Inspection on 23/08/05 for Stone Cottage

This inspection was carried out on 23rd August 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 15/12/05

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 Meeth Okehampton Devon EX20 3EP Lead Inspector Antonia Reynolds Unannounced 23 August 2005 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 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 Stationary 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 D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Stone Cottage Address Stone Cottage, Meeth, Okehampton, Devon, EX20 3EP Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01805 804683 01805 804693 stonecottage@atlas.plus.com Atlas Project Team Limited Vacancy Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Three service users with a learning disability aged 18 - 65 Date of last inspection 11/1/05 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 D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.10am and 4.10pm. The organisation’s Area Manager, Mike Brummitt, was present throughout the inspection. The Registered Provider, Paul Hewitt, the home’s Deputy Manager, Dawn Andrews and another Area Manager, Tim Stevens, were also present for some 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. What the service does well: What has improved since the last inspection? The home now has a full complement of nine staff. Some rooms in the home have been, or are in the process of, being redecorated. Service users have access to a swimming pool located at another of the organisation’s care homes. A full time day service organiser has been employed who has arranged work placements within the organisation for two of the service users. A large motor home has been purchased to enable service users who are uncomfortable with unfamiliar environments to go on holidays and short trips away. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3 and 4 The home’s Statement of Purpose and Service User Guide provide service users and 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. Due to the nature of their needs, individual service users may not always have a choice of where they live, however the management team makes every effort to ensure that they only admit people whose needs they can meet, and who are compatible with existing service users. Where possible, prospective service users are given opportunities to visit the home to decide whether they would like to live there and to meet the other service users and staff. Individual records are kept for each of the service users and these contained detailed assessments, care plans, risk assessments and behavioural management guidelines. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 and 9 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Service users’ plans are detailed and staff are fully aware of the needs of each person. Any restrictions on choice or freedom are documented and agreed with the service user and other people involved in the person’s care, such as relatives, health professionals and social services. Detailed risk assessments are carried out relating to various aspects of the service users’ lives to ensure that they are able to participate in anything they choose to do, with the least risk. All untoward or unexpected incidents are documented and monitored carefully to identify possible causes. Discussion with the management team, as well as observation, showed that service users participate in all aspects of life in the home, although the level of involvement depends on individual abilities and willingness. Where possible, service users have written agreements regarding daily routines and domestic responsibilities and these are discussed with the service users each morning. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 11, 12, 13, 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: Information in care plans, as well as talking with service users, staff and the management team, show that people are enabled to attend various courses at local further education colleges if they wish to. A full time day service organiser has been employed who has arranged work placements for two of the service users at another care home within the organisation for which payment is received as part of the individual’s development incentive programme. Service users are able to go shopping and take part in various leisure activities of their choice when they choose to, unless the risk assessment indicates otherwise. Service users who are not able to use a community-based swimming pool can use a pool located in the grounds of another care home within the organisation when a qualified lifesaver is on duty. It was evident, through observation during the inspection, that service Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 11 users consider this to be their home and are empowered to make decisions, in negotiation with the staff team. The home provides two cars for use by the service users which enables different activities to take place at the same time. Staff are not expected to use their own cars to transport service users. Service users take it in turns to choose the menu, alternatives and snacks are always available and records are kept of meals provided. Wherever possible, service users are involved in meal preparation and cooking. Service users are encouraged and facilitated to keep in touch with, and see, family and friends, and the home ensures this happens by providing staff support and transport, at no cost to the service users or their families. Service users have the opportunity to go on holidays paid for by the organisation and, where possible, active consultation with service users takes place. The service users in this home tend to take holidays in the UK, but the organisation is willing to arrange holidays abroad if this is requested subject to risk assessment. If service users do not wish to go on holiday, day trips are arranged. The organisation has recently purchased a large motor home that may facilitate holidays for those service users who do not like being in unfamiliar environments. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 18 and 19 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: Service user plans provide detailed information about personal and health care needs. The Area Manager confirmed that formal reviews, involving service users, relatives and representatives from health and social services are in the process of being arranged. Through observation it is clear that timings are flexible and the choice of the service user. Information contained within service users’ files, as well as discussion with the management team, confirm that external professional advice and guidance is sought when necessary from local health care professionals and/or social services. Visits to and from health care professionals take place in private although staff are always present to facilitate communication and because of the needs of the service users. