Inspection on 21/05/08 for The Cottage

This inspection was carried out on 21st May 2008.

CSCI found this care home to be providing an Good service.

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

The Cottage 21/05/07

The Cottage 05/01/06

The Cottage 26/09/05

The Cottage 18/01/05

The Cottage 21/09/04

The Cottage 09/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Cottage 20 Oulton Road Stone Staffordshire ST15 8DZ Lead Inspector Pam Grace Key Unannounced Inspection 21st May 2008 09:30 The Cottage DS0000005077.V364766.R02.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 The Cottage DS0000005077.V364766.R02.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. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Cottage Address 20 Oulton Road Stone Staffordshire ST15 8DZ 01785 811918 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) RMP Care Mrs Dorothy Tarpey Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st May 2007 Brief Description of the Service: The Cottage is a registered care home, which accommodates Adults with a Learning Disability. At present there are six ladies living in the home. The home has six single bedrooms, with access to toilet and bathroom facilities. The home is domestic in style and provides comfortable clean accommodation. The outside area is secure. The home is within walking distance of Stone town centre and there are local shops, take-away, hairdressers, public houses and an off licence and delicatessen within a few paces of the home. The people living in the home are integrated into the local community. The registered manager is Dorothy Tarpey, who also manages the home next door. The fees charged for the service at The Cottage, are from £498.00 - £898.00 per week. The fee information included in this report applied at the time of inspection the reader may wish to obtain more up to date information from the care service. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This means the people who use the service experience good quality outcomes. This visit was an unannounced key inspection and therefore covered the core standards. The inspection took place over approximately eight hours by one inspector who used the National Minimum Standards for Younger Adults as the basis for the inspection. Prior to the inspection, the care manager completed an Annual Quality Assurance Audit (AQAA) for us. There were also four “Have Your Say” questionnaires received from people who use the service. A tour of the home was undertaken. On the day of the inspection, the home was accommodating six people. We spoke with people who use the service, examined records, carried out indirect observation, and spoke with two staff on duty. Three care plans and three staff records were examined and observation of daily events took place. Medication procedures were inspected so that we could see how safe they were. We did not make any requirements, but made four recommendations as a result of this unannounced inspection. What the service does well: Observation of staff showed positive attitude and relationships with people who used the service. Staff continue to strive for high standards within the home and have supported people who use the service in a sensitive and supportive way. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 6 Staff receive a thorough induction to the home which is “Skills for Care” based. This involves the completion of a workbook by both the staff member and a senior member of staff. Each person using the service has a plan of care, which they have helped to develop. Some people living in the home need support to communicate with others. People are involved in a variety of leisure and work activities. Staff support people to identify what activities they want to be involved in on a daily basis. People are able to develop life skills, to complete domestic chores in the home, and take responsibility for shopping and cooking. Staff said they are committed to supporting people to achieve identified goals. People are supported to go out for meals, or to the pub, and food is prepared and cooked with the support of staff members. Staff enable and support people to keep in touch with their family and friends, either by arranging visits, and or by phone or letter. What has improved since the last inspection? What they could do better: The Annual Quality Assurance Assessment (AQAA) document, completed by the general manager, contained too much information in relation to policy and procedures, and did not contain enough information in regard to the outcome groups. This was highlighted and discussed with the general manager during our visit. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 7 Plans for improvement include to continue updating the home, by replacing radiators with covers which will increase safety and prevent risk. Planned decoration of one person’s bedroom. To update old fashioned furniture in bedrooms and communal areas The statement of purpose and service user guide should clearly state that additional charges are made for individual holidays, and transport so that people are fully informed of these costs before moving into the service. People who use the service should have an individual written contract, which is signed and up to date, and contains relevant information regarding fees. We recommend that the home strengthen their risk management recording to include contingency plans to ensure that the people living in the home are kept safe and so staff understand the action they need to take. Individual fire risk assessments should be signed and dated in line with regular reviews. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 8 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 The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 and 5 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Information provided to people about the service could be improved upon to make sure that they have the full facts about costs to enable them to make the decision about the suitability of the service and it’s ability to meet their needs. People presently living at the service had their individual needs assessed before they moved in. Contract information could be improved upon so that people are fully aware of costs that will be charged. EVIDENCE: People had a copy of the Statement of Purpose and Service user Guide, which is used across the organisation. These documents had been explained to people who use the service with the use of pictorial support. The Guide included details of the terms and conditions of occupancy and fee level. Both documents had recently been reviewed. However, it is recommended that information should include the costs for individual holidays and transport. This was highlighted and discussed at the time with the care manager. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 10 The care manager and staff confirmed that pre-admission assessments had originally been undertaken by social services and or the specialist community learning disabilities service. However, because people who use the service had been living at the home for a number of years, records had since been archived. We were unable to view the original documentation in relation to people’s pre-admission assessments. This was highlighted and discussed with the care manager at the time. The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: “We recognise that every prospective resident should have the opportunity to choose a home which suits their needs and abilities. To facilitate that choice and to ensure that our residents know precisely what services we offer, we will do the following. Provide detailed information on the home by publishing a statement of purpose and a detailed service user guide. Give each resident a contract or a statement of terms and conditions specifying the details of the relationship. Ensure that every prospective resident has their needs expertly assessed before a decision on admission is taken. Demonstrate to every person about to be admitted to the home that we are confident that we can meet their needs as assessed. Offer introductory visits to prospective residents and avoid unplanned admissions except in cases of emergency”. People who provided feedback from our surveys, and people spoken with, said that they were “asked if they wanted to move into the home”, and they “were given information before they moved into the home”. One person said, “I asked if I could move to the big white house” another person spoken with said “my friends live in my house”, “I am happy here”. All four surveys received from people who use the service said that they were asked if they wanted to move to this home, and that they received enough information about the home before deciding if it was the right place for them. We looked at three care plans and saw three contracts. The fees were in the process of being reviewed, and the revised fees had not been added to the paperwork. Some contracts were not signed. This was highlighted and discussed with the care manager at the time. The care manager confirmed that this was in the process of being completed for all people who use the service. It is therefore recommended that people who use the service should have an individual written contract, which is signed and up to date, and contains relevant information regarding fees. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 11 The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 12 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 and 9 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. Individual risk assessments could be improved upon to further reduce any risk to people who use the service. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, provided by the care manager, confirmed the following: “The service user plan describes any restrictions on choice and freedom imposed upon the service user by any specialist programme, all such restrictions being previously agreed with the service user. The service user plan establishes individualised procedures for service users who are considered likely to be aggressive or cause harm or self-harm. These procedures should focus on positive ways of coping with, or preventing, such The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 13 behaviour. The service user plan is drawn up with the full involvement of the service user together with their family, friends and/or advocates as appropriate, and with relevant involved agencies and specialists”. We looked at three care plans, all which contained a client profile, with person centred information. Evidence of health services input was also seen. Each plan was individualised, and recognised the personality and needs of the person. The plans were reviewed on a regular basis; any changes to the skills achieved were recorded. Evidence contained within care plans seen pointed to there being six monthly reviews held for each person. However, care plans contained out of date paperwork, which should be archived on a regular basis. Instructions for staff should be on headed paper, which would be more easily recognised. Directives from management should be signed and dated by management. These were highlighted and discussed with the care manager at the time. People spoken with said that they were consulted and encouraged to be involved in their care plan. This consultation was also confirmed when we spoke with staff during the inspection. Surveys received from people who use the service said, “I like going to college, and I like looking after my garden”. Another survey said, “I like to go into the town”, and “I can choose holidays each year”. We saw that people were asked by staff if they wanted drinks, food and snacks, which were made available throughout the day, with a choice of options for hot or cold food and or drinks. Risk assessments seen identified in detail the risks for each individual, however, these were incomplete, and did not have contingency plans in place. It is therefore recommended that the home strengthen their risk management recording to ensure that the people living in the home are kept safe and that the staff understand the action they need to take to prevent risk. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 14 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13,15,16 and 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: We looked at three care plans. Information regarding triggers to any known behaviour, for example what may upset a person, or known fears were included within the care plan. Information was recorded in regard to how the person communicated. Assessments covered all aspects of daily living for example; traffic awareness, cooking skills, travelling in vehicles. Information relating to the person’s culture and religious needs were included in the plan, and how these were to be met. People at the home are able to express their own sexuality with appropriate support. For example; one person talked about staff supporting her with her relationship with her boyfriend, and said “I like visiting my boyfriend and going to the pub”. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 15 Personal risk assessments recorded identified risk, level of risk and how to support the person. However, we found that they were not complete, in that they did not have contingency plans identified and in place. It is recommended that risk assessments should include contingency plans, which minimise the risk to the individual. This was highlighted and discussed at the time with the care manager. The Annual Quality Assurance Assessment document (AQAA), completed by the care manager, confirmed the following: “Local colleges are used and one lady accesses this independently on public transport, other people use different colleges and use taxis to get there. Independently and with support. Holidays are chosen by residents and documented by staff so that choices can be listened to. Residents are supported to maintain family contact where appropriate and requested. Care plans include plans for cleaning bedrooms and developing household skills. One gentleman actually works with the local oak tree farm acorn garden services of which he is a valued employee and part of the community. Menus show that meals this week consist of cottage pie and veg fish homemade chips and veg, sausages and mash veg, chicken Jacket potatoe and veg. Chinese takeaway. Menus are chosen by the clients themselves with asistance about healthy eating to give an informed choice when making decisions. Lifestyle choices are supported with access to all local facilities i.e gym westbridge park local shops and library and local services such as hairdressers. Other activities have been promoted with one lady accessing a stafford nightclub to celebrate a friends birthday. Residents are fully supported and their independence is promoted in all aspects of their home lives”. Surveys received from people who use the service made the following comments in relation to lifestyle, “I hoover the carpets and I do my washing on Thursday”, “I am very happy”, “I speak to everybody”, “I go jogging and to the cinema”, “I am happy here”. Discussion took place with people who use the service throughout the visit. This covered their daily programmes, activities, visits to the local day service and to see their families and friends. Daily activities and life continued as normal during our visit. Staff explained the inspection process to people using the service, during the inspection visit. People spoken with said that they “do shopping”, “cook their own meals sometimes”, that they “enjoyed their food very much”. “We go to the pub or the take away sometimes”, “I like buying fish and chips”. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 16 The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 17 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document, completed by the care manager, confirmed the following: “Each resident is registered with a local GP, dentist, optician and chiropodist. All clients are supported with access to health care services, including mental health services. Residents choose dress and are supported in their appearance, personal hygiene support is provided for three ladies. Residents are encouraged to take care of and be responsible for their own medication, with varying levels of staff support as assessed on an individual service user basis”. We looked at three health care plans, these recorded health care needs and how people were to be supported. For example; if a person had epilepsy, a record would be kept of any seizures, and actions taken. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 18 Each person was registered with a local General Practitioner (GP). There were good relationships fostered between the home, the learning disabilities service, the GP and the local pharmacist. Other specialists maintain further contact and support. For example; Speech and Language Therapist, and where necessary, district nurses were approached for advice, information and any equipment necessary. People using the service attend surgery and or clinics as appropriate to their health needs. The evidence to support this was contained within daily records, and care plans seen. The storage of medication was within a locked cupboard within the dining room. Medication was stored appropriately, and correct administration of medication was observed on the day of the inspection visit. People who self medicate receive appropriate support from staff, and have a locked box within their own room to safely keep their medication. People spoken with during the inspection visit told us, “staff help me if I’m not feeling well”, “I see the doctor if I don’t feel well”, “staff take me in the car to the hospital”. Discussion with staff revealed that they knew people well, and how to support each individual. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 19 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and have access to a robust, effective complaints procedure. People are protected from abuse, and have their rights protected. EVIDENCE: The Annual Quality Assurance Assessment document, which was completed by the care manager, confirmed the following: “All oral complaints, no matter how seemingly unimportant, should be taken seriously. There is nothing to be gained by staff adopting a defensive or aggressive attitude. Front line care staff who receive an oral complaint should seek to solve the problem immediately if possible. If staff cannot solve the problem immediately they should offer to get the home manager to deal with the problem. All contact with the complainant should be polite, courteous and sympathetic. At all times staff should remain calm and respectful. The outcomes of the investigation and the meeting should be recorded in the complaints book and any shortcomings in the homes procedures should be identified and acted upon. The home should discuss complaints and their outcome at a formal business meeting and the homes complaints procedure should be audited by the home manager every six months.” The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 20 The care manager and the complaints log confirmed that the service had received no complaints since the previous inspection. Complaints are documented and recorded. There is also a “Grumbles book”, which is used on a daily basis for minor grumbles. Discussion took place in relation to keeping suggestions and maintenance issues separate from Grumbles. The care manager said that they encourage relatives to approach them if they have a problem. It would be discussed and addressed where appropriate at a time convenient to the family. There had been no complaints and no safeguarding