Inspection on 15/12/05 for Stone Cottage

This inspection was carried out on 15th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 12/03/07

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 Antonia Reynolds Unannounced Inspection 15th December 2005 10:50 Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 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.V252834.R01.S.doc Version 5.0 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.V252834.R01.S.doc Version 5.0 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.V252834.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Stone Cottage is a care home providing personal care and accommodation for three people, aged 18 – 65, with learning disabilities, who may demonstrate behaviours that challenge services. It is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. This home 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 was opened in 1997 and 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 very large garden, mainly grassed and with parking facilities at the front of the house. All areas are accessible to the service users. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.50am and 3.30pm. The home’s Manager, Graeme Keirle, was present throughout and the Responsible Individual, Paul Hewitt, was also present for most of the time. A tour of the premises took place and records relating to care, the staff and the home were inspected. All three of the service users, as well as two staff members on duty, were spoken with and observed during the visit. Comments cards were received from the service users, completed by staff on their behalf, and two relatives, all of which expressed satisfaction with the care being provided. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 The home has a Statement of Purpose and Service User Guide available for prospective service users with details of the services the home provides, enabling an informed decision about admission. 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.V252834.R01.S.doc Version 5.0 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 and 8 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Discussion with service users, the Manager and staff, as well as observation, confirmed that service users were enabled as much as possible to make decisions about their lives and participated in all aspects of life in the home, although the level of involvement depended on individual abilities and willingness. Staff were fully aware of the needs of each person and confirmed that information contained within the care plans provided them with the detail they needed to provide consistency. All untoward or unexpected incidents were documented and monitored carefully to identify possible causes. Records relating to service users’ money were up to date and accurate. From these it was evident that service users paid for personal items, toiletries, replacement of some damaged items such as personal bedding, as well as making a contribution to the occasional takeaway meal. Other costs, such as transport, were met by the organisation. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 14, 15, 16 and 17 Service users can learn life skills, attend college, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Discussions with service users and the Manager, as well as observation, showed that personal development opportunities and independent living skills were actively encouraged and developed. One of the methods of encouragement was a development incentive programme where service users were paid for tasks achieved. Service users were enabled to attend suitable courses at local further education colleges and participate in various activities both inside and outside the home. Service users were supported to go shopping and take part in leisure pursuits of their choice, unless the risk assessment indicated otherwise. It was evident that service users considered this to be their home and were empowered to make decisions, in negotiation with the staff team. The home provided two cars for use by the service users which enabled different activities to take place at the same time. Staff were not expected to use their own cars to transport service users. Service users were encouraged and facilitated to keep in touch with, and see, family and Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 10 friends, and the home ensured this happened by providing staff support and transport, at no cost to the service users or their families. The Manager confirmed that all the service users had opportunities to go on individual holidays this year, either with families or staff support. Service users confirmed that they have a choice of meals, chose the menu and participated in shopping and meal preparation. Service users had access to the kitchen and were involved in all the domestic activities in the home. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users can be confident that personal support is provided in the way, and at the time, that service users want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Discussion with service users, as well as observation, showed that personal and health care needs were being met. The Manager confirmed that all the service users had regular appointments with the dentist and optician. It was clear that timings were flexible and the choice of the service user. Discussion with the Manager confirmed that external professional advice and guidance was sought when necessary from local health care professionals and/or social services. Previous inspections have confirmed that visits to and from health care professionals take place in private but staff are always present to facilitate communication and because of the needs of the service users. Individual risk assessments were carried out regarding whether or not service users were able to keep their own medication, the result being that no-one self administered medication. The organisation has its own system for the administration of medication which they have tried and tested over many years, and believe that it is the most appropriate system for them. Medication was locked away safely and records pertaining to its administration were clear, well kept and accurate. Medication prescribed to be taken ‘as required’ was Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 12 only administered by staff following consultation with a senior manager. Any invasive procedures were only carried out by staff members who were trained to do so and were well known to the service user. A discussion took place about returning unwanted/out of date medication to the local pharmacy and the procedures for this. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Service users can be confident that complaints are always dealt with seriously and any concerns from service users will be listened to and acted upon immediately. EVIDENCE: The home had a complaints procedure and staff and management always responded immediately to any issues raised by service users. Observation and discussion showed that service users or their relatives can raise any issues or concerns at any time and the staff listened and responded immediately. Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 The standard of the environment is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home was comfortable, safe and clean and it was evident that service users felt ‘at home’ in the environment. The home’s lounge room and dining rooms were comfortably furnished and had been redecorated recently. There was also a conservatory that was the designated smoking area. The Responsible Individual confirmed that there are plans in place to extend and refurbish the entire building. Each service user had a single bedroom, two on the 1st floor that are large, and one on the ground floor, which is smaller. Bedrooms were individually decorated, reflecting the personality of the person, and contained many personal possessions. None of the bedrooms had wash hand basins or en suite facilities due to the needs of the service users. One of the bedrooms had minimal furnishings due to the particular needs of a service user. There was a bathroom on the 1st floor with a bath, toilet and wash hand basin, which was in the process of being redecorated. There was also a shower room and separate toilet on the ground floor. Bathrooms and toilets were fitted with suitable locks that can be opened from the outside in an emergency. There was an allocated bedroom on the ground floor for night staff who sleep in. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35 and 36 Service users benefit from high staffing levels and well supported and supervised staff, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: The Manager confirmed that there were usually two or three staff on duty during the day and, at night, one waking and one sleeping member of staff. On the day of inspection, there were two staff members on duty as well as the Manager. Care staff carried out all the domestic and household tasks, working with service users to be as independent as possible. The organisation operated an ‘on call’ system whereby members of the management team were available both in and out of office hours. Unannounced inspections have also shown that the senior Managers within the organisation respond promptly to crises when needed. Discussions with the staff and management team confirmed that regular staff meetings take place, which service users can also attend, a well as individual and group supervision sessions. A discussion took place about the documenting of individual supervision sessions as this tends to only occur if there are specific issues to be addressed. The organisation had a training officer who maintained an overview of what the organisation required, as well as ensuring that individual staff members received the training they needed. Staff on duty confirmed that they had received training, such as induction and health and safety, as well as training specifically related to the service users, such as behavioural management courses. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 The management approach of the home is open and positive and provides clear leadership, with the management team believing in leading by example. Providing quality care is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The home did not have a Registered Manager following the resignation of the previous Manager in July 2005. Another Manager has been appointed (since 4th July 2005) who was in the process of completing the organisation’s trainee management programme and will then apply to the Commission for Social Care Inspection to be registered. Lines of accountability were clear and the organisation had a management structure that enabled it to cover absences when required, and provided an effective ‘on call’ system to support staff. The members of staff and management who were spoken with confirmed that they were consulted and included in any decisions regarding the running of the home. The organisation has devised its own quality assurance system, specifically designed around the service user group for whom the home is intended. The system included consultation with service users, Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 17 relatives/representatives and other stakeholders. Discussion with the Manager showed that the quality of care was constantly under review and any poor practice issues were addressed immediately. Service users were consulted informally through discussion and observation and any action taken relating to an individual was recorded. Monthly provider visits were being carried out and copies of the reports sent to the Commission for Social Care Inspection. No health and safety issues were identified during the visit. Stone Cottage DS0000003866.V252834.R01.S.doc Version 5.0 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 3 X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stone Cottage Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X 3 X DS0000003866.V252834.R01.S.doc Version 5.0 Page 19 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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.V252834.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 0845 015 0120 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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