Inspection on 01/10/07 for The Peacocks

This inspection was carried out on 1st October 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Peacocks 01/06/10

The Peacocks 15/09/09

The Peacocks 04/07/06

The Peacocks 01/09/05

The Peacocks 15/06/05

The Peacocks 03/11/04

The Peacocks 06/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 The Peacocks 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG Lead Inspector Ian Wright Unannounced Inspection 1st October 2007 13:45 The Peacocks DS0000009079.V351625.R01.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 Peacocks DS0000009079.V351625.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 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 Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Peacocks Address 10 Stithians Row Fourlanes Redruth Cornwall TR16 6LG 01209 218271 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) Ms Margaret Hinchliffe Ms Cheryl Ann Dean Care Home 3 Category(ies) of Learning disability (3) registration, with number of places The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th July 2006 Brief Description of the Service: The Peacocks provides care for three people with learning disabilities. The registered persons live on the premises with their son. The house is a terraced cottage, just outside the village of Four Lanes, between Helston and Redruth. Residents have access to the lounge and kitchen / diner. There is a bathroom / toilet upstairs, and each resident has their own bedroom. The front garden has a pond, and tables and chairs for people to use. The building and garden is not accessible to wheelchair users. The registered persons have a multi purpose vehicle, which is used to transport residents for outings or appointments. The inspection report is available in the porch of the home, and it is suggested a copy is requested from management or via the CSCI website if required. The range of fees at the time of the inspection is £302-£322 per week. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection took place in four and a quarter hours in one day. All of the key standards were inspected. The methodology used for this inspection was: • To case track two people who use the service. This included, meeting and discussing with the people who use the service their experiences, and inspecting their records. • Observing care practices. • Discussing care practices with management. • Inspecting records and the care environment. Other evidence gathered since the previous inspection, such as notifications received from the home (e.g. regarding any incidents which occurred), was used to help form the judgements made in the report. 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 summary of this inspection report can be made available in other formats on request. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 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 Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 5 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 receive a copy of the contract issued by the Department of Adult Social Care when they are admitted to the home. People who use the service subsequently receive suitable information regarding their rights and responsibilities. The pre admission assessment procedure is satisfactory and should enable the registered persons to ascertain they can meet the needs of prospective residents, before admission is arranged. EVIDENCE: Individualised copies of contracts issued by the Department of Adult Social Care were available for inspection on peoples’ files. There have been no admissions since the last inspection. However the registered provider’s outlined a suitable approach to completing a pre admission assessment, and enabling applicants to visit the home, should a vacancy become available. There is a brief policy regarding assessment and admission, which details what process would be followed. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 8 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, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. All people who use the service have a care plan and these have been reviewed in the last year. Care plans ensure staff have suitable information to provide care. People who use the service are involved in some decisions about their lives. The registered persons approach to handling residents’ monies appears satisfactory so people living in the home can be assured their finances are maintained appropriately where staff are involved in this area of their lives. The registered persons have a satisfactory approach to risk, so people who use the service can be assured they will be supported to take risks as part of an independent lifestyle. EVIDENCE: There is a copy of a care plan in each resident’s file and there is evidence these have been reviewed in the last year. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 9 People who use the service said they could make decisions regarding their lives; for example such as if they wanted to go out, what to eat and when they could go to bed. There may be scope for further development in this area for example through the goal setting and the person centred planning processes. Suitable risk assessments are in place to assess any risks people living in the home may be subjected to. Staff look after some monies on behalf of people who use the service. Records are kept for this. The monies of two people who use the service which were checked and were satisfactory. The registered provider has a satisfactory policy regarding equal opportunities. There are currently no people who use the service from ethnic minorities, although the registered provider stated the home would be more than happy to accommodate people who use the service from other cultures. The local population is predominantly Cornish, and from ‘White-UK’ background. Women people who use the service have equal opportunity compared with their male counterparts. Issues regarding sexuality seem to be suitably addressed. Due to the layout of the building, the service would not really be suitable for someone with a physical disability. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 10 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): 12, 13, 15, 16, 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 can participate in a range of activities, and are able to mix with the wider community. People who use service are encouraged to maintain relationships with friends and relatives. People who use the service appear to have their rights respected, and are enabled to take some responsibility in their daily lives. Suitable arrangements are in place so people who use the service have a satisfactory diet. EVIDENCE: People who use the service said they attend a range of day activities including attending work placements, educational courses and day centres. The registered providers have a multi purpose vehicle, which enables people to go out escorted during the evenings and at weekends. There is evidence regular trips are arranged. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 11 Some people who use the service said they visit friends and relatives and can also maintain contacts via the telephone or post. Visiting arrangements are flexible. People who use the service said they could get up and go to bed when they wish, although some may need reminding to get up on the days they attend activities. People said they generally went up to their rooms to watch TV around 9pm. However they said they could stay and watch TV in the lounge if they wished. The registered persons were observed to be respectful in the manner they worked with people living in the home. There are some opportunities for people living in the home to have involvement in household tasks such as cleaning. People living in the home said the food provided was satisfactory. Records of meals provided are kept in the diary, and these show a good variety of food provided. A varied and good supply of food was kept in the kitchen cupboards. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 12 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, 20 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. Personal care appears to be delivered to a good standard. There appears to be suitable links with medical professionals. No medication is currently administered. EVIDENCE: People who use the service said they received suitable care and support from staff, and care needs are appropriately documented in care plans. The registered providers said there are suitable links with GP’s, opticians, chiropodists and other professionals. The registered providers said there was currently no involvement from the learning disabilities team, or Cornwall Adult Social Care staff (e.g. a social worker). The registered provider said access to dental services is limited (due to lack of services available) and people have to get the hospital for treatment. People who use the service said they regularly saw medical professionals when required. No medication is currently prescribed or administered, but there is a suitable storage facility should this situation change. The registered persons would also need training in this area if medication for individuals is required. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 13 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, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The registered persons have suitable complaints and adult protection procedures. These should ensure any complaints or allegations received regarding people who use the service are dealt with appropriately. The registered persons have received a ‘Protection of Vulnerable Adult’ check and ‘Criminal Record Bureau’ check as necessary. EVIDENCE: The registered provider has developed basic but satisfactory complaints and adult protection procedures. A summary of the complaints procedure is also included in the statement of purpose. The address of the Commission for Social Care Inspection needs to be updated on some of the homes’ documentation. This will ensure complainants know how to contact CSCI if they are dissatisfied with the way any complaint is managed by the registered provider. The registered provider said the manager and herself had attended training regarding the prevention of abuse. However no certificates were on file and these should be made available for inspection. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 14 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, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Peacocks provides a clean, well-maintained and homely environment for the people who live there. EVIDENCE: The building was inspected. The home offers a pleasant and homely environment for the people who live there. There is a pleasant front garden with a seating area which people who live in the home can use. Bedrooms and communal areas are of a satisfactory size to meet the needs of people living there. There are suitable toilet and bathroom facilities, which residents can use. All bedrooms and communal rooms are well decorated, individual and homely. The home was clean and hygienic on the day of the inspection. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 15 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, 33, 34, 35 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. The registered persons provide all care and support. People who use the service should be able to be assured they will receive suitable levels of staff support. The personnel records of the registered persons are satisfactory. Staff training needs improvement for example there must always be a first aider on duty. Improvement will ensure training meets regulatory requirements, and people who live in the home can be more assured that staff have appropriate training to meet their needs. Equal opportunities issues regarding recruitment and work practices seem appropriate. EVIDENCE: The registered persons provide all the care in the home. Two of the residents spend short periods of time in the home without staff support. This has been risk assessed, and the registered persons said they have discussed the appropriateness of this with the residents’ funders (social services). There is always one of the registered persons sleeping in. Should the two residents spend any greater periods of time without staff support (i.e. more than one hour at a time), this must be discussed with CSCI and agreed before implementation. Staff files were inspected. Personnel records of the registered persons are generally satisfactory for example a criminal records bureau check was The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 16 completed on both individuals. The previous regulatory body for care services also completed other checks, when the persons were registered as provider and manager. If any individuals are employed to provide personal care and support for the residents appropriate checks will need to be completed on these individuals. Staff training and staff training records need improvement. By law staff are required to receive the following training: • A suitable and structured staff induction when they commence employment • Regular fire training in accordance with the requirements of the fire authority • There must always be at least one first aider on duty (at appointed person