issues reported to us. Surveys received by us from people who use the service said “I am happy with everything”, “Do the staff treat you very well?, the response was “very well”. All surveys received confirmed that people know who to speak to if they are not happy. People who use the service confirmed that they were very aware of who to tell if they had a complaint. One person said “ I just tell Dot”, another person said “Dot is the boss, we tell her about it”. The complaints procedure had been printed into a pictorial and clear format to enable people using the service to understand it. This information was on view in the home, and easily accessible to people. Three staff recruitment records evidenced that staff are recruited following robust procedures, which included Criminal Records Bureau and Protection of Vulnerable Adults checks prior to commencement of employment. Staff spoken with at the time of the inspection confirmed this. Staff we spoke with were very aware of the need to Protect Vulnerable Adults, and said that they had received training in respect of this. The home’s training matrix confirmed that training is undertaken by staff in regard to the Protection of Vulnerable Adults. A spot check of two people’s finances revealed that the home appropriately records and receipts all personal monies held for people who use the service. One person is responsible for her own finances, and has a locked facility in her room. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 21 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25 and 30 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, and comfortable environment, which encourages independence. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) document completed by the care manager commented on the following: “We provide small homely environments for service users. Bedrooms are decorated to personal choice and suggestions on colour schemes are acted upon. Facilitate people to have access to or provide specialist equipment.Shared spaces compliment individual service users. the home is clean and hygienic. The home is cleaned with the help of staff through service users individual plans to maximise independence. All service users are involved in the cleaning The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 22 of the home to the best of their abilities. Cleaning jobs are shared appropriately and completed daily. Staff maintain a high level of cleanliness. Maintenance is carried out by suitably qualified technicians. One service user has a wheelchair and is maintained by the providing agency. The home has a spacious downstairs bathroom to accommodate easy access and a facility suitable for assisted bathing. Grab rails in place to enhance safety”. A tour of the building confirmed that all areas internally had been well maintained. There is an ongoing programme of re-decoration and refurbishment for the service. Throughout the home good standards of hygiene were observed, this is a credit to the staff and people who use the service. The kitchen is domestic in nature. The lounge is a large room, which is big enough to accommodate the people who use the service. The separate dining room is well used for mealtimes, and for some activities. There are modern and comfortable type furnishings in place, which people using the service had helped to choose. The outside rear has a level paved area, which leads into the area for the sister home, and is accessible for wheelchair users. Bedrooms seen had been personalised, furnishings and fittings were of a good standard, and had rooms had been decorated to their individual choice. People who use the service told us that they were “happy with their bedrooms”, and with their lounge. One person said that they “could have visitors any time, if they wanted to”, and “I can watch television any time”. “I hoover the carpets and I do my washing on Thursday”. Surveys received confirmed that the home is always fresh and clean. The AQAA document also confirmed that appropriate safety checks had been undertaken. Since the previous inspection, the lounge and dining room had been painted, a new fire door had been fitted to the kitchen, and to a bedroom, and plans are in place to replace and update old furnishings in bedrooms and communal areas. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 23 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 and 36 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Staff are trained, skilled and provided in sufficient numbers to support the people who use the service and to ensure the smooth running of the service. EVIDENCE: The Annual Quality Assurance Assessment document (AQAA), which is completed by the care manager, confirmed the following: “Staff employed at the home are a team of staff available to all homes within the RMP Care group. This allows for great flexibility whilst people visit friends at other houses and allows someone familiar to cover holidays for those staff who are more permanent at this home. RMP Care try not to use Agency staff and have only done so when this will not impact on the service users when for instance a lady whose needs altered and werent being met at RMP was waiting to go elsewhere to receive specialist health treatment waking night staff was required. We used Agency staff just for the waking night. We have a good team who will provide cover for other members of the team and provide continuity of care for the residents.” The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 24 From our discussions with staff, the care manager, and the examination of staff recruitment and training records, we were assured that the recruitment and training provided, promoted an effective staff team. Staff spoken with confirmed that staffing levels were flexible to meet the needs of the people who use the service, and their commitment to daily activities, for example; attendance at college, transport to an appointment, or a shopping trip. A member of the staff team and or the care manager would be available at the home during the day. The staff rota for week commencing 12/5/08 confirmed that one staff member was on duty all day till 5pm, with a sleep in duty over night. An additional staff member would be on duty from 5pm until 10.00 pm, this was to accommodate and support people who were going out for the evening, and or needed support during that time. The staff rota also evidenced that staffing levels had been maintained. Three staff records were examined, there had been no new staff recruited, and the manager confirmed that the service