Inspection on 01/06/06 for Stoneybridge Cottage

This inspection was carried out on 1st June 2006.

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

Stoneybridge Cottage 27/09/05

Stoneybridge Cottage 02/06/05

Stoneybridge Cottage 15/03/05

Stoneybridge Cottage 05/01/05

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 Stoneybridge Cottage Pengover Liskeard Cornwall PL14 3NH Lead Inspector Philippa Cutting Key Unannounced Inspection 1st June 2006 09:30 Stoneybridge Cottage DS0000060821.V296233.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 Stoneybridge Cottage DS0000060821.V296233.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. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Stoneybridge Cottage Address Pengover Liskeard Cornwall PL14 3NH 01579 348774 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) Mr Nigel Bruce Troke Mr Nicholas Simon Troke Vicky Anne Parker Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th September 2005 Brief Description of the Service: Stoneybridge Cottage is registered to provide care and accommodation for one person with a learning disability. It is in a rural location on the outskirts of Liskeard in Cornwall. It was selected for its quietness and general situation away from people. Although only one mile from the nearest houses in Liskeard it is not practical to walk there, as there is no footpath and traffic - although light - is quite fast. There are however plenty of other areas accessible by car where people can walk. On the first floor the home offers a bedroom & bathroom for the service user’s exclusive use, an extra room that is currently unused, sleeping accommodation for two staff and office space. The ground floor consists of a large sitting room, separate dining room, kitchen and utility room with a shower and WC. There is a garden that is secure plus some outhouses which could become a workshop or similar. Parking is available. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection that took place over five hours and encompassed an inspection of the records, the premises, discussion with the staff, one of the registered providers and limited contact with the service user through his choice. The service user had recently returned from a brief stay with his family. Staff said that it usually took him a few days to settle back into his routine at Stoneybridge after such a visit. The routines in the home are arranged to suit its sole occupant and staff have a sound knowledge of his needs and preferences. What the service does well: What has improved since the last inspection? What they could do better: Westlake Care has identified the need for increased input in overseeing administrative & training tasks as the company has expanded. They have addressed this by appointing an Operations Manager. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 6 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. Stoneybridge Cottage DS0000060821.V296233.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 Stoneybridge Cottage DS0000060821.V296233.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,5 The service user appears to be content in the home. All required documentation has been provided to his representatives. EVIDENCE: The present service user has lived at Stoneybridge since it opened. Although he is unable to express an opinion verbally staff say that his reaction when he returns there after, for example, time away with family, suggests that he feels safe and supported in the home. Contracts for the service user are a vexed issue as the placing authority is still only issuing these for two weeks at a time although they are now, the inspector was told, sent eight weeks in advance. Stoneybridge has its own contract detailing the terms and conditions of residency. A copy of the home’s documentation has been given to the service user’s family. Stoneybridge Cottage DS0000060821.V296233.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9,10 The routines at Stoneybridge are designed around the service user’s needs and seek to be as inclusive as possible. The service user’s responses suggest that his needs are being well met. EVIDENCE: The social worker involved with the service user visits to review the care and accommodation offered. By chance this had taken place a few days before this inspection. The inspector spoke to the social worker by telephone. He said he felt the service user’s needs were being met satisfactorily and that no major changes were needed to the care plan, which was reviewed with the service user’s family, the staff and the service user for as long as he chose to be present. The home had not yet received the report from this meeting. The inspector noted that staff had taken notes at a previous meeting and had queried comments that they felt did not reflect accurately either what was said or the status quo, in order to be quite clear about the services that were to be provided. The service user has great difficulty in expressing wishes or making decisions verbally. The staff say that when people get to know him they can read his Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 10 body language, plus his behaviour will demonstrate whether or not he is content. Examples were noted in the daily recording. He is offered opportunities and encouraged to participate in activities in the home & will sometimes do so. Risk assessment underpins all assessment and aspects of care. Staff who work at the home are required to sign a confidentiality document. Difficulties with the service user’s benefits, highlighted at a previous inspection, have been resolved by the Department of Works & Pensions with his family so that the service user is now in regular receipt of his personal allowances. Stoneybridge Cottage DS0000060821.V296233.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,14,15,16,17 The service user’s life style is limited by his abilities but the staff try to be creative in providing opportunities for him to exercise choice and experience variety. EVIDENCE: Staff regularly seek leisure outlets for the service user but have identified considerable constraints over what is appropriate and what is not. Progress in this respect likely to be slow and therefore a review of the documentation over a period of months, if not years, is needed to demonstrate the progress made. The staff help the service user maintain contact with his family with whom he spends occasional holidays. The daily routine is influenced by the service user, with encouragement when necessary, in regard to where he spends his time, when he gets up and what he eats. A healthy diet is promoted - the service user is able to express some preferences for foods of his choice. Daily recording is good & staff leave thorough notes to back up their handover at the end of a shift. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 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 the following standard(s): 18,19,20 The service user’s personal health and emotional wellbeing is monitored constantly. Any needs are responded to appropriately, involving professions ancillary to medicine when required. EVIDENCE: The service user is able to manage some of his personal needs and allows staff to help with others. His routines for personal hygiene etc are established and appear to be accomplished without too much difficulty. The daily records and reports on file showed that help & advice is sought from specialists and other professions both as regular reviews and when needed. A review by a Speech & Language Therapist is awaited. The service user’s Consultant has reviewed his medication. It is administered by staff who report that there are no difficulties when the service user is offered his tablets etc. Staff are undertaking a distance learning course in the safe handling of medication. Medication procedures are carefully and accurately documented with all medication being kept locked. Should the service user go home for a holiday his medication is sent with him with full instructions as to dosage and timing. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 13 Staff have observed that there are frequently discrepancies when he returns. These are noted and recorded. The home has not had to respond to any major illness but has supported the service user through minor incidents. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 14 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): 22,23 The processes that are in place and staff awareness indicated that the service user is protected from harm, neglect or abuse. Any triggers that indicate distress are acted on. EVIDENCE: The service user would not be able to make a complaint but his behaviour would show if he were unhappy about anything. The service user’s family have taken up challenges on his behalf in the past. His family has a copy of the home’s complaints procedure. They were asked to complete a survey about the services offered by Stoneybridge, partly to establish whether they felt their son’s needs were met and partly as a quality control measure. Some of the responses suggested that they were not entirely satisfied but the comments at the end of the survey were very positive. This implied that they had not entirely understood the questions. The registered provider was advised to clarify the answers provided with the family, as on face value, some of the responses would need addressing if accurate. The staff have had training with regard to the protection of vulnerable adults. There are documented procedures on how any aggressive outbursts should be handled. As stated previously, financial issues and the possible mishandling of the service user’s benefits have been resolved. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 15 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): 24,25,26,27,28,29,30 The home is maintained in sound condition and presented in a way suited to the service user’s needs. EVIDENCE: Stoneybridge was selected for its quiet location and screening (fences) have been erected to provide further privacy in the garden. The internal and external facilities suit the service user who has access to all parts of the house, apart from the office, which is kept locked when not in use. It is not practical to walk to the local town (approximately one mile) but the service user has transport provided through his mobility allowance. From experience the staff have realised that the service user prefers his bedroom to be darkened and very plain, verging on austere. His bed frame has been secured to the floor as it was felt he could be in danger of injuring himself as he sometimes tips it over. Now only the mattress can be tipped which is not felt to present a significant risk. This does not appear to have distressed the service user. No specialised or adapted equipment is needed. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 16 The house is kept clean and tidy; the service user has his own bathroom & toilet facilities upstairs and a large lounge and a separate dining room downstairs. Staff have their own rooms where they can sleep at night and a shower & toilet. Some redecoration took place whilst the service user was away, staff taking care to keep to the same colours as much as possible. The service user made his views known about certain changes on his return. Externally there is a small garden plus some ducks that the service user may choose to watch or sometimes help staff feed or clean. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 17 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): 31,32,33,34,34,35,36 The staff team is a cohesive group who have developed a detailed knowledge of the service user’s needs, which they meet. The home has a robust recruitment procedure. EVIDENCE: There are two members of staff on duty at all times. An assessment has been carried out regarding night duties and staff feel that it is safe for both staff to sleep. The staff’s sleeping quarters are in close proximity to the service user’s bedroom and he would not be able to go downstairs without passing their rooms. The nature of the home is that it would be very unlikely for someone to be able to do this without making a noise. A new member of staff has joined the care team since the last inspection. The inspector was told that several people had been interviewed but the service user’s response to one person indicated that he had ‘taken’ to her. The other staff felt that this was a positive sign that the service user could demonstrate choice and preference. The file for this person was inspected and contained all required information including a job description, references, statutory checks and a contract of employment. She described her induction, which was a gradual process, allowing the service user to get used to her presence. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 18 Files for other members of staff were inspected and were satisfactory. Staff are encouraged to study for National Vocational Qualifications if they do not already hold them. Courses pertinent to the home’s ethos are sought. Staff hold regular staff meetings where any issues are considered and future plans discussed. They try to ensure that matters relating to the service user or any problems he presents are not discussed in front of him but he is welcome & encouraged to attend otherwise when general house matters are aired. All staff receive regular recorded supervision. When asked, staff agreed that sometimes their work was humdrum if the service user had chosen to retire to his room or indicated that he wanted to be on his own. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 19 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): 37,38,39,40,41,42,43 The home appeared to be well run, with attention being paid to good recording that could be cross-referenced. Staff were welcoming, responsible and caring; the ethos of the home promotes the well being and safety of all those in the home. EVIDENCE: A new registered manager has been appointed due to expansion by Westlake Care. She was not present during the inspection but one of the joint registered providers was. The registered provider said that the company had recently restructured its administration and appointed a person as Operations Manager to oversee policies, training and other administrative tasks within the company. She was reviewing a number of tasks including the policies and procedures and the induction for new staff so that it would accord with the Skills for Life induction programme. This latter record has been forwarded to the inspector following the inspection and appears to be a full document covering all the required aspects. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 20 In general all documentation and required records were seen to be in place. Any discrepancies were slight and drawn to the registered provider’s attention, e.g. ensuring that all fire tests are recorded when the usual person responsible for this is absent. Comments regarding the home’s quality assurance survey have already been made. The home is advised that greater importance will be placed on quality assurance and self-audit in the future. The registered providers may therefore wish to consider whether their present system is adequate to meet this. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 21 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 X 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 4 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT4 Standard No 18 19 20 21 Score 4 4 4 X 3 3 3 3 3 3 3 Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 22 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. 1. Refer to Standard YA23 YA39 Good Practice Recommendations The registered provider should check the answers provided on the home’s survey to ascertain whether they are what was meant or whether the questions were misinterpreted. Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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. Extracts may not be used or reproduced without the express permission of CSCI Stoneybridge Cottage DS0000060821.V296233.R01.S.doc Version 5.2 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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