level). • All staff must have manual handling training. If there is no manual handling of people living in the home required, staff still require training to lift objects such as shopping, furniture etc. • All staff must have basic training in infection control. • If staff handle food they must receive training regarding food hygiene. The assessment showed: • Staff induction- no staff are currently employed so this matter is currently not applicable. • Fire Training. Basic fire awareness training was completed in August 2006. This needs to be completed at least annually. • First Aid. The registered manager said she has recently completed this training, and a copy of the certificate was forwarded to the commission after the inspection. The registered provider has also obtained suitable training in this area. • Manual Handling. No residents currently need any assistance regarding moving and handling. However if the registered provider employs staff, there should be training given, for example, in moving and handling inanimate objects. Training in the moving and handling of people is required if residents’ needs change and they need greater assistance in this area. • Infection control. The registered persons have obtained information regarding this matter. Both registered individuals state they have read this guidance. Considering the size and nature of the home this seems satisfactory. • Food hygiene. Both registered individuals have obtained training in this area in 2004 (provider) and 2007 (manager). Both individual should update their training at least every three years. The registered provider has a suitable approach regarding National Vocational Qualifications in care. The registered manager said she has obtained an NVQ 4 in care and management. The certificate for this needs to be placed on her file. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 17 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, 42 Quality in this outcome area is generally good. This judgement has been made using available evidence including a visit to this service. The registered persons have suitable experience and skills to manage the home. The home has a satisfactory approach to quality assurance. The management of health and safety issues needs some improvement so people who use the service can be assured they live in a safe environment. EVIDENCE: The registered persons appear to be suitably and experienced to manage the home. Ms Cheryl Dean is designated the registered manager for the home. Ms Dean possesses a National Vocational Qualification in management and care (at level 4). The registered provider has a satisfactory approach to quality assurance. A survey of residents’ views is completed annually. A residents’ meeting is conducted each month to assist in ascertaining peoples’ views, and help The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 18 resolve any issues in the home. There seems a suitable approach to ensuring regular redecoration and maintenance. The registered provider has a health and safety policy. Records kept of checks are generally satisfactory: • Portable electrical appliances were last tested on 3/ 4/06. These tests have to be completed at least every two years. • The electrical hardwire circuit was last tested in December 2006. A full test needs to be recompleted every five years. • As this home has only three residents (plus the registered provider’s family) the fire authority currently does not require there to be emergency lighting or a fully integrated fire system. However the registered persons complete satisfactory checks on the fire system on a weekly basis. A fire risk assessment is in place. • The environmental health officer (food hygiene) visited in 2003 and deemed arrangements generally satisfactory. • Satisfactory information has been obtained regarding the prevention of legionella and the registered provider said these had been implemented. However some improvement is required: • There needs to be a health and safety risk assessment system in place which outlines any risks to staff and people living in the home. There is information on the Health and Safety Executive website regarding this. For example see: http:/www.hse.gov.uk/risk/ • The registered provider said gas appliances were only installed in 2006, and will not need to be serviced until after two years after installation. However a gas safety certificate should be obtained from a CORGI registered gas engineer at least annually. • Health and safety training (various courses required under health and safety legislation) need improvement as outlined in the last section of the report. The Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 19 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 3 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 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 Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 20 YES 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. 1. Standard YA35 Regulation 18. 19 Requirement The registered person shall ensure that persons employed to work at the care home receive training appropriate to the work they are to perform. This must include suitable assistance, including time off, for the purpose of obtaining further qualifications appropriate to such work. (For example such training must include training as required by regulation such as fire training.) Accurate records of training must be kept including a certificate of completion of training courses attended. (Timescale of 01/12/2006 not met 2nd Notification) The registered person shall ensure that— (a) All parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety; Version 5.2 Page 21 Timescale for action 01/02/08 2. YA42 13, 23 01/11/07 The Peacocks DS0000009079.V351625.R01.S.doc (a) Unnecessary risks to the health or safety of residents are identified and so far as possible eliminated. (c) The premises to be used as the care home are of sound construction and kept in a good state of repair externally and internally; (d) Equipment provided at the care home for use by residents or persons who work at the care home is maintained in good working order; (For example there must be: (1) Evidence that a satisfactory health and safety risk assessment system is in place. Evidence of risk assessments must be forwarded to the commission within the timescale set. (2) Gas appliances should be tested at least annually. Evidence of this must be forwarded to the commission within the timescale set. 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 Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Peacocks DS0000009079.V351625.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!