Inspection on 05/09/07 for Rose Cottage

This inspection was carried out on 5th September 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Rose Cottage 02/06/06

Rose Cottage 24/11/05

Rose Cottage 15/04/05

Rose Cottage 18/11/04

Rose Cottage 19/07/04

Rose Cottage 12/06/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Rose Cottage Grange Road Bursledon Southampton SO31 8GD Lead Inspector Neil Kingman Unannounced Inspection 5 September 2007 13:45 Rose Cottage DS0000012072.V344292.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 DS0000012072.V344292.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 DS0000012072.V344292.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Cottage Address Grange Road Bursledon Southampton SO31 8GD 02380 407048 02380 407048 rose.cottage@wrcl.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) Wessex Regional Care Limited Miss Zoe Coral Russell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2 June 2006 Brief Description of the Service: Rose Cottage is a registered care home providing care support and accommodation for up to four adults of both sexes with learning disabilities. Miss Zoe Russell manages the home on behalf of the provider Wessex Regional Care Limited The home is a bungalow situated in Grange Road, Bursledon, near its junction with Portsmouth Road, which is the main bus route to Southampton city centre, with a bus stop adjacent to the home. There are local shops within a mile of the home. All rooms are for single occupancy and have been furnished and decorated to peoples’ individual tastes. Communal areas comprise a large lounge and open plan kitchen/dining room. The home has a large enclosed garden at the rear and to one side, while there is room at the front for several vehicles to park off road. Wessex Regional Care has three homes in the area, another one in Hampshire and one in Southampton. Weekly fees range between £1314.31 and £1787.10. The manager states that a copy of the home’s service user’s guide, together with the terms and conditions of residency are provided to all prospective residents, or their representatives where applicable. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Rose Cottage and brings together accumulated evidence of activity in the home since the last key inspection on 2 June 2006, at which there were five requirements identified as needing to be addressed. Part of the process has been to consult with people who use the service by way of survey comment cards. Responses were received from all service users, two visiting healthcare professionals, a relative of one of the service users and a person who provides an outside exercise facility for them. Included in the inspection was an unannounced site visit to the home by an inspector on 5 September 2007. A senior care support worker was in charge initially and the registered manager joined us during the afternoon. At the visit we had an opportunity to tour the building, speak with staff on duty and meet all four people who use the service. We also looked at a selection of records. Prior to the site visit the manager sent to the Commission a detailed selection of information about the service including an Annual Quality Assurance Assessment (referred to as the assessment during the report), which has been used with other information to inform the various judgements made about the service. What the service does well: This inspection of Rose Cottage has judged it to be an improving service with substantial strengths, where the improvements have been managed well. The home has a good forward thinking manager who is well qualified, keeps up to date with best practice and supports the staff group. People who live in the home lead active lives. Staff provide the support they need to follow their interests, maintain contact with family and friends and develop life skills, which promote their independence and their ability to lead normal meaningful lives. The feedback from the various surveys undertaken was generally very positive with mostly boxes ticked rather than comments made. However, notable responses to the health professionals surveys were: “Responsible, caring staff always attend with the service users.” “All the service users appear very happy and all the staff seem professional, and more importantly, seem to care!” Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 6 A visiting relative commented, “Rose Cottage has improved over the last year since Miss Russell has been in charge and the staff are now all working together.” Service users have very personalised private accommodation (bedrooms). The home has an ongoing programme of redecoration and replacement of fixtures and fittings as necessary. Staff receive ongoing mandatory and service specific training to ensure they are able to understand and meet peoples’ needs. 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 DS0000012072.V344292.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 DS0000012072.V344292.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 – People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The manager ensures that the care support needs of the people who use the service will be met by undertaking a proper assessment prior to them moving into the home. EVIDENCE: Pre-admission assessment People should know that their needs will be met when they move into a home. An important part of ensuring this happens is the pre-admission assessment process. At the last inspection this standard was judged to have been met. The manager confirmed that there had been one new admission to the home since the last inspection and described the procedure that was followed before the individual moved in: • • • The admission had been planned from December 2005 and a preadmission assessment carried out around that time using the home’s assessment tool. An assessment from a previous placement was available for consideration. There followed a series of introductory visits including a weekend stay to provide an opportunity for the prospective service user to establish DS0000012072.V344292.R01.S.doc Version 5.2 Page 9 Rose Cottage • compatibility with others who live in the home, and to judge whether the home would be suitable. The individual finally moved into the home in July 2006. We noted that a copy of the pre-admission assessment was on the service user’s file as were assessments on a sample of two other files viewed. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • • Service users are referred to us through care managers/consultants. We then send the prospective service user a statement of purpose and service user guide to work through with their current service. If they still wish to continue then myself and another manager will go and do a needs led assessment - taking into consideration and assessing their physical health, mental health, behaviour, personal life skills, domestic life skills, social, educational, occupational and employment needs. The assessment tool also covers: religious needs, cultural needs, commuication needs, current and future aspirations. • Rose Cottage DS0000012072.V344292.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 and 9 - People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: Personal plans – The home operates a key worker system with key support workers having additional responsibilities for identified people. Each person has a personal plan, which reflects their individual needs, aspirations and goals. At the last inspection a requirement was made for the personal plans to be updated and reviewed regularly. In addition, it was noted that plans were not person centred. At this site visit we looked at a sample of three plans. The intention was to look at the outcomes for people in general by assessing all areas of care and support for those sampled. It was apparent that significant improvements had been made in the development of personal plans. Information is written in Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 11 plain language and includes pictures and photographs, it is up to date and evaluations (reviews) are being carried out monthly. It was noted that information in personal plans is now very ‘person centred’ and includes: • • • • • • Comprehensive personal profile Identified ‘life Skills’ Internal and external activities sheet Support and observation record Food preferences Person centred plan of care/support, which covers all areas of the person’s daily life, is particularly centred on the specific needs of the individual and contains personalised risk assessments. In discussions the manager explained that a good deal of work had been carried out to develop the personal plans in a person centred format; ensuring that they demonstrate that people using the service are in control of their lives and that the service works for them. Part of the process had been to involve the service users in their development, and mindful that some have a short attention span innovative ways had been worked out to introduce plan evaluations into appropriate moments in every day life. Decision making Information in Personal Plans and discussions with the manager and staff on duty provided evidence of staff respecting peoples’ rights to make their own decisions. They each have their own needs, interests and opinions, which are reflected in their plans. One care support worker spoken with had just returned from a fitness activity, which was a regular interest for two service users. The other two enjoyed doing something completely different. The manager confirmed, and records showed that people are supported to manage their financial affairs in different ways according to their individual skills and circumstances. Each person has their own bank account and is given support to be as independent as possible in this respect. She explained that someone independent of the home, either family or the advocacy service, represents the service users. However, two of them had made their own decisions to cease using that service. It was clear from discussions with the manager and staff that they are fully committed in supporting individuals to lead purposeful and fulfilling lives as independently as possible. The manager confirmed that a good deal of progress had been made towards a goal that three hoped to achieve of leading a more independent lifestyle in a support living setting. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 12 Risk taking – At the last inspection a requirement was made that all risk assessments must be updated and reviewed regularly. At this site visit we noted that the requirement had been met. Good risk assessments were noted in the sample files viewed. They are person centred and include all relevant information, actions and interventions to minimise the risk, and the perceived benefit to the service user. In discussions with the manager and staff about examples of challenging behaviour it was clear that the home has strategies for managing situations, which keep incidents to a minimum. . Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • • We have fully implemented person centred planning and supported each service user in compiling a circle of friends/support. We have involved Choices Advocacy and the families of the individuals that live at Rose Cottage at the request of the service user. This has had an extremely positive effect on each of the service users lives. Due to this approach we have been able to repair damaged relationships with professionals and we have a much more constructive approach. Each person centred package reflects each service user’s changing needs, objectives and goals. Each pcp is evaluated 4 weekly or at a time requested by the service user where they are able to discuss each plan with their key worker. Within Rose Cottage we have two weekly service user meetings, this can be done as a group or individually - this is each service user’s choice, and is an opportunity