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Service users are protected from abuse, neglect and self-harm. 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 has a complaints procedure and staff and management always respond immediately to any issues raised by service users or their relatives. Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. Regular house meetings are held where any issues or concerns can be raised and dealt with immediately, although service users can raise any issue at any time. Discussion with the management team confirmed that they are fully aware of adult protection issues and procedures. External training has been undertaken by staff members but the management team are considering changing the training provider as the existing training does not relate specifically to the service user group the organisation provides care for. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 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 standard(s) 24, 25, 26, 27, 28, 29 and 30 The standard of the environment is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home is comfortable, safe and clean and it is evident that service users feel ‘at home’ in the environment. The home’s lounge room and dining room are comfortably furnished and in the process of being redecorated which is an ongoing process. Each service user has a single bedroom, two on the 1st floor that are large, and one on the ground floor, which is smaller. Bedrooms are individually decorated, reflecting the personality of the person, and contain many personal possessions. None of the bedrooms have wash hand basins or en suite facilities due to the needs of the service users. One of the bedrooms has minimal furnishings due to the particular needs of a service user. To provide privacy, shutters are on the outside of the window and staff close these at night. This situation is kept under continual review by the management team. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 15 Bedrooms do not contain all the items as listed in the standard and previous inspections have confirmed that this is due to individual choice, or the items are not considered necessary, as the service users spend very little time in their bedrooms. Bedrooms do not have private telephones, but service users have access to the home’s portable ‘phones. There is a bathroom on the 1st floor with a bath, toilet and wash hand basin, and a shower room and separate toilet on the ground floor. Bathrooms and toilets are fitted with suitable locks that can be opened from the outside in an emergency. Kitchen and laundry facilities are satisfactory and effective infection control practices are in place. The washing machine is in the kitchen and the Area Manager confirmed that the environmental health department has been consulted and expressed no concerns about its location due to the small number of service users and their needs. The home does not have a call alarm system or any specific aids and adaptations, apart from hand rails, as these are not required for the service users. There is an allocated bedroom on the ground floor for night staff who sleep in. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: Staff files inspected show that the organisation has a robust recruitment procedure and all the required information is available. Criminal Record Bureau checks are carried out and are kept securely in another of the organisation’s homes. It was agreed that these would be checked during the next inspection of that home. Confirmation that they are carried out is evident in staff files. 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. Staff files contain notes of individual supervision sessions. The organisation has a training officer who maintains an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. The staff on duty confirmed that they had received training on various subjects, such as induction and health and safety, as well Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 17 as training specifically related to the service users, such as behavioural management courses. Staffing rotas are available in the home showing that there are usually at least two or three staff on duty from 8am to 9pm and, at night, one waking and one sleeping member of staff. Care staff carry out all the domestic and household tasks, working with service users to be as independent as possible. The organisation operates an ‘on call’ system whereby members of the management team are available both in and out of office hours. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 41 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 does not have a Registered Manager at present following the resignation of the previous Manager in July 2005. Another Manager has been appointed (since 4th July 2005) who is 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 are clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 19 The members of staff and management who were spoken with confirmed that they are consulted and included in any decisions regarding the running of the home. Documentation relating to service users is detailed and accurate. Records relating to health and safety issues, such as risk assessments, incident report forms, the accident book and fire log book are available and up to date. Hazardous substances are stored safely and food hygiene procedures are being followed, including the recording of fridge/freezer temperatures. Previous inspections confirmed that design solutions are in place to control the temperature of the hot water tap on the bath and that risk assessments have been carried out relating to service users and hot water/surfaces. A gas safety check was carried out in November 2004, all portable electrical appliances had been checked in December 2004 and the home has an electrical wiring safety certificate that expires in December 2007. Monthly provider visit reports are being carried out and copies of the reports sent to the Commission for Social Care Inspection. Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Stone Cottage Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 x x 3 3 x D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Stone Cottage D54-D07 S3866 Stone Cottage V231785 230805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 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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