Inspection on 26/09/05 for The Cottage

This inspection was carried out on 26th September 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Cottage 21/05/08

The Cottage 21/05/07

The Cottage 05/01/06

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 09/07/2008.

CARE HOME ADULTS 18-65 The Cottage 20 Oulton Road Stone Staffordshire ST15 8DZ Lead Inspector Mr Berwyn Babb Unannounced Inspection 26th September 2005 10:00a The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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.V254397.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2005 Brief Description of the Service: The Cottage had recently been altered to create a six bedded home for younger adults of either gender who have a learning disability. The premises are located to the rear of No 20, Oulton Road, Stone, a five bedded unit also under the proprietorship of RMP Care and under the management of the same Registered Care Manager. The accommodation comprises six single bedrooms, two on the ground floor and two pairs of upstairs bedrooms, each accessed by a separate set of stairs with two handrails. One set of bedrooms upstairs has en-suite facilities, the other set share a dedicated shower room located between the two. The ground floor bedrooms share the benefit of an extended shower room/toilet. There is a dining room with a curtained off area for staff sleep in and a comfortably furnished dedicated lounge. This is conveniently situated next to the kitchen which also houses the domestic washing machine. The property faces onto a paved yard that stretches from the rear of No 20 Oulton Road to a set of wooden double gates giving access onto Old Road, Stone. This yard and the boundary wall have benefited from the use of planters to create some garden style vistas and can also be used for BBQ’s and sitting out in the summer. For security purposes, this area is lit at night. The home is within walking distance of Stone town centre and there are local shops, take aways, hairdressers, public houses and an off licence/delicatessen within a few paces of the home. The aims and objectives are to provide a small, comfortable home, staffed to meet individual service user needs and enable development and integration into the local community. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection had been pre-arranged with the home to be an annual inspection. All but one of the residents were present at different times during the day, the sixth lady, all current residents are female, was staying with her family for a couple of days which was a regular part of her care package. The Registered Care Manager was present throughout the inspection and three members of staff were met at different times during the day. All gave helpful assistance and extended hospitality for the whole of this very positive inspection. The home was warm and in a good state of repair and the welfare of residents appeared to be the primary concern of everyone the inspector met. The residents themselves were enthusiastic about sharing in the inspection and exhibited a real pride in showing off and talking about their home. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Those records examined, both the care plans of the home and the social work care management assessments, demonstrated that service users and those people acting on their behalf had adequate information about the ability of the home to meet the assessed needs and aspirations of the individuals to make a balanced judgement about it being a suitable placement. Records demonstrated an incremental expansion of introductory visits and each resident had an appropriate tri partate agreement with Social Services and RMP Care. EVIDENCE: The Statement of Purpose was reviewed and recent amendments to reflect the changes in the home were noted together with the very detailed commitment to best practice policies. The inspector wondered whether a softening of some of the wording to include more particular information about the environmental detail of the home would be beneficial and the Care Manager agreed to look into this. The needs of all current residents had been assessed under the Care Management procedures from Social Services prior to them being admitted to the home. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 8 Records showed that they had been involved in the above procedure and had been able to meet members of the management and staff and existing residents during a programme of expanding visits to the home which forms part of the pre-admission process. The contracts observed in the care plans had been reviewed adequately covered all the aspects demanded by this standard. The inspector was impressed with the discussion of use of alternative staffing during the recent holiday that the home had been on, to respond to the needs of the service users both as they became apparent and in line with the type of condition that constituted their particular form of learning disability. RMP Care demonstrate a commitment to team work in assessing and meeting the on-going needs and aspirations of their residents. This team not only included staff and management of the organisation but also appropriate professionals and members of the community team from the local specialist provision at New Burton House in Stafford. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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 Observation during the inspection, discussion and review of documents including care plans, demonstrated that residents were being assisted to make decisions affecting their lives, including participating in the daily running of the home and were supported when necessary in order to minimise identified risks in meeting their independent lifestyle. EVIDENCE: The inspector was impressed with the knowledge that management and staff displayed of the detail of each residents individual behaviour leading them to be able to respond in a manner that prevented situations from arising or escalating. Such details recorded in the care plans, together with the input necessary from staff to maximise the scope of decisions taken by residents to affect their lives. The inspector was able to observe throughout the day how staff were at great pains to explain to residents everything that was happening and the reasons behind such actions. The response of residents was in line with their capacity to engage with this information. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 10 It was encouraging to see that where a documented behavioural pattern was judged to be putting a resident at risk, the response had been to implement on-going work including advice and input from the community team to allow the residents to continue with the chosen activity in a greater degree of safety, rather than restricting them from engaging in something which they wanted to do. All records and information relating to residents was observed to be stored in a cabinet that was kept locked at all times but observation confirmed that residents were informed about the information being kept upon them, regardless of their level of interest in this fact. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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 Discussion and observation confirmed that the activities undertaken by residents were appropriate as were their choices of recreation. They were supported and guided in their relationships, access to the local community in a way that gave meaning to the phrase participation and had their rights respected including the ability to participate in the planning and execution of their diet. EVIDENCE: There was evidence from speaking to residents and staff and from reviewing care documents that unless restricted by age or illness, residents were encouraged through college courses, one to one staff guidance and local individually or jointly funded initiatives to maintain and expand their practical life skills, fulfil their spiritual needs and maximise their social engagement. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 12 One current resident works for two days in a shop and others have social programmes at local educational organisations. During the recent long, hot summer vacation, RMP Care, the County Council and a local church had collaborated in providing art and pottery sessions for the benefit of residents. At other times residents were observed both directly and through their care records to have been shopping, attending the local swimming pool, attending keep fit classes, to be having treats out with their key worker on special days such as birthdays, to be visiting garden centres and other leisure facilities, to enjoy the social aspect of meals out and take away meals brought in and to have an annual holiday of their own choosing, following a robust and extensive discussion and negotiation. Bowls of fresh fruit were available in the communal areas of the home and residents appeared to enjoy this aspect of the healthy eating programme that RMP are seeking to encourage into the dietary habits of their residents. Menu records confirmed that full consideration was given to residents choice of comfort foods, but also the menu provided a sensible balance a sensible balance. People’s favourite choices were recorded and such things as curry nights, pizza parties and fish and chip suppers were also to be found among the menu records. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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): 18,19,20,21 Observation and review of detailed records support the view that residents were receiving appropriate personal support for both their social and health needs and medication was being properly managed and that the reality of mortality was being appropriately addressed. EVIDENCE: Examination of care plans demonstrated that services had been appropriately accessed to support the residents at times of emotional crisis and of health need. Residents had been assisted to keep appointments for dentists, opticians and other tertiary healthcare professionals such as chiropodists. All current residents were active enough to attend their own doctor and other medical centres in normal circumstances. Community and district nurses where being accessed for advice and input where necessary and where medication was being administered by members of staff there were appropriate agreements signed by or on behalf of the resident for this to happen. Where residents were keeping medication in locked facilities in their own room, there were appropriate records for the monitoring of the administration of these medications. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 14 The recent holiday had demonstrated the benefit of a staff group containing both genders, even for a group such as the residents of The Cottage who are currently all female. RMP Care have male staff in employment and these have and will be used for appropriate tasks. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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): 22,23 Residents were living in an environment geared to protect them from potential abuse and were encouraged to express any concerns that they may have. EVIDENCE: The policy manual contained a full and detailed complaints procedure, attention to which is drawn by the posters in the home and by provision of complaints leaflets throughout the home. The minor grumbles book was observed and details of the last entry were confirmed with the proprietor responsible for maintenance who was present in the home at the time and this demonstrated a satisfactory response to the concern expressed. A member of staff was asked about attitudes towards the protection of vulnerable adults and knowledge of the procedures agreed between all agencies and how responses demonstrated a wide knowledge and deep commitment to the area of preventing any of the residents of The Cottage from becoming subjects of abuse. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 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): 24,25,26,27,28,29,30 The Cottage is an amalgamation of two former units that have been substantially upgraded to provide high quality furnishing, fabrics and décor, together with modern, appropriate and luxurious bathing and toilet facilities. EVIDENCE: The Cottage has recently been decorated, refurnished and refurbished throughout and has been established by joining two former units together at the ground floor level. It now comprises of two bedrooms on the ground floor and two sets of two upstairs bedrooms both accessed by their own individual staircase. Both these staircases have hand rails on both sides for the convenience of residents. All bedrooms are single and two of them are ensuite. The other bedrooms benefit from one newly refurbished and one newly installed shower room/toilet and the quality of the workmanship in these areas to be commended. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 17 The room of each resident reflected their own choices including the provision of double sized bed for reasons of either choice in alignment of sleeping position or for reasons of safety from involuntarily falling out of bed. Each room had pictures and ornaments and other articles that reflected the residents background, family and individual taste. All rooms were large enough for staff to be able to access either side of the bed if needed. The generously sized lounge is equipped with comfortable furnishings and large television set and music centre and sideboard and the dining room also has a smaller television set and a two seater settee as well as the dining accommodation providing alternative viewing when residents want to watch different things. The only equipment that could be classified as specialist was the second hand rail to both sets of stairs leading to the two sets of upstairs bedrooms. One lady in the downstairs room does use a wheelchair for long distances and this is comfortably accommodated within her room when not in use. The home was spotlessly clean throughout and discussion with staff demonstrated that they were aware of cross infection issues and demonstrated a sensitivity towards the dignity of residents when prompting them to manage their continence. They only area that the inspector was less than satisfied with was a former cupboard in one of the downstairs bedrooms and the care manager has agreed that this now shelved recess shall be redecorated in line with the rest of the room as soon as possible. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 18 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): 31,32,33,34,35,36 Observation, discussion and examination of records supported the view that staff are collectively well trained to meet the needs of residents with an emphasis on supporting each other to meet the assessed needs and choices of the residents in the most professional and congenial manner. EVIDENCE: The Cottage is part of a small group of homes run by RMP Care Ltd and all situated within half a mile of each other. Generally they have a very low staff turnover and are able to cover any absences by staff from other homes whose staff, as a result of the close working and interchange between the units are already known to the residents of the home. A good rapport was observed between residents and staff and at no time has this inspector ever witnessed RMP carers across residents or behind their heads. They have always included residents in any conversation that was taking place even if this was a staff to staff matter concerning an element of their care. Staff/inspector discussion during the day revealed a depth of knowledge about each resident and of skill and experience being brought to bear to meet their assessed needs. When asked staff were aware of limitations of their role and responsibilities and demonstrated the benefits of working for an organisation where one person is identified to and takes responsibility for organising The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 19 appropriate staff training. This was seen to have included both mandatory areas such as moving and handling, fire training, food and hygiene and health and safety, as well as the necessary academic input equip them with the knowledge needed to meet the needs of people with specific types of learning disability. Staff spoke highly of the supervision and support they received both from the care manager of the home, Mrs Tarpey and also from the training officer, Miss Lawton. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 20 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): 38,39,40,41,42,43 Inspection of a sample of records confirmed the staff and management culture of positive regard for the residents and a commitment to ensuring their health, safety and welfare. EVIDENCE: Both of the proprietors of RMP Care work full time within the organisation and Mr Stevenson who oversees maintenance and refurbishment attended the home at a moments notice when a member of staff identified a deficient joining strip between the kitchen and lounge floors. The replacement of this before the end of the afternoon with a more appropriate strip was an indication of the benefit of close family involvement in their business. Residents were observed to be talked to at all times and to be encouraged to express their views on a range of subjects pertinent to the running of the home and the delivery of their care. Evidence was produced of change of venues for outings, for menus, for meals in response to the choices of The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 21 individual residents. Although, all of the residents of The Cottage chose to go on the recent holiday to Butlins, the inspector is aware that within the rest of the organisation some people were taken on an individual holiday abroad with their key worker and in fact two people from another home, both of whom are well known to the residents of The Cottage joined them in their holiday to Butlins as this was the pinnacle of their own particular holiday choice. The inspector looked at some of the policies and procedures manuals and read sample policies chosen at random, discussed these with management staff and felt that they were designed and reviewed appropriately to protect the rights and best interests of the residents of the home. All records are kept in a locked cabinet, the keys to which are located with the senior member of staff on duty and access to which is restricted to residents, staff and members of partner agencies. Observation of practices, policies and records suggested that the management and staff were taking all steps possible to safeguard and promote the health, safety and welfare of the residents in their care. As noted earlier, when a member of staff identified that a hazard had arisen, Mr Stevenson immediately attended the home and replaced the offending item. RMP Care have furnished the CSCI with a certificate from their accountant to confirm that there is competent and accountable management of the service resulting in fiscal probity. The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 4 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 4 3 3 4 LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 4 4 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Cottage Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 4 4 3 3 3 3 3 DS0000005077.V254397.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? No 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 The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 The Cottage DS0000005077.V254397.R01.S.doc Version 5.0 Page 25 - 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!