Inspection on 25/01/06 for Swiss Cottage

This inspection was carried out on 25th January 2006.

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

Swiss Cottage 17/01/07

Swiss Cottage 23/08/05

Swiss Cottage 14/02/05

Swiss Cottage 12/08/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOME ADULTS 18-65 Swiss Cottage 130 Roman Road Winklebury Basingstoke Hampshire RG23 8HF Lead Inspector Debbie Oliver Unannounced Inspection 25th January 2006 2.00 Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Swiss Cottage Address 130 Roman Road Winklebury Basingstoke Hampshire RG23 8HF 01256 324 828 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) Together Working For Wellbeing Mrs S Ingleby Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: Swiss Cottage is a detached property set back from a busy main road in Basingstoke. It is within easy reach of the local shops and a bus ride away from the local college and the main town centre. Together is the registered provider and Mrs Sue Ingleby is the registered manager. The home is registered to provide care and accommodation to six service users who have mental health issues. The home comprises of six single bedrooms, two sitting rooms, a dining room, a kitchen and laundry facilities. The garden is well maintained, providing additional recreational space. The staff at Swiss Cottage encourage service users to retain their own privacy and endeavours to support them in reaching their own personal goals. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three hours and the inspector also went back on 31st January 2006 to look at staff records for a further hour. The manager was available on the second day of the inspection and the staff and service users also assisted with both visits. Many of the core standards were inspected during the previous visit on 23rd August 2005; therefore referral to both reports will give a full overview of the service. An opportunity was taken to look around parts of the home, view some records and talk to three staff and three service users. Relatives were not visiting on the day of inspection. What the service does well: What has improved since the last inspection? The statement of purpose and licence agreements have been updated so service users have all the relevant information on where they live. The smoking room has been redecorated to ensure added comfort for the service users. There is clear documentation to show staff have received fire training twice in a twelve month period to ensure service users are protected. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 6 The health and safety officer has prepared a risk assessment for the garage doors and there is confirmation that the doors will be replaced to ensure they do not place anyone at unnecessary risk. 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. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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): 1 and 5 Information is available to enable prospective service users to make an informed choice about where they live. Each service user has a written statement of terms and conditions with the home and are aware of their rights within the home. EVIDENCE: Since the last inspection the statement of purpose has been updated and so gives service users the information needed to make an informed choice about where to live. Therapeutic techniques not being used in the home and details of the Commission have been included but the home still needs to include that all inspections are now unannounced. Each service user has a licence agreement and rooms to be occupied has been included as well as the actual room number the service user is staying in so service users cannot be forced to move rooms without their permission. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 and 9 There is a clear and consistent care planning system in place with regular reviews to adequately provide staff with the information they need to satisfactorily meet service user’s needs. Service users make decisions about their lives with assistance as needed. Risk assessments are in place and ensure service users are able to take risks as part of an independent lifestyle with regular reviews to ensure the information is up to date. EVIDENCE: The support plans have been redesigned and the inspector saw two of these. They are now personal life plans and they show the areas service users want to develop in such as every day life skills and for some to move onto more independent living. The service users have total responsibility for the plans and keep them in their bedrooms, although a copy is kept in the office in a locked facility. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 10 Two service users spoken to said they are much happier with the new plans and they enable them to have more control over their lives. Since the last inspection regular reviews are in place to ensure the plans remain up to date. Service users spoken to said they are supported to make decisions and this includes going out for a walk whenever they want and going in to town on their own. There are also regular service user meetings with one service user being the chairperson. Risk assessments are in place and show that service users are supported to take risks with regular reviews in place. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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): 16 and 17 Service users’ rights are respected and responsibilities recognised in their daily lives to enable continued independence. Service users are offered plenty of fresh food with lots of choices to enable a balanced and healthy diet. EVIDENCE: Service users spoken to said they are treated with respect and they have responsibilities within the home such as household tasks. On the day of the inspection one service user was seen assisting staff to prepare the evening meal. All service users are on part self care and this means the home gives them money to buy and prepare their own breakfast and lunch and staff prepare the evening meal. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 12 Service users spoken said they like the food but if they didn’t want the main meal there are alternatives that they can prepare themselves. It was seen in the minutes of the service user’s meeting that ideas were given for menus. There was plenty of fresh fruit and vegetables available with a good size kitchen to prepare food. It was discussed that the fridge door has been locked, as food has gone missing leaving nothing available for the evening meal. This has been discussed with service users as to why a restriction has been put in place and they have signed to confirm their agreement. The documentation for this was seen. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The home has good systems in place that ensures the medication needs of service users are met. EVIDENCE: The home has a policy on medication and a copy of the Royal Pharmaceutical Society Guidelines. All the relevant documentation is in place relating to receiving, administering and disposal of medication and the inspector viewed this. All staff receive training by having a six monthly assessment completed by the manager or deputy, three observations of the administration process and written responses to pre-prepared knowledge questions. They have also all completed the safe handling of medication distance learning course; the inspector viewed the certificates for this. None of the service users currently require controlled medication. One service user self medicates and the relevant documentation is in place to support and review the situation. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 14 There is a clear stock control of medication and as required medication is also recorded and a running total is kept. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Arrangements for protecting service users and responding to concerns are satisfactory but further training would enhance this. EVIDENCE: Most areas of these standards were assessed during the last inspection. The complaints book was seen and there have been no complaints. The complaints procedure was also seen and is in a suitable format for service users. The manager confirmed that adult protection training has been booked for February and the inspector saw the timetable for this training. The manager also agreed to obtain a copy of the updated adult protection policy. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 16 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 and 30 A comfortable, safe and clean standard of accommodation is provided for the service users, which meet their needs. EVIDENCE: The home is generally well maintained and suited to the service user’s needs. It is decorated to a standard that creates a comfortable and homely ambience. The home was also clean and tidy on the day of the inspection. The smoking room has been decorated and service users spoken to said it looks much better. The downstairs bathroom is looking tired with the paint on the wall peeling. The staff on duty stated there is a programme this year for the redecoration of the home with the exception of the bedrooms. It was agreed the bathroom would be seen as a priority. The laundry room was also seen and is suitable for the purpose and gloves and aprons are available to minimise infection. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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): 32, 34 and 35 There is a good skill mix of well trained staff to support service users. The relevant recruitment practices in place ensure service users are protected. EVIDENCE: The inspector viewed four staff files and all contained a criminal records bureau check, an application form, references and a health check. Staff have many years experience in this field of work and have received core training and some have received training relevant in the area of mental health including working with substance abuse and working with violence and aggression. The manager also confirmed that staff receive regular supervision. Service users spoken to said staff support them well and are approachable. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 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, 39 and 42 The home is managed efficiently and service users benefit from a well run home. Service users views are sought to ensure they are involved in the selfmonitoring, reviewing and development of the home. The health, safety and welfare of service users are well promoted with staff being well trained. EVIDENCE: The registered manager has the skills and experience to manage the home and is a qualified nurse. Service users spoken to said they like the manager and feel she is approachable and easy to work with. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 19 There are regular service user meetings on a monthly basis and staff and service users are involved. The minutes were seen and showed views being put forward and how these have been actioned. Regulation 26 visits are undertaken on a monthly basis and staff and service users are involved in these visits and this is documented. Service users views are sought annually through questionnaires and this information is then used as part of the annual review of the home. Views are also sought from staff, relatives and professionals. The health and safety of the home is well maintained and most areas were assessed during the last inspection. However since the last inspection there is now detailed information on fire training being given including in house training and a quiz. This has happened twice in a twelve month period. Fire safety was also discussed at a recent team meeting. Additionally it was discussed that the garage doors have not been replaced but the new doors are currently being made. The risk assessment is in place until such time as the doors are replaced. Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 X 3 X 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 3 X 3 X X 3 X Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 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. 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 Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Swiss Cottage DS0000012309.V274815.R01.S.doc Version 5.1 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!