was fully staffed. Staff spoken with confirmed that the provider gives loyalty incentives to employees, including flowers on their birthday, and meals out. One member of staff said, “they really look after us”. The provider’s ability to retain their staff has resulted in existing staff having worked at the home for many years. This has had a very positive outcome on the consistency of support and care that people who use the service have received. Records we examined related to ‘long term staff members’. Those records evidenced that appropriate police and security checks had been made prior to their employment. One member of staff needed to update their references. One original reference had not been specific in regard to the named member of staff, and the other reference had not been dated. This was highlighted and discussed with the care manager at the time. Two relevant references are needed to ensure the safety of people who use the service. We saw the service’s training matrix for 2008, which covered the whole of the organisation. Staff spoken with, and records seen confirmed that mandatory and update training was current, and that they received regular supervision via their line manager. Staff meetings are held wherever possible on a three monthly basis. Staff meeting minutes were available for us to view. The AQAA confirmed the current training courses being undertaken by staff and the numbers of staff qualified to NVQ standard. These were seen to be satisfactory. New members of staff would receive a “Skills for Care” induction The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 25 package, which includes a workbook that is signed off by a senior member of staff during the induction period. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 26 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 - Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. The service has effective quality assurance systems which; have been developed by a qualified, competent manager. EVIDENCE: The AQAA document confirmed the following: “The registered manager has been employed by RMP Care since 1993 and works closely with the company General Manager. The care manager has regular contact with the company proprietor. The care manager ensures all financial records are kept to safeguard residents financial interests. A general Risk Assessment course has been attended by the manager to continue good practice and the General Manager is undertaking an accredited The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 27 10 day leadership and management course to increase knowledge. We want everything we do in the home to be driven by the needs, abilities and aspirations of our residents, not by what staff, management or any other group would desire. We recognise how easily this focus can slip and we will remain vigilant to ensure that the facilities, resources, policies, activities and services of the home remain resident-led.” People who use the service are well supported by the sensitivity, training, and experience of the staff employed by the company. Meetings for people who use the service, and for staff are held on a regular basis. People are encouraged and supported to speak out at meetings. There is evidence that the service has a robust recruitment procedure in place. This evidence came from the staff we spoke with and records we sampled. The ethos of the home was reflected in the policies and procedures, the records, attitude and competence of the staff in addition to comments received from the people who use the service. People’s citizenship and their rights, are protected by the staff and the training that they undertake. There is a suggestions pro forma for everyone to put forward ideas, these are listened to and acted upon by the care manager in a timely way. Records seen confirmed that the practice and procedure for weekly fire alarm testing and fire drills were current. The home had a fire risk assessment for people who have special needs in relation to fire evacuation, all people using the service had been fire risk assessed. The risk assessment had also been included in their care planning process, and staff spoken with during the inspection, were aware of those special needs in the event of a fire. Those records were not dated, and signed, it is therefore a recommendation that fire risk assessments are signed and date in line with regular reviews. The Annual Quality Assurance Assessment (AQAA) document, completed by the general manager, contained too much information in relation to policy and procedures, and did not contain enough information in regard to the outcome groups. This was highlighted and discussed with the general manager during our visit. The function of this home is to provide continuing care for people who have experience of learning disabilities. The home is intended to provide a home for life for its residents if they wish for this, and will help those who wish for more independent living through support and assistance designed to maximise their skills to live in their chosen setting”. The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 28 The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 29 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 2 2 3 3 X 4 X 5 2 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 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 x The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 30 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 YA1 Good Practice Recommendations To make sure that people considering using the service are fully aware of all costs the statement of purpose and service user guide should clearly state that additional charges are made for individual holidays and transport. To make sure that people who use the service are made fully aware of their rights and charges applicable to them they should have an individual written contract, which is up to date and contains relevant information regarding fees. To minimise risk to people, the service should strengthen their risk management recording to include contingency plans, and to ensure that the people living in the home are kept safe and that the staff understand the action they need to take. To increase safety fire risk assessments for individuals should be dated and signed in line with regular reviews. 2. YA5 3. YA9 4. YA42 The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI The Cottage DS0000005077.V364766.R02.S.doc Version 5.2 Page 32 - 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. 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