for them to be consulted about things occuring in their home i.e. decoration, items being purchased, policy changes, activities occuring. These meetings take into account all of the opinions of the service users and are centered around the day to day running of the home. Service Users are supported to take risks as part of an independent lifestyle and any activity or task that a service user wants to do is risk assessed. All of their views are incorporated into the risk assessment tool used. At each review the following are reinforced: - What rights and choices are - What the complaints procedure is - What the GSCC Codes of Practice is - What confidentiality is and how we keep to it and what they should expect. DS0000012072.V344292.R01.S.doc Version 5.2 Page 13 • • • • Rose Cottage 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 and 17 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle, and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. EVIDENCE: Education and occupation – During the site visit we had an opportunity to meet with and talk to all four people who live at the home and view a sample of records relevant to peoples’ daily life and social activities. People have an internal and external activities sheet on their file. In conversations with the manager and staff, one of whom was a key worker it was clear that a good deal of support is provided for individuals to make choices that enhance their independence. As mentioned above three are Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 14 developing their life skills with a view to being considered for a more independent placement. All service users attend some form of day service on days during the week. However, in terms of opportunities for work and further education one attends a workshop where they work with tools and engines and another attends college. At the day centres they are involved in a range of activities, mainly craft based that also help with independent life skills. Community links, social inclusion and relationshipsIt was clear from our observations and from information in personal plans that people enjoy going out from the home. A programme of activities ensures their lives are varied and interesting. Staff treat residents as individuals and as well as planned weekly activities staff also organise ad hoc ones such as trips to pubs, bowling, swimming, shopping and places of interest. Several examples of recent excursions were given and one service user in particular was keen to talk about future plans that had been made. They confirmed that each has an opportunity to go on holiday away from the home each year. One service user is supported to attend church most Sundays. The manager and staff confirmed that considerable progress had been made this year to develop community links, and people who had become friends with service users through those links attended a recent party held at the home. All but one service users have regular contact with their families and visits take place either in Rose Cottage or the family home. The home makes visitors welcome and service users are able to receive them in the communal areas, or the privacy of their rooms. Daily routines – All those who live in the home have one day at home each week when they are supported to undertake domestic activities such as cleaning their rooms, changing the bed linen and doing laundry. Some help care support staff to complete the weekly shop for the home and one was noted to be helping with the preparation of the evening meal. People are encouraged to undertake domestic tasks but can opt out if they choose to do so. They can choose which day is to be their home day and the time of day that suits them to carry out the chores. During the site visit we noted service users had their own keys to their rooms and generally kept doors locked. Staff knocked on doors, and waited for a response before entering and addressed people by their preferred names. In discussions with the manager and staff it was clear that respect for peoples’ Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 15 privacy and dignity is paramount and several examples were given of changes in care support practices, which have promoted their independence and provided positive outcomes for individuals. Meals – During the site visit we had an opportunity to observe both the lunch and evening meals. Both were noted to be friendly, social occasions. The manager explained that the service users discuss the menus for meals during their regular house meetings. Those seen during the site visit showed food to be varied and nutritious, and generally followed the seasons. Staff take turn to prepare the meals and they confirmed that this arrangement works well and adds to the domestic feel of it being peoples’ home. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We empower the service users to make choices and decisions through their monthly evaluation. Their care packages specifically cover: social/emotional needs, communication and independent living skills, which are evaluated 4 weekly. We provide the information needed for the service users to be able to make the decisions i.e., college brochures / newspapers / access to the internet etc. This can also be demonstrated through the two weekly service user meetings and monthly monitoring visits. We also put all information that comes through the doors i.e. adverts for activities in the community and college etc on the information board. Once the service users have made their choices and decisions we provide the necessary support for that to take place. The service users’ community awareness and access has been promoted to a very high standard. Each has an internal and external activity plan that has taken into consideration all of the individual’s wishes about what community and leisure activities they want to do - based on the information that they have actively gone out and sought and the information given to them