Inspection on 21/01/08 for Rose Cottage

This inspection was carried out on 21st January 2008.

CSCI found this care home to be providing an Good service.

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

Rose Cottage 24/05/06

Similar services:

Insight - Eastchurch

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 Rose Cottage Oak Lodge Road New Romney Kent TN28 8BG Lead Inspector Wendy Gabriel Unannounced Inspection 21 January 2008 09:30 st Rose Cottage DS0000065105.V358014.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 Rose Cottage DS0000065105.V358014.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. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Cottage Address Oak Lodge Road New Romney Kent TN28 8BG 01797 362 842 01797 366 237 rose.cottage@craegmoor.co.uk 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) Lothlorien Community Ltd Mrs Gillian Elizabeth Waghorne Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th May 2006 Brief Description of the Service: Rose Cottage is owned by Lothlorien Community Limited, which is a member of Craegmoor Group Limited. It is a large detached house located in New Romney that provides care for six people with a learning disability. All bedrooms are single and there is adequate w.c. and bathing facilities. The home is within walking distance of the high street, supermarket and the beach. A bus service to local towns is close by. Fees for Rose Cottage at 21/01/08 are in the range of £737.11 and £1068.87. There are additional charges for chiropody, hairdressing, massage, some toiletries and magazines. Please contact the provider for up to date information. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The Registered Manager and three members of staff were on duty at the time of the unannounced inspection. One member of staff escorted a person who lives at the home to a hospital appointment during the course of the inspection. One of the remaining members of staff was new to the home that morning and the other was from another co-owned home nearby to assist that day. The home was clean, tidy and homely. People living there were seen to freely access different areas and although verbal communication was limited, there was very good rapport between them and the staff and Registered Manager. A range of evidence has been used to inform this report including speaking to the Registered Manager, being introduced to and speaking briefly to the two staff on duty at the time, an accompanied tour of most of the premises looking at some records and regulatory information the home had sent to the csci since the previous inspection. What the service does well: The home takes care with communication and Maketon is included in training. One person who lives in the home kindly showed how she uses picture formats for a daily activity and another had his own book with pictures of his favourite activities that he could use when speaking to staff about his daily life. Both people were seen to use the communication system happily and easily. The Registered Manager and staff are making the place very homely with the use of artwork created by people living in the home. These are suitable for the age range of the residents and create a nice atmosphere to the environment. The Registered Manager said this was in preference to staff buying a selection of pictures that would be their choice and not residents. The home has responded very well to the needs of a resident who mobility has been temporarily set back. Bedroom accommodation has been altered and reviewed to the benefit of two different residents. Rose Cottage DS0000065105.V358014.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. Rose Cottage DS0000065105.V358014.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 Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents know their individual aspirations and needs are assessed. Written information including a statement of purpose is available for prospective residents to enable a suitable choice of home to be made. EVIDENCE: The home provides pre admission documents to assess prospective residents and enable an informed choice to be made about whether the home is suitable for the individual. Independent advocates may be used to make sure residents are enabled to make their choices freely. A welcome pack to the home includes the statement of purpose and service user guide as well as information to inform the new person to the home and their relatives. The previous CSCI inspection report is also on display in the home. The smaller environment has been a settling influence for several of the residents and one person in particular has had improved behaviour patterns since moving into the home. The psychiatrist is currently involved with this person to assist with an on going assessment and help make sure any move is suitable. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents know their needs and preferences are recorded in their individual plans. Residents are assisted to make decisions about their lives. Risk assessments support residents to make choices. Confidential information is held securely. EVIDENCE: Three person centred plans were viewed and these contain a variety of useful information detailing preferred activities and personal care requirements. Risk assessments are detailed and are regularly reviewed. These are clearly written to inform staff of actions required when assisting individuals. Person centred plans are reviewed monthly and any changes recorded. The Registered Manager discussed personal assessments that are regularly reviewed by the home in order to improve support to people living in the home and to update any identified needs. A recommendation is made for the names Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 10 of the attendees at the assessment be recorded as well as the date of the review. Daily activity and household tasks are written and the Registered Manager said that people in the home could decide what and when they would help with on a daily basis. One person visited the Registered Manager and although verbal communication was limited, was able to discuss his preferences for his afternoon activities. It was very clear that the individuals’ choice was enabled and not prescribed for him. The home holds peoples’ money and clear and detailed records of money held, spent and saved is maintained. A sample of cash held corresponded with records kept. Confidential information is held in locked facilities in a locked office. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are enabled to take part in activities of their choice both at home and in the community. People can choose to take part or not in any activity. Family and friendships are maintained. Menus are varied and can be provided to suit different dietary needs. EVIDENCE: The home organises a range of activities and one person indicated to the inspector that she was able to choose what to do and was enabled to choose not to participate in certain organised events or activities. During the day one person was invited to choose how to spend the afternoon and through non-verbal communication was able to let the Registered Manager know where he wanted to go and what he wanted to do when there. It was very clear that he was assisted to make his own choices and not just go along Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 12 with what others were going to do. By his body language and facial expressions it was also clear that this level of choice was usual and expected. The local community welcome people from the home, for example, the inspector was informed that some of the pubs recognise people living in the home when they visit. Several different pubs are visited and one person happily made it clear which was his favourite. Holidays were being planned for the coming year and the Registered Manager said that the owning company pays a certain amount towards holidays. Some questionnaires from when the home first opened were viewed and comments from families were very positive about peoples’ lifestyles. More questionnaires are due to be sent out again. The Registered Manager said that some people visit their families regularly or one or more times a year. The home assists with escorting people to their families especially when they live at some distance. Families are very welcome to visit and the Registered Manager wants to increase family’s events in the coming year. Bedrooms are individual and contain personal items. Several people showed the inspector their rooms during the tour of the premises. One person preferred not to meet the inspector at that time. People were seen to freely access bedrooms, sitting room, office and kitchen. The kitchen is divided into two distinct areas and people are able to be involved without getting near the large cooker, which for some could be a risk area. People can choose from the menu and will help prepare meals if they wish. The kitchen is well organised and was seen to be clean and tidy. The fridge and freezer were both full and fresh vegetables, fruit and meat were available. Fridge and freezer temperatures are kept. The laundry has to be accessed through the dining end of the kitchen, but because the environmental health officer has seen this, the home uses closed containers to move laundry through the kitchen. Evidence of these were seen. The laundry was also clean, tidy and free from clutter. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People receive support in a way they prefer and their physical and emotional needs are met. Medication administration and procedures protect residents. EVIDENCE: Medication is stored in a suitable facility that is also secured to the wall in a locked room. Controlled drugs corresponded with numbers recorded in the controlled drugs register. A recommendation made at the previous inspection regarding controlled drugs has been met. Staff all undertake medication administration training but are not allowed to administer medication until they have also undertaken a competency test and been deemed competent and confident by the Registered Manager. All staff undertakes epilepsy administration training. Details of individual medications and risk assessments are in individual person centred plans. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 14 Physical, emotional and health care matters are recorded. One person was escorted to a hospital appointment at the time of the inspection and the home had reviewed and reorganised rooms to assist this individual become more independent. The home uses the services of a psychiatrist who is employed by the company and who visits the home once a month. The people in the home at the time of the inspection were well dressed in an age appropriate manner. All were very individual and reflected personal taste. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are protected from abuse by staff training. People know they are listened to and encouraged to make their views known. EVIDENCE: All staff receives PoVa (Protection of Vulnerable Adults) training and are aware of the whistle blowing procedure. There is complaints information in different areas of the home and there is a recording document if any complaints are received. No complaints had been received by CSCI since the last inspection. People in the home have small picture cards to use if they wish to complain and are readily accessible and clear to see. Staff receive adult protection training and there was a detailed notice in the office describing types of abuse for staff to be aware of. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People live in a homely and safe environment. The home is clean and hygienic. Bedrooms, bath and toilet facilities meet peoples’ needs. People enjoy communal rooms that compliment their individual rooms. EVIDENCE: The home is in an area of similar properties and presents as being part of the community. An accompanied tour was undertaken of most of the premises and people were asked if they would let the inspector view their rooms. People were also invited to accompany the inspector and talk about their rooms. Bedrooms seen were individual and reflected personal interests of the occupants. It was evident that people had been encouraged to express personal choices. One person told the inspector that she had chosen to not take part in a particular activity but had other interests that she was Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 17 encouraged to maintain. Although no bedrooms are en-suite, they all had wash- basins and there are adequate bathing and toilet facilities. The Registered Manager said that some ‘brightening up’ of paintwork was needed and the company had agreed that this. The hall and stair carpet were looking tired and the Registered Manager said she was hoping also to get this done in the coming year. One of the shower rooms was being renewed and was close to completion. Other bath and shower rooms and toilets were clean and tidy. The Registered Manager agreed to find a more discrete place for the sharps box used by staff. Although it was safe it did not look very homely in an otherwise comfortable shower room. The home was very clean and coshhe items are securely stored. The kitchen is tidy and well organised. The laundry is tidy and clear of clutter. Staff have to use covered containers to take laundry through the dining part of the kitchen as this is the only route to this area. The Registered Manager said that the environmental health officer had agreed to this providing dirty laundry is covered. There are also algenate sacks provided for foul linen. Staff has received training in infection control. The living room and dining room provide suitable communal space for the people in the home and there are double doors in the dining room leading into the garden. This is currently being used as a bedroom for one person not able to access upstairs at this time, but the change of bedrooms is almost complete and the dining room will be brought back into service. Other arrangements had been made for meal times in the kitchen and lounge and were a suitable emergency arrangement. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People are protected by the homes recruitment policy. Appropriately trained and supervised staff meet peoples needs. EVIDENCE: A new member of staff started work on the day of the inspection. This person completes the staffing compliment for the home. There are normally two staff on duty throughout the day. One wake and one sleep staff work overnight. The Registered Manager works in the home in addition to the support staff. Because one person has had some 2-1 care needs identified by the home and because funding is not available for this, the Registered Manager occasionally undertakes support work to allow for example, outings to take place for the individual. A robust recruitment practice takes place and this was verified by a sample of two staff files. CRB checks are undertaken and references applied for. The company provides detailed induction booklets for new staff to work through. Staff receive supervision. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 19 The Registered Manager said that the company was good at encouraging staff to progress through the company. Evidence was seen in certificates, training matrix and calendar of a wide range of training being undertaken by staff. This includes the mandatory courses as well as more specialised courses such as Maketon, epilepsy, coshhe, equal opportunities, CPI, management of violence and aggression and medication. All staff except the newest recruit has either undertaken NVQ2 or 3 or is enrolled to start. Rose Cottage DS0000065105.V358014.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): Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from a well run home and their rights and best interests are safeguarded. Peoples’ health and safety is protected by well trained staff and a home run by a competent manager. EVIDENCE: The Registered Manager has completed her Registered Managers Award. There had been a good response from relatives in the homes questionnaire sent when the home had been open less than a year about the Registered Manager and that she has ‘good insight ‘and is ‘very good’. People were clearly used to going to the office and speaking to the Registered Manager and the atmosphere in the home was relaxed, friendly and happy. Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 21 Non-verbal communication was understood and responded to by the Registered Manager and staff. People were given time to express themselves and always given the opportunity to make sure their views were understood and acted on. As previously commented on, it was obvious by body language and facial expressions that this was usual practice expected by people living there. The home is run for the best interests of the people living there. This was apparent through conversations with the Registered Manager and listening to communication between staff and people living in the home. People who live in the home and staff have regular meetings. The company also organises conferences for the local group of co owned homes, where a representative of people living in the home will attend and put forward views and ideas to the company. The conferences have been going on for a few years and are a successful means of inclusion for all people in the home. Questionnaires are due to be sent to relatives in the near future as part of the quality assurance. The home undertakes annual audits for finance, medication, health and safety, person centred plans and infection control. Maintenance and annual checks are in place and fire policies and procedures are up to date. Rose Cottage DS0000065105.V358014.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 3 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 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 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 3 X 3 X 3 X Rose Cottage DS0000065105.V358014.R01.S.doc Version 5.2 Page 23 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. 1 Refer to Standard YA6 Good Practice Recommendations Record the names of all people attending reviews and the date of the review. 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