Inspection on 12/03/07 for Stone Cottage

This inspection was carried out on 12th March 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

Stone Cottage 15/12/05

Stone Cottage 23/08/05

Stone Cottage 11/01/05

Stone Cottage 23/08/04

Stone Cottage 03/03/04

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 Stone Cottage Stone Cottage Meeth Okehampton Devon EX20 3EP Lead Inspector Anita Sutcliffe Announced Inspection 12 March 2007 10:00 th Stone Cottage DS0000003866.V319275.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 Stone Cottage DS0000003866.V319275.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. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stone Cottage Address Stone Cottage Meeth Okehampton Devon EX20 3EP 01805 804683 01805 804693 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) Atlas Project Team Limited Vacancy Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Stone Cottage is a care home providing personal care and accommodation for up to three service users, aged 18 - 65, with learning disabilities, who may demonstrate behaviours that challenge services. Currently there are two service users living at the home. The home was opened in 1997 and is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. It is situated in a rural setting on the edge of the village of Meeth, with views across Dartmoor. It is reasonably close to shops, pubs, and other amenities in local villages and towns, but transport is required. The home is comprised of a two-storey detached house, with a conservatory attached. All the home’s bedrooms are single and none of them have wash hand basins or en suite facilities. There are separate lounge and dining rooms, as well as a conservatory. The home has a large garden, mainly grassed and with parking facilities at the front of the house. All areas are accessible to the service users. Current fees are: £1,817 – 3, 054 Additional expenses include hairdressing, clothing and some personal items. The most recent inspection report is available on request. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information toward this key inspection has been gathered since April 2006. The home provided current information about its service. Each staff member had the opportunity to complete an anonymous survey and comment about the home, one chose to do so. Two health and social care professionals, associated with the home, also provided information. The visit to the home was on a Monday morning and unannounced. Both service users were met. Staff were spoken with and observed with service users. All of the premises were visited; some records were examined. The manager designate, a recently recruited support worker and representatives from the organisation were present. There is no registered manager but the Commission has received an application for registration. What the service does well: Stone Cottage is a safe place to live. Staff know what they are doing. They will listen to residents and help them learn and have a good life. Management and staff take every opportunity to support service users toward a fulfilled and meaningful life. They have knowledge, skills and expertise in their work. The environment is of a good standard. Food provision is good. Risk is well managed and the safety and well being of service users is a high priority of the organisation. A health and social care professional said: “I have found the Atlas Organisation to be an excellent service”. What has improved since the last inspection? Support worker could think of nothing that could be improved. The manager listed environmental changes that improve the comfort and safety of service users. There are now two cars available for service users use, so they are able to go out individually should this be their preference. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Stone Cottage DS0000003866.V319275.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 Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any prospective service user would be provided with information and involved in the decision about moving to Stone Cottage. EVIDENCE: No new service users have been admitted to the home since the last inspection. However, the organisation has a detailed admissions procedure where all prospective service users are assessed prior to admission by the senior management team within the organisation. Stone Cottage DS0000003866.V319275.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 excellent. This judgement has been made using available evidence including a visit to this service. Service users are listened to, their needs understood, challenges well managed and they are supported to meet their potential. EVIDENCE: Both service users were met and the inspector sat in on the morning meeting where the day’s events were discussed and planned. Service users were fully involved. The day planned included work at the home and visits to local towns. Staff are fully aware of the needs of each service user. Where their needs are such that restrictions on choice or liberty are imposed service users are aware of the reasons, risk is well considered and managed, and detailed records are kept. Advice is appropriately sought from experts outside the organisation, such as care managers and health care professionals. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 10 Staff understand how to reduce behaviour that adversely affects a service user’s life, enhance positive behaviours that enrich their lives and teach new skills. Comment from a health and social care professional included: “I have found the organisation an excellent service”. A member of staff said: “There are well structured care plans, tailored to the individual”. Stone Cottage DS0000003866.V319275.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): 11, 12, 13, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users have the opportunity to benefit from a quality lifestyle, being supported to reach their full potential. EVIDENCE: Although the home is rural there are frequent trips to local amenities. Where a service user benefits from individually tailored activities this is arranged. It was evident that the service user could decide which staff member would assist them. Special social events are shared with other Atlas homes. Service users also have a holiday each year. In 2006 these included trips to Cornwall. Hobbies and interests are very well promoted. Skills are developed. There are plans for one service user to enrol on a computing course at the local college. He currently helps with gardening and learns woodwork. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 12 The home goes to great lengths to help maintain positive family connections for service users. A service user said how much he likes the food at the home. They are able to influence the menu, which was varied and well balanced. Planning, buying and preparing food is a shared activity at the home. Stone Cottage DS0000003866.V319275.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 and health care needs are understood and met. Medication is handled diligently, with strict controls in place to ensure service user well being. EVIDENCE: Service users rely completely on staff support to ensure their health care needs are met. They are supported to make choices. Emotional health needs are well managed through detailed care planning and support management. Physical health care needs are fully met. Staff say that no service user has the ability to safely handle their medicines, so this is done for them. Medicines are securely stored; records clearly kept. Staff work within the organisation’s very strict guidelines and practice when handling medicines. In line with other Atlas homes in Devon, because of ‘previous errors by some dispensing chemists’, the organisation chooses a ‘third person’ (senior staff Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 14 member) to dispense medicines from their original containers into the home’s own. They feel this is safer, will reduce the likelihood of mistakes and is in the best interest of service users. They report that there has never been a medication error within Atlas homes. This practice does, however, add extra risk factors and should be reconsidered. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through strong leadership and the culture of the organisation. EVIDENCE: Service users would be unlikely to use a formal complaints procedure but staff were observed to have the skills to communicate well with them. Service users appeared relaxed and were quick to greet members of the organisation when they arrived. There is regular opportunity for discussion, one to one or within a ‘house meeting’ as observed during the inspection visit. The home report no complaints made within the last year. The Commission have received no complaints about the home and surveys also indicate there were none. Two staff, through surveys, say they are aware of adult protection procedures. There is strong management within the organisation with a passion for the protection of service users. Prevention of abuse is a standard part of staff training. The manager and a support worker described correctly how they should respond if there was a concern. The home has effective policies and procedures in complaints and the prevention of abuse. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 16 Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a home, which is clean, well furnished, warm, safe, comfortable and meets their individual needs. EVIDENCE: All parts of the home were visited. It was warm, clean and comfortable throughout. The furnishings and décor are modern and in a good state of repair. Both service users said they liked their bedroom and confirmed they had chosen the colour scheme themselves. Furniture was purchased which suits the particular lifestyle of the person, in one case this being a sofa so they can relax as they prefer when listening to music. The laundry facility is adequate to meet the needs of current service users. The outside of the home provides space, is tidy and well kept. The home is well maintained and in a good state of repair. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 18 Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 19 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 & 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice. EVIDENCE: Staff say they are never asked to care for people outside their area of expertise and confirmed that support and advice is always available to them saying: “There is excellent support from management and staff”. There is a good ratio of staff to service users, that being three staff to two service users on most days. A staff member described his recent recruitment and discussed his induction to the organisation, home and work. He did not work unsupervised until it was assured he was safe to work with vulnerable adults, and had sufficient skills to work safely and effectively. The registered provider ensures staff are in no doubt as to what is expected of them. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 20 Staff training provides them with the knowledge necessary to deliver a high standard of care also ensuring service users and staff are safe. It includes fire safety, food hygiene, behaviour management and prevention of abuse. Staff consider the training to be of good quality one saying: “Excellent training in behavioural elements”. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 21 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, 38, 39, 40 & 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, run in the bet interest of residents, and their health and safety are properly attended to. Providing quality care is the focus of the organisation. EVIDENCE: There is an effective management structure within the organisation. Service user welfare is the prime concern and there is very strong leadership and support for staff. The organisation has an appointed manager of the home, but currently no registered manager. An application has been received by the Commission so as to meet this statutory requirement. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 22 Staff are clear what is expected of them and feel very well supported in their work. The health, safety and welfare of service users are met through effective care planning and support, competent staff, good management and administration and investment in the building. The inspector and manager discussed a recent event when first aid was effectively administered to a service user who was choking. She is now aware that this event should have been reported to the Commission. Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 23 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 4 32 4 33 4 34 3 35 3 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 X LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 4 3 4 X 3 X Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 24 N/A 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. 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 Stone Cottage DS0000003866.V319275.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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