tests in future. Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 20 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 21 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 7, 19 Requirement Suitable information and documents need to maintained for all staff working at the care home (for example as outlined in schedule 2 of the Care Homes Regulations 2001- such as a CRB check) The registered person shall, having regard to the size of the care home, the statement of purpose, and the number and needs of the service users ensure (s)he has the qualifications , skills and experience necessary to manage the home. Persons employed need to receive training appropriate to the work they are to perform; (for example training in food handling, first aid, infection control, manual handling and fire-as is appropriate). The registered person shall ensure that all parts of the home, to which service users have access, are so far as reasonably practicable free from hazards to their safety. Equipment provided for use by DS0000009023.V338649.R01.S.doc Timescale for action 01/08/07 2. YA35 7, 10, 18 01/11/07 3. YA42 13, 23(2) 01/08/07 Robben Cottage Version 5.2 Page 22 service users or persons who work in the care home must be maintained in good working order. (For example: • Fire equipment must be tested at intervals recommended by the fire authority. • A satisfactory electrical hardwire certificate must be obtained. This test must be completed at least every 5 years. • Portable electrical appliances must be tested at least every 2 years. • A risk assessment must be completed regarding the prevention of legionella, and any action taken( if necessary) in line with HSE guidance.) 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 Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton Devon 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 Robben Cottage DS0000009023.V338649.R01.S.doc Version 5.2 Page 24 - 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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