Inspection on 27/02/07 for The Cottage

This inspection was carried out on 27th February 2007.

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

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

Other inspections for this house

The Cottage 09/09/05

The Cottage 03/05/05

The Cottage 26/11/04

The Cottage 25/06/04

The Cottage 02/03/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Cottage, The Linstone Drive Norton Yarmouth Isle of Wight PO41 0RL Lead Inspector Neil Kingman Unannounced Inspection 27 February 2007 10:30 X10015.doc Version 1.40 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 Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. 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. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Cottage, The Address Linstone Drive Norton Yarmouth Isle of Wight PO41 0RL 01983 760527 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) Mrs Sonia Mary Price Mrs Sonia Mary Price Care Home 2 Category(ies) of Old age, not falling within any other category registration, with number (2) of places Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9 September 2005 Brief Description of the Service: The Cottage is a small well appointed home that is registered to provide care and accommodation for two elderly residents. It is situated in a quiet residential area by the coastal town of Yarmouth. The proprietor Mrs Sonia Price manages the home as a domestic scale unit, with the residents made to feel part of the family. Both residents are accommodated in their own ground floor rooms, one of which has an en-suite facility. In addition, there is an assisted bathroom with toilet and wash hand basin on the ground floor. The home is a detached property that sits in its own grounds. There are various sitting areas around the well-stocked garden. The home backs onto open countryside and provides fine rural views. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by The Cottage and brings together accumulated evidence of activity in the home since the last key inspection on 9 September 2005. The results of this inspection should be looked at in the context of a small domestic scale unit with two very elderly residents (late nineties and over one hundred years of age) who have lived in the home for over five years. In addition, the proprietor has confirmed that they will be the last residents to live in the home. There were responses to the visitors/relatives survey received from representatives of both residents. Included in the inspection was an unannounced site visit to the home by an inspector on 27 February 2007. The managing proprietor Mrs Price was available throughout the day. During the visit the inspector spoke with both residents in the privacy of their rooms, although it is fair to say that informed views could only be obtained from one. The inspector toured the part of the building to which residents have access with the proprietor and looked at a selection of records. What the service does well: The results of the last two inspections were very positive and this inspection demonstrated the home continues to provide high quality and very comfortable accommodation that has been furnished to meet the needs of the individual residents. The proprietor and the part-time care support worker provide a flexible and person centred service, which operates in the very best interests of the residents. The staff support residents to maintain contact with family and friends and involve residents in all aspects of family life. One family member with a background in social care commented that, “there couldn’t be a more friendly and efficiently run small home anywhere.” One resident remarked, “I couldn’t wish for kinder treatment.” Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 6 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 summary of this inspection report can be made available in other formats on request. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The managing proprietor ensured that the care needs of the people who live at The Cottage would be met by undertaking a proper assessment prior them moving into the home. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: Pre-admission assessment The proprietor confirmed that she has no plans to admit any new residents to the home. Both residents have lived at The Cottage for over five years, having been admitted before the Care Standards Act and National Minimum Standards came into force. However, the managing proprietor said that she carried out a Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 9 full needs assessment on both, prior to them moving in, with information gleaned from a variety of sources including the residents themselves and family members. Each resident has an individual plan, which covers his or her needs and choices. The inspector noted they contained an assessment of their individual needs. Intermediate care The residents at The Cottage are long term. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each resident has an individual care plan. They provide a good demonstration that residents’ health and social care needs are identified and met. The home operates a safe procedure for dealing with medicines and enables residents, where appropriate, to be responsible for their own medication. The home ensures that residents’ privacy and dignity are respected at all times, especially with regard to the arrangements for health and personal care. EVIDENCE: Care planning – Each resident has an individual personal care file containing a plan of care. The inspector looked at both files and noted they contained: • • An admission form containing a full range of information about the resident A copy of the resident’s contract. DS0000028749.V325806.R01.S.doc Version 5.2 Page 11 Cottage, The • • • A plan of health and social care with needs assessment, how needs will be met and monthly reviews. Daily recording of significant events. An end of life plan. The proprietor was able to speak with authority on the specific needs of both residents and had clearly identified all potential risks associated with their lives in the home. It was judged that the structure and content of care plans was most appropriate for the assessed needs of both residents. Health and access to care services The proprietor confirmed, and records evidenced the regular contact with the GP, optician, dentist, hearing specialist and chiropodist. The home