Inspection on 04/07/06 for The Peacocks

This inspection was carried out on 4th July 2006.

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 found no outstanding requirements from the previous inspection report, but 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 01/10/07

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 Key Unannounced Inspection 4th July 2006 14:30 The Peacocks DS0000009079.V300771.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.V300771.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.V300771.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.V300771.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st September 2005 Brief Description of the Service: The Peacocks provides care for three people with learning disabilities. The house is a terraced cottage, just outside the village of Four Lanes, between Helston and Redruth. Service users have access to the lounge and kitchen / diner. There is a bathroom / toilet upstairs, and each service user has their own bedroom. The front garden has a pond, and tables and chairs for service users’ use. The building and garden is not accessible to wheelchair users. The registered provider has two private vehicles, which are used to transport service users 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 if required. The range of fees at the time of the inspection is £295-£315 per week. The Peacocks DS0000009079.V300771.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 ten and a quarter hours over two days. All of the Key Standards were inspected. The methodology used for this inspection was to: • Case track all service users. This included, where possible, meeting and discussing with the service users their experiences, and inspecting their records. • Observe care practices. • Discuss care practices with management. • Inspect 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), were 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: Two requirements have been made as a consequence of this inspection. Firstly, to improve statutory training received by the registered persons and volunteers for example first aid, food hygiene, fire awareness, infection control and manual handling (as individually applicable). Secondly, to improve some health and safety precautions as required by law, such as a five yearly test on the electrical hardwire circuit, and introducing a health and safety risk assessment procedure. It is also recommended (i.e. as good practice but not legally required) that there is appropriate liaison with CSCI and Cornwall County Council about an The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 6 issue regarding a service user risk assessment to increase that person’s independence. Secondly a quality assurance policy is written outlining the measures the registered persons currently take to ensure a quality service. Lastly soap and a towel should be in the bathroom / toilet to encourage hygiene standards for staff, service users and visitors. 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 Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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 Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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): 2, 5 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Suitable policies and practices are evident so service users can be assured a full assessment will take place before they come to live at the home. This ensures the registered providers will ascertain they can meet service user needs. All service users receive a County Council contract outlining their terms and conditions. This ensures service users are aware of their rights and responsibilities. EVIDENCE: A suitable assessment procedure was inspected. The registered providers also outlined the process they would follow if they needed to assess a new service user. This would include full consultation with existing service users. There have been no admissions since the last inspection. Current service users have a copy of a preadmission assessment on their files. All service users are issued with a copy of a social services terms and conditions at the time of admission. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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, 9 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Service users have a suitable care plan. Approaches to providing service users with suitable care and support seem well thought out. Equality and diversity issues appear to be suitably addressed. Subsequently service users can be assured they will receive suitable support to live their lives according to their needs and wishes. EVIDENCE: A suitable care plan was inspected for each service user. These are reviewed as necessary. Service users said they are able to make decisions about their lives. The registered persons seem to have an encouraging attitude towards enabling service users to live their lives how they wish. The registered persons outlined a suitable approach to assisting service users with their finances. The inspector and registered persons discussed the possibility of enabling service users to spend more time without staff support. This appears to be in line with service user wishes to live more independently. Some service users already spend time in the house without staff support, and also travel in the community without staff accompanying them. It was recommended: The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 10 • • • The registered provider risk assesses this issue, in consultation with individual service users and their representatives (e.g. family, social worker). A risk assessment for individuals concerned should be written, and signed by appropriate parties. Liaises with CSCI regarding how the goal for individual service users is implemented Keeps the approach under review in liaison with concerned parties. The registered persons have an appropriate approach to managing equality and diversity issues. The registered persons were able to demonstrate suitable knowledge and awareness of equality and diversity issues regarding the care of service users. There are currently no service users from ethnic minorities, although the registered providers stated they would be more than happy to accommodate service users from other cultures. The local population is predominantly Cornish, and from ‘White-UK’ background. Issues regarding sexuality, gender and disability seem to be suitably addressed. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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): 12, 13, 15, 16, 17 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. There is a range of activities, which meet service user needs. Service users are supported to make and maintain personal relationships. Meals are provided suitable to service user needs. Subsequently service users can be assured they are enabled to live a varied and rewarding lifestyle. EVIDENCE: The registered persons and service users outlined a suitable range of work, education and leisure activities, which are available. This included attending day centres, sheltered work placements, going to college, going out on trips in the car etc. Service users have a number of holidays. The registered providers own a mobile home in Perranporth, which service users visit regularly. Other holidays are also planned. Two service users are able to go to the village without staff support, and use public transport. Service users regularly go to the local pub. Service users receive appropriate support to maintain family and friendship links, and there are suitable arrangements for service users to receive visitors. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 12 Service users can get up and go to bed when they like. Although bedrooms are not lockable, service users feel their personal belongings are secure. Service users said they have the choice either to spend time in their bedrooms or with others in the lounge. Service users said they have some involvement in house hold tasks such as shopping, cleaning their bedrooms, and washing up. The registered persons have a number of pets, and a child, which are very much enjoyed by the service users. Service users said they enjoy the food provided by the registered persons, and are involved in deciding what to eat. Service users said there was plenty of food available, and they could access the kitchen. The inspector said meals provided could be recorded in the diary, rather than there needing to be a fixed menu. There seems an appropriate mix of healthy and nutritious meals available. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Arrangements for personal support and health care are to a good standard so service users can be assured their care needs will be met to a good standard. EVIDENCE: Service users said they receive suitable personal support from the registered persons. They said the registered persons are caring and supportive. The registered persons said suitable links have been developed with external professionals such as general practitioners and dentists. Service users do not currently have an allocated social worker or community nurse. Interaction between service users and staff was observed to be positive. No medication is currently prescribed, but there are suitable facilities for its storage should this be necessary. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. Suitable systems for managing complaints and adult protection are in place so service users can be assured any concerns they have should be listened and responded to. EVIDENCE: Suitable complaints and adult protection policies were inspected. Service users said they would feel confident approaching the registered persons if they had any complaints or concerns. Service users all said they were treated with respect and dignity, and had not experienced or witnessed any bad practices. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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): 24, 30 Quality in this area is good. The judgement has been made using available evidence including a visit to the service. The registered persons provide suitable accommodation so service users can be assured they live in a clean, comfortable and homely environment. EVIDENCE: The building was inspected. The building was clean, well maintained, and contained suitable fixtures and fittings. Spatial standards are satisfactory. Service users said they were happy with the accommodation provided. All service users have their own bedrooms, and they are able to bring their personal belongings, and small items of furniture into the home. There was not soap or a hand towel in the bathroom. The registered persons said this was because service users used their own. However it is recommended these be provided for visitors, and to encourage service users to wash their hands-particularly, as there are no wash hand basins in bedrooms. The registered persons have their own accommodation at the rear of the house. One of the lounges is also for their personal use, and the kitchen is shared with service users. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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): 32, 33, 34, 35 Quality in this area is adequate. The judgement has been made using available evidence including a visit to the service. Staffing levels meet service users’ needs. Recruitment records are adequate, but would need to be more comprehensive should new staff or volunteers be employed. Staff training needs some improvement so all staff receive appropriate training to meet health and safety, and regulatory requirements. EVIDENCE: The registered persons do not employ any staff. Two volunteers occasionally provide additional support; for example if the registered persons have to go out. This arrangement has been in place for several years. Information regarding the registered persons, and the two volunteers is limited, but does include appropriate CRB checks. The two volunteers are friends of the registered persons. The need to provide suitable information e.g. references, an application form, should their be further recruitment of staff or volunteers in future is understood by the registered persons. At least one of the registered persons is usually ‘on duty’, although for limited