by the team, their families and friends etc. This is evaluated 4 weekly to ensure it is always kept up to date The service users needs and wishes for developing and maintaining relationships with family, friends, sexual relationships and personal relationships have been incorporated into their social pcp, which is evaluated 4 weekly to ensure it is always kept up to date. The service users rights and responsibilities in reference to their daily routines, diet, meals and mealtimes are promoted through admission induction, service user meetings, evaluations and reviews. We ensure that it is explained from the moment a service user is DS0000012072.V344292.R01.S.doc Version 5.2 Page 16 • • • • • Rose Cottage • • referred to Rose Cottage that they will be given a key to their bedroom, staff will knock on their doors before entering, that the staff are there to support them and talk to them, that they do have access to all rooms within Rose Cottage apart from one another’s bedrooms without their authorisation and there is an expectation that they as a group are responsible for the daily house keeping - pending on level of skill etc. This is done as a team effort (staff and service users) through regular meetings. It is agreed who will do what and when and a plan is drawn up - which is reviewed 4 weekly. The menus are reviewed and compiled by the service users and a senior. They reflect the seasons of the year. The times of when a service user wants to eat are respected and they do know that they do not have to eat all together (being institutional). If they choose to eat at different times to one another they know they can. If they choose to have something different from the menu, they know they can. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 17 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 and 20 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: Personal support – At the time of the inspection there were four people resident at Rose Cottage and all are fully mobile, needing no specialist aids or equipment. People’s individual plans clearly record their personal and healthcare needs and detail how they will be delivered. Staff use a person centred approach to deliver care and support and meet people’s changing needs. However, service users are largely self-caring, being able to mange their own personal hygiene, with encouragement and support in some cases. The manager and staff explained that service users are encouraged to be independent and choose their own clothes, hairstyles and hobbies, which reflect their individual personalities. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 18 Healthcare – Personal plans showed that peoples’ health care needs are regularly addressed. They receive checks from the GP, dentist, optician and specialist health care professionals, either at the surgery or in their own rooms depending on the circumstances. All health care needs are identified in their person centred plans under the headings; physical, mental, behavioural/psychological needs. Details of healthcare professional visits are recorded in detail together with outcomes. The manager confirmed that people are supported to attend health clinics either using the home’s car or public transport. The assessed needs of one person are such that healthcare checks are carried out at the home. The manager confirmed that the home enjoys a very good liaison with the Community Learning Disibility Nursing team and in particular a named consultant who pays regular visits to meet with the service users. There is a good gender mix in the staff group, which means that all preferences can be accommodated. Medication We looked at the home’s arrangements for service users’ medication with the manager. Records showed that medication is administered by staff who have received appropriate training in medicines administration and deemed competent by the manager. The home uses a NOMAD (cassette box) system, which helps taking individual doses more straightforward. In addition, each service user has a locked metal facility in their room in which to store their own medication together with their individual record. This takes place within a risk assessment framework and promotes the service user’s independence, with staff giving them appropriate support according to their individual abilities. The system adopted by the home complied with its policy and procedure for all aspects of dealing with medicines. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We have comprehensive person centred plans where the service user has been at the very centre of any decision / choice. Their care package has been made so that the needs of the service users are being met (every need) in a way that they choose and understand, ensuring that their privacy, dignity and independence is maintained and promoted. The service users are supported in accessing all primary health care DS0000012072.V344292.R01.S.doc Version 5.2 Page 19 • Rose Cottage • • services and are supported to see their consultants and care managers / OT etc. Some of our service users have chosen to see a chiropodist who visits Rose Cottage at a date and time convenient to the service user. All services accessed are recorded within their pcp and anytime they are used it is recorded on a monitoring form and recorded in the house diary. We have a consent form that the service users have completed stating what medication they require and need support administering. All other medication that they can do independently is risk assessed and supported. We have been working closely with our service users this year to ensure that the maximum independance is promoted. This is done through pictorial and written support aids / pcp. All the support given works in line with our medication policy. All staff are trained in medication. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 20 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 and 23 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, and are protected from abuse. EVIDENCE: Complaints The homes assessment indicated that there had been 2 complaints about this service since the last inspection visit. Both had been responded to well within 28 days and neither had been upheld. We noted both complaints were recorded in the complaints register, which gave details of the nature of the complaint, the action taken and any follow-up. The home’s complaints procedure is detailed in the service user’s guide with the information available in pictorial format. There are several situations where service users have opportunities to raise any concerns, e.g., one-to-one approaches to staff or the manager, formal residents house meetings and satisfaction surveys that are periodically carried out. Observations of service users’ interactions with staff showed that they would be able to discuss any concerns or make complaints with the staff, their key workers or the manager. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 21 There were 4 different responses in the service users survey to the question, ‘Do you know how to make a complaint?’ The visiting healthcare professionals indicated they knew how to make a complaint. Safeguarding adults Information provided as part of the home’s assessment indicated that policies, procedures and codes of practice are in place in the area of safeguarding adults and the prevention of abuse, and records showed that staff receive specific training in the subject. Staff spoken with confirmed that they had received training in safeguarding adults and were very clear about the importance of reporting issues of concern without delay. Since the last inspection there has been one safeguarding of adults referral, which was dealt with appropriately by the home. The home provides a secure system of safeguarding service users’ monies. The arrangements were fully explored and judged to be appropriate. In a dip sample of records entries were found to be accurate, monies balanced and receipts were kept of incidental purchases. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We provide ample opportunities for the service users to tell us their views. These opportunities are in an informal, formal meeting/survey/questionnaire format where we can demonstrate that they have been expressed and listened to, that there are realistic target dates for them to be actioned if required and they are reviewed to ensure that actions actually have been actioned. We do this very well! If it is a view that we are unable to support then through a process of involving the appropriate people we can demonstrate why. We have a complaint log book in our CSCI folder and each complaint is dealt with, within a three day period. This is also monitored through Regulation 26 visits. The complaint procedure is reinforced to each service user during a review process - which is done at least 6 monthly. I ensure all of my team are abuse trained and this is done through support and supervision, Induction and training. I ensure that there is information at hand for staff and service users to refer to in case of an abuse situation. DS0000012072.V344292.R01.S.doc Version 5.2 Page 22 • • • Rose Cottage • • • • We have policies and procedures to follow in case of an abuse situation such as a Whistle blowing procedure, an Abuse policy, an Abuse procedure set out by Social Services. We have comprehensive procedures in place to protect each service user from financial abuse and comprehensive methods of recording and montoring this. Any behavioural needs that require the response of physical intervention is risk assessed and used only as a last resort. We have a Restraint policy for this and comprehensive training provided for the team to ensure it is done as safely as possible with the least amount of contact needed. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 23 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home’s premises are suitable for its stated purpose. They are comfortable, safe and well maintained. On the day of the site visit the home was clean, hygienic and free from unpleasant odours. EVIDENCE: Premises – Rose Cottage is a bungalow located in a rural area of Bursledon on the outskirts of Southampton and offers the service users a safe and comfortable home. The building is suitable for people who are independently mobile and all areas including the garden are accessible. During the site visit we toured the building with the senior on duty and later individual residents invited us to view their rooms. It was noted that bedrooms were generally spacious, reasonably well decorated and equipped, Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 24 and individually personalised. One service user was looking forward to having their room redecorated after Christmas. It was clear from discussions that they would be fully involved in the process of choosing colours etc. In discussions with the people who use the service it was evident that they liked their rooms; one in particular was pleased to point out a particular interest that had been developed following a very interactive visit to the home by fire safety officers. While there are no en-suite facilities each room has a wash hand basin and there are bath/shower rooms with WCs close by. The home has a good-sized lounge, comfortable and homely, with adequate seating, and a TV. There is a large open plan kitchen and dining area. The premises are bright, airy and comfortable. Cleanliness During the site visit all areas were noted to be clean, tidy and free from unpleasant odours. There is a laundry room, which is away from areas where food is prepared, cooked or eaten. The manager said that there were plans in place to upgrade the laundry and introduce new washing and drying machines. Liquid soaps and disposable towels were noted to be sited in all area where communal hand washing takes place. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • We carry out 6 monthly quality assurance inspections which ensures we monitor the layout of the premises: ensuring it is safe, comfortable and properly ventilated. This is also monitored through monthly visits carried out by the service manager. Rose Cottage has a house vehicle and has a bus stop just outside the property which promotes access to local amenties - the service users regulary access the local shops / library / gym / pubs / restuarants / country parks (Royal Victoria Park) and primary health care services. We also have in place a purchase ordering system. Where on a daily basis ANYTHING that a staff member or service user identifies as needing to be repaired or replaced is actioned. We have very high standards for the cleanliness and hygiene within Rose Cottage. We have been given a score of Excellent from Environmental health when they carried out their inspection earlier in the year. The certificate for this is on the kitchen wall. We have hand washing facilities in the kitchen, utility room, bathroom, DS0000012072.V344292.R01.S.doc Version 5.2 Page 25 • • • Rose Cottage • • shower room and in each service users bedroom. We have signs reminding people to wash their hands. We have a specific hand wash that staff and service users use to get rid of all bacteria. We have cleaning programmes in place for staff and service users to follow - for during the day and at night. We have in place all relevant policies for this area in written and pictorial format. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 26 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and are deployed in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. EVIDENCE: Staff recruitment The manager confirmed that two new care support workers had been recruited since this standard was last assessed. Individual staff recruitment files were available for inspection and showed that the home’s recruitment procedure includes an application form, a contract of employment, a health questionnaire, proof of identification, two written references and police and Protection of Vulnerable Adults (POVA) checks on all staff. We looked at the recruitment records of the two newly recruited staff and found them to be in good order. The manager confirmed that the service Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 27 users are now involved in decisions around the recruitment of new care support workers. Staff training, development and competencies The manager has produced a training plan, which shows at a glance the position with regard to staff training. However, a more detailed computerised plan was available to view. The manager confirmed that this plan is regularly updated and has a facility to provider reminders when refresher courses are due. Records demonstrate that the full range of mandatory training is provided together with additional service specific training such as: • • • • • • • Autism including challenging behaviour Person Centred Planning Epilepsy Medicines management Safeguarding adults Communication skills Equality and diversity The manager described and produced evidence of the induction programme care support workers undertake when joining the home. The current programme follows the Common Induction Standards recommended by ‘Skills for Care’. The manager confirmed and records showed that three of the six permanent staff have achieved, or are about to commence training for the National Vocational Qualification (NVQ). Four of the six bank staff regularly used by the home have achieved the NVQ at least level 2. Care support workers spoken with said that the home provides a very good staff training package, which equips them well for the work they do. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • Some of our staff are NVQ trained from levels 2 - 4. Some of the staff that have not yet started their NVQ have completed the Induction Award under the new common induction standards. All of this training has provided the underpinning knowledge required for the staff members to do their role. This is further developed through support and supervisions and other training days such as Abuse Awareness, Equality and Diversity, Communication skills, Infection Control, Medication Administration, Food Hygiene, Health and Safety, DS0000012072.V344292.R01.S.doc Version 5.2 Page 28 • Rose Cottage • • • • Fire Awareness, Moving and Handling, First aid, Theory management of aggression, Breakaway Techniques, Physical Intervention techniques and Autism Training etc. We have task anaylsis forms that we complete when asking staff to undertake specific roles. This identifies whether the staff member in fact has the skills to do the task. The recruitment policy is the framework for which we work within - in the staff personal file you will see we obtain: 2 written references, a full enhanced CRB disclosure and POVA check. A new staff member is given a copy of the GSCC codes of practice and they are told of the importance of this. We ensure that the recruitment process promotes equality and diversity. All staff once employed have to complete a 12 week induction award under the new common induction standards which specifically covers the promotion of equality and diversity. The NVQs also have units/assignments and case studies on equality and diversity that we encourage our staff to undertake. Some organisations and colleges also run training days specifically on equality and diversity which we send staff on as well. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 29 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 - People who use the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. EVIDENCE: Management – The registered manager Miss Zoe Russell has been in post for just over a year and is fully qualified, having achieved the NVQ at all levels in care and the Registered Managers Award (RMA). She has worked in services for people with learning disabilities for over nine years and states that she keeps up to date with regular mandatory and service specific training. All staff spoken with regarded the home as being well run, with regular staff meetings and formal supervision. They confirmed that the morale of staff was Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 30 good and the manager was very approachable and supportive. One commented that the manager was, “The best manager ever.” There was evidence from the home’s assessment, records in the home and comments from staff that since taking up the post the manager has introduced a clear sense of direction. She demonstrates a sound understanding and application of ‘best practice’ with the systems and practices now in operation, including issues of equality and diversity. The manager completed the home’s assessment thoroughly and returned it promptly. Quality assurance – The manager gave examples and we saw records of the home’s approach to quality assurance, which include: • • • • • • • • Regular service users house meetings where issues are recorded and addressed. Formal surveys with service users with plans to extend the surveys to relatives, visiting friends and professionals. Monthly personal plan evaluations involving the service user and the key worker. Regular statutory visits by the proprietor to monitor the conduct of the home. Six monthly quality audits, which review all policies, procedures and the environment. Regular staff meetings and formal supervision sessions. Ongoing maintenance of the building. The Wessex Regional Care Limited business plan. Health and safety At the last inspection a requirement was identified that workplace risk assessments and COSHH assessments must be in place. At this site visit it was noted that the requirement had been met with comprehensive assessments having been produced. The home’s pre-inspection information signed by the manager confirmed that policies and procedures were in place to ensure safe working practices in the home. A sample of records was viewed including health and safety risk assessments, fire alarm tests and risk assessments, public liability insurance, gas and electrical certificates, all of which were in good order. A recent Environmental Health inspection noted procedures in the home to be excellent. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 31 Staff training records showed, and staff confirmed that statutory training is scheduled and updated in manual handling, first aid, fire training, infection control and food hygiene. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does well in this area: • My experience and qualifications are set out in the service users guide and statement of purpose. I have NVQ 2 in Care, 3 in Promoting Independance and 4 in Management of Care. I have an Advanced Modern Apprenticeship in Health and Social Care and my RMA Registered Managers Award. I have approximately 9 and 1/2 years experience of working in care. I think we as a home do achieve the written aims and objectives which is reflected above. All policies and procedures are reviewed at least once yearly. The service manager embraces training and has supported all my requests of specific training and put me forward for training she feels I would benefit from i.e. in Autism, Train the trainer, Infection control, Person Centred Planning, Diversity, the Common Induction Standards etc. All of the above has enabled me to communcate and give a clear sense of direction and leadership that the staff and service users understand. The monitoring systems and procedures I have in place ensure that the way I work is open and transparent and the changes I have managed and implemented over the past 12 months have created a more open, positive atmosphere that any person who has visited the service since May 2006 has commented on. We have 6 monthly quality assurance inspections. We have monthly regulation 26 inspections. The directors do inspections. I am the Person Centred Planning Co-ordinator and Trainer - I also do specific PCP audits on each service including Rose Cottage - The service manager is involved with the PCP audits within Rose Cottage for good practice. We do 4 weekly evaluations and 3 monthly reviews. We have monthly team meetings and two weekly service user meetings. We have monthly Key Worker meetings. We have weekly internal operational meetings and monthly external manager finance meetings. We have surveys and questionnaires for the service users to complete. Policies and procedures are reviewed at least once yearly. All the staff are trained in Moving and Handling, Fire Safety, First Aid, Food Hygiene and from September 2007 will be trained in Infection Control. We have comprehensive health and safety risk assessments and policies in all areas required - in pictorial and written format. All of which have been worked through with the service users and staff. We also have risk DS0000012072.V344292.R01.S.doc Version 5.2 Page 32 • • • • • • • Rose Cottage • • • assessments and a policy on Lone Working in a care home and in the community. We have annual PAT testing and GAS testing where we have certificates for evidence. We have an accident book for staff and services. In the health and safety folder we specifically cover RIDDOR, Legionella and this is where all the risk assessments are kept that meet this standard. All staff are trained in this area also through the Induction Award under the new common induction standards. Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 33 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 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 x 4 x 4 x x 3 x Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 34 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 Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 35 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 Rose Cottage DS0000012072.V344292.R01.S.doc Version 5.2 Page 36 - 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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