accesses the services of one GP from the Yarmouth practice, who knows both residents well. The managing proprietor said that she herself accompanies the residents to all healthcare appointments. It was evident in discussions during the site visit that both residents receive a very person centred service. A visiting relative commented, “Mrs Price cares superbly for the resident, who couldn’t be in a more friendly and efficiently run small home anywhere.” Both residents are mobile without the help of aids or adaptations. However, given their age and the likelihood of needs changing the managing proprietor has ensured that a hoist, walking frames, wheelchair and other specialist equipment are readily available in the home. The home has equipment necessary for the promotion of tissue viability, which, together with the personal care provided by the home ensures that pressure sores are prevented. Medication One resident is able to maintain control of their own medication, carefully monitored by the proprietor, and within a risk assessment framework. The other is not currently prescribed medication. The inspector spoke with both residents, looked at the arrangements in place for medication and judged them to be appropriate in the circumstances. Privacy, dignity and respect – On the day of the site visit the inspector noted the interactions between the residents and the managing proprietor. It was very clear that their privacy and dignity are well respected. The resident who was able to give an informed view spoke very highly of the way they were treated. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 12 Residents’ rooms are for single occupancy and both have a telephone installation. The inspector noted both residents were very well dressed in good quality clothes of their own choice. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 - Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The Cottage offers a personal and flexible service where choices and preferences are encouraged and supported. Activities are offered to suit the needs of the residents. Friends and family are made to feel welcome and can visit at any time. The managing proprietor places a great deal of emphasis on encouraging and supporting residents to remain as independent as possible. Both have family to assist with financial affairs. The promotion of choice extends to all aspects of daily living including personalisation of rooms, and meals. Residents’ nutritional needs are satisfied with a varied and balanced diet of good quality fresh food. EVIDENCE: Routines and activities – Due to the age of the residents (late nineties and over one hundred) they are not as active as they once were. The inspector noted routines to be tailored to Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 14 their individual preferences, e.g., one rises fairly early and breakfasts in the dining room, whereas the other rises late and breakfasts in their room. One resident confirmed that Mrs Price and the care support worker take care of their every need and support and facilitate whatever they want on a daily basis. Activities through choice tend to involve naps, reading books, newspapers and magazines, and watching television. Trips out that used to be quite frequent are less now due to the residents’ ages and assessed needs. Visiting arrangements – Friends and relatives are encouraged to visit at any time. The home being domestic in character has many visits from neighbours, the residents’ families and Mrs Price’s family and friends. All are well received and offered food and refreshment. On the day of the site visit an elderly neighbour visited and took lunch with the residents. It was clear that this was an established and welcome addition to the daily routine. Personal autonomy and choice – As previously described it was evident that residents are supported to do whatever they want in their lives. Both have family members to advocate for them and assist with their financial affairs. The inspector noted their comfortable rooms to be well personalised, with furniture, pictures and personal items of their choice. Meals and mealtimes – The proprietor offers residents food that they like, which is varied, nutritious and home cooked. All vegetables are fresh, some having been home grown. She makes jams and preserves and ensures that there is always a variety of fresh fruit in the home. Both residents were full of praise for the meals provided and confirmed that mealtimes are arranged around their own preferences. Mrs Price keeps menus and records of food served daily. They demonstrate the quality and variety of food provided. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home treats residents’ complaints seriously and responds appropriately. The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. EVIDENCE: Complaints – Being a small family run unit the interaction between the proprietor and the residents is close and informal. While there is a formal complaints procedure in the place in reality both residents and their families would address any concerns to Mrs Price, in whom they have every confidence. This was clear from discussions with the residents, observations during the site visit and from comments in the visiting relatives survey. Adult protection The home has an adult protection policy and procedure, which follows local authority guidance. The proprietor demonstrated an awareness of the procedure and what would be required if any concerns came to light. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 – Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The location and layout of the home is suitable for its stated purpose in providing a safe and comfortable environment for the residents. The facilities, fabric and decoration are all above standard. All areas of the home are kept clean, hygienic and there are no unpleasant odours anywhere in the home. EVIDENCE: Environment – Both residents are accommodated in rooms on the ground floor. The inspector was able to speak with each resident in private and view their rooms and facilities. Each room is well laid out so as to provide ease of movement and clear access to wardrobes etc. Furniture and decorations are to a high standard. One of the rooms has an en-suite toilet and wash hand basin while the other is sited directly opposite an assisted bathroom, which has a toilet and Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 17 wash hand basin. The home has central heating and is double-glazed throughout. All wash hand basins and the bath are fitted with valves, which safely control the temperature of the hot water. There is a large lounge/dining room providing a central focus in the home. According to the proprietor the residents spend quite a lot of the time in their rooms but will have their meals together in the dining area. The inspector noted the lounge to be well furnished with comfortable seating and a television. Each resident has their own comfortable armchair. The home has a large landscaped rear garden and patio area that backs onto open countryside. It is readily accessible for both the residents who are still mobile and can get around the home and gardens with the aid of walking sticks. The ground floor bathroom is fitted with a hoist to assist residents with getting in and out of the bath. The home has a range of additional equipment such as an Oxford Hoist, wheelchair, walking frames etc. that can be utilised if required. Cleanliness The home has a purpose built laundry and utility area fitted out with modern equipment. The laundry/utility area has an impermeable floor and wall finishes that can be easily cleaned. There has been an environmental health inspection within the last few months the results of which were positive. At the time of the site visit all areas of the home to which the residents have access were very clean and hygienic, with no unpleasant odours anywhere. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 - Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff in the home are deployed in sufficient numbers and have the necessary skills and experience to meet the needs of the people who live there. Although neither the managing proprietor nor the part-time care support worker has a National Vocational Qualification (NVQ) there was no evidence to suggest the residents are not in safe hands at all times. The home operates a robust staff recruitment procedure, which ensures service users are protected. The staff training and development programme ensures the residents’ needs are met in line with the aims of the home. EVIDENCE: Staffing levels and Recruitment The home is run by the proprietor who lives on the premises. She employs one care support worker on a part-time basis who has worked in the home for about eight years. In addition, there is a handyman who ensures the premises are at all times well maintained. There are no plans to employ any others in the foreseeable future. With just two very elderly residents the current staffing arrangements ensure they receive a safe, flexible and personal service throughout the week. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 19 The records relating to the part-time member of staff had been examined at past inspections and found to contain all the required security checks and relevant information including references. Staff Training – In the context of a small domestic scale home that has operated successfully for many years the needs of the residents continue to be well met by competent staff. Both the proprietor and the part-time care support worker have certificates in first aid, food hygiene and manual handling. Both residents were full of praise for the way they are treated by Mrs Price and the other member of staff. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 - Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home, which is run by an experienced registered manager, who is fit to be in charge and updates her skills and knowledge with periodic training appropriate to the aims and objectives of the home. The home is run in the best interests of the residents. The home has no involvement with residents’ financial affairs other than to provide a facility for safekeeping money or valuables on request. Policies, procedures and practices ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 21 EVIDENCE: Management – The proprietor Mrs Price has a nursing background and some thirteen years’ experience of providing care for elderly residents and was able to talk with authority on the care needs of the present residents. Having now reached the current national retirement age she has stated her intention not to admit any further residents to the home. Although not having the recommended management qualifications, through discussions it was evident she has kept abreast of developments in the fields of health and care. Quality assurance – The standard relating to quality assurance is assessed in the context of the size and nature of the home. There was ample evidence to show that the home is run in the best interests of the residents. The one resident well able to give an informed view was very clear that their views are regularly sought by both the proprietor and the care support worker. Residents felt they were members of an inclusive social group, which included the proprietor’s family and grandchildren, friends and neighbours. The home is regularly maintained to a high standard and has been upgraded over the years to provide a safe and comfortable environment with positive outcomes for the residents. Policies, procedures and practices are appropriate for the aims and objectives of the home. Residents’ monies – The proprietor explained that it is the policy of the home not to involve itself in the residents’ financial affairs. Both of the home’s residents have family members who assist them in this respect. One of the residents spoken with was perfectly satisfied with the present arrangements. Health and safety – The home has a range of policies and procedures relating to the health and safety of residents and staff. The home’s equipment and facilities are subject to regular safety checks and for example the fire alarm system is regularly tested and bath hoist regularly serviced. The pre-inspection information provided by the proprietor as part of the inspection pre-fieldwork planning showed that all relevant maintenance and associated records are maintained. Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 4 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 4 x x x x x x 4 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x 3 x x 3 Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 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 Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Cottage, The DS0000028749.V325806.R01.S.doc Version 5.2 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!