Inspection on 05/01/06 for The Cottage

This inspection was carried out on 5th January 2006.

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

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

Other inspections for this house

The Cottage 21/05/08

The Cottage 21/05/07

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 09/07/2008.

CARE HOME ADULTS 18-65 The Cottage 20 Oulton Road Stone Staffordshire ST15 8DZ Lead Inspector Mr Berwyn Babb Unannounced Inspection 6th January 2006 12:30 The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 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.V275194.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 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.V275194.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection completed the 2005/2006 inspection cycle, and concentrated on those standards identified by the Commission as key, and needing to be assessed once each year, that had not previously been inspected. Some key standards may be repeated, as will other standards that became relevant as the inspection progressed. The inspector found the home to be warm and clean, with one staff member making preliminary preparations for the evening meal, and another monitoring the welfare of two residents who were in the home. [Others were engaged in their daytime occupations of college, training, or attending the rural project] He spent time with the Registered Care Manager, and members of staff and residents, and found them all to be satisfied in their roles within the home. Care plans demonstrated that residents were having their assessed needs met in the most dynamic way to enhance their independence, dignity, and quality of life. Observation of, and discussion with the residents confirmed this view, and showed their pride and “ownership” of “their” home. What the service does well: What has improved since the last inspection? A new television has been purchased for the lounge, as has a new luxurious three-piece suite. In the kitchen a new dishwasher and tumble dryer have been installed. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 6 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.V275194.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 Key Standard 2 was assessed and found to be satisfactory at the inspection of 26th September 2005 [as were all the standards in this section]. The most recent evidence showed that prospective residents came and met existing residents and staff, to assess whether this was the right place to have their needs met, before entering the home. EVIDENCE: The inspector was able to review in depth the care plan of the most recently admitted resident. This showed that she was already well known to other residents and staff in the home, through her attendance at a local day service provision. Before moving into the home, she had joined residents for group social events, and then in her own pre-admission programme, had visited four afternoons, meals, and an overnight stay, before moving in on a full time basis. When this resident was interviewed, she very strongly confirmed that it had been her choice to come and live at The Cottage, saying she wanted to come and live with the people she knew and liked, in their “Sweet Little Home”. The inspector also spoke with a member of her family, who further confirmed the propriety of the pre-admission process and the opportunities given to the whole family, to visit the home, and to be part of his daughter’s expanding programme of pre-admission visits. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8 All standards in this section were assessed as being satisfactory, in the previous inspection of 26th September 2005, and from this inspection it was deemed that personal care planning reflected the assessed needs and choices of the individual resident, and how these change over time, and the steps to be taken to assist them in meeting these. Evidence was also seen of them being involved in those decisions, that affected their lives, and the running of the home. EVIDENCE: The inspector was able to triangulate the information that he saw in individual care plans, with observations of what was happening during the inspection, and discussion with those residents whose care plans he had read. Likes and dislikes, such as time of getting up, number of sugars in coffee, not wanting to be in a smoky atmosphere, having somewhere quiet to go when the general tenor of the home became too noisy, were all found recorded. Food choices and places to go on holiday, whilst shown in the plans, will be discussed further under their appropriate standard headings. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 10 The participation of the residents in the day to day running of the home, was seen both in their care plans, and in the minutes of residents meetings (called house meetings at this home), and in the choice of one resident to take her time to finish her dinner alone, rather than engage in the inspection, and from discussion with residents about arrangements that were made to enable their choice of leisure activity both inside and away from the home. Care plans and observation all showed where input, or lack of input, into the daily tasks and chores of the home, were made in accordance with both the choices and differing physical abilities, of each individual resident. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15,17 All standards were assessed and found to be satisfactory at the previous inspection on 26th September 2005, but from this inspection, directly reported evidence confirmed that residents were able to maintain and establish, appropriate links with family and other friends. EVIDENCE: One resident and the inspector were able to engage in a fairly protracted, and more “in depth” interview. The inspector was also able to speak with members of this resident’s family on the telephone. What he was told, confirmed what he had already read in her care plan, which was that she chose to maintain regular phone contact with her family, as well as receiving them for visits in the home. She also invited family members to social events held at the home. In addition to entertaining her family, she was able to engage in exchange visiting with a wider circle of friends, including particularly close friends, and engage in such things as meals out together with them. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 12 Discussion with staff and corroboration from care plans, showed appropriate concern to establish that there was a base understanding of the implications of relationships, and to arrange for assessment, discussion, and education, be this on a one to one basis, or using outside sources of education such as health care professionals, or training at college or day services. When the inspector first entered the home, a member of staff was engaged in preparing for the later evening meal, and he was impressed with the quantity and variety of fresh vegetables that were being processed to go with the fish and jacket potatoes that had been chosen by the majority of residents for their main meal. He was also impressed with the amount of fresh fruit that was available in the home, both in bowls in the communal areas and in smaller quantities in the bedrooms of the individual residents. Care plans demonstrated awareness of dietary issues, and professional support over these, ranging from the need to maintain the body mass of some residents, to a programme of encouraging more “healthy eating” style of diet for others. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 21 All standards in this section were assessed and felt to be satisfactory during the previous inspection on 26th September 2005, but particular attention was paid to the way issues of dying and death were dealt with at this inspection. EVIDENCE: During the in depth discussion with residents, mention was made of how she had recently attended a funeral, and the subsequent periodic distress that this was causing her. She said that when she became upset staff or managers sat with her, and together they discussed various issues surrounding our mortality, and the processes gone through by the body, both during and after dying. From her description this was being done with both openness and sensitivity, and was an area where she was recognising the benefit to her of both the skills and homely ethos of the staff of The Cottage. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Whilst both standard 22 and 23 were satisfactorily reviewed in the previous inspection of 26th September 2005, they were looked at again and continued to show that residents were living in an environment geared to protect them from potential abuse, and were encouraged to express any concern they might have. EVIDENCE: The inspector engaged in an in depth formal interview with a member of staff, and from her learnt that RMP Care placed particular emphasis on issues around abuse, in both their induction, and subsequent training programmes. She was aware of the procedures laid down in the policy for the Protection of Vulnerable Adults agreed between various statutory parties in the area, and recognised a wide range of actions or omissions that would be an abuse to the individual. She was aware of what procedures to follow should she suspect that abuse had taken place, and of various indicators and triggers, that would cause her to have such suspicions in the first place. Literature in both written and picture form was on display at various points throughout the home, giving residents information about what to do if they had a concern or a complaint. One resident interviewed about this stated that if anything was wrong she would tell her father, or the care manager, but then became so distressed by the idea of there being anything wrong in the home that the subject was not further pursued with her. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 All standards in this section were favourably commented upon in the previous inspection of 26th September 2005 and during this inspection, particular mention is being made to the overall cleanliness of the home. EVIDENCE: The home was spotlessly clean and tidy throughout and bright and fresh, without any hint of malodour. Talking to staff demonstrated that they were aware of issues about cross infection, and it was observed that they were sensitive towards the dignity of residents whilst prompting them to manage such things as their continence. As this home is the amalgamation of two former cottage properties, inevitably there are areas used as passageways, even where these pass through communal rooms, the cleanliness of the carpets and paint work in these areas was the equal of that anywhere else in the house. Being able to achieve this standard of domestic good housekeeping must be complimented as being commendable. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 16 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): 31,34 All standards in this section were assessed and shown to be satisfactory in the previous inspection of 26th September 2005, and during this inspection the recruitment policies and staffing structures of the home were again shown to be in keeping with the requirements of the standards. EVIDENCE: The inspector undertook an in depth formal interview with a member of staff, during which she recounted the whole of the process of her recruitment to the home. This had started with seeing the job advertised at the local job centre, making contact for an application form, being called to an interview at which she was introduced to the residents, and then being started as a supernumery trainee on a probationary contract as soon as she had provided two written references and a fault less CRB check. She was given a job description and a written contract, and straight away started on an induction programme. After six months her reviews had all been satisfactory, and at that point she was made a permanent member of staff. She went on to say that she had been further supported by the freely given advice of the senior management, and by being able to raise any issues at the staff meetings that were held on a regular basis. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 17 She was aware of the hierarchical structure within the staffing and management of the home, and of the boundaries and parameters of her own responsibilities within that overall structure. Within her position she had a key worker role to some of the residents, and was able to expand the particular relationship with them, thus being in a better position to support them, and help them meet their individual needs and aspirations. When questioned she was also aware of the limitations of her skills and training, and knew when to ask for assistance and advice from managers, seniors and colleagues. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 All standards were satisfactorily commented upon in the previous inspection of 26th September 2005, and during this inspection observation, discussion with residents and staff, and examination of records, indicated a positive regard for the residents and a commitment to ensuring the health, safety and welfare of everybody in the home. EVIDENCE: The inspector undertook an outside visual appraisal of the home, and a tour of the environment inside, spoke to residents and staff, and confirmed various records including those relating to accidents, maintenance of plant within the home, medication and risk assessments for both the environment, and activities that residents desire to undertake. Given the ethos of integration practiced by this home, this included looking at risk assessments for activities away from the actual premises, including awareness of environmental dangers, ability to use public transport safely, and ability to make a safe contact in case of unforeseen occurrences. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 19 The inspector found the medications were being properly and safely stored and recorded. He also found that assessment, education and training was being undertaken to allow residents to leave the home and engage in their local community, and to travel substantial distances to undertake daily education, occupation, and activity. It was a feature of these risk assessments, that the outcomes were aimed at enabling residents, rather than reducing the scope of their activities. The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 4 5 X 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 X 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 3 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 X 3 X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X 4 X X X X X 3 X The Cottage DS0000005077.V275194.R01.S.doc Version 5.1 Page 21 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. 1 Refer to Standard YA24 Good Practice Recommendations The registered person is recommended to review the provision of artificial lighting in the dining room, to ensure that there is a sufficiently bright, and diffused, provision of light, to meet the needs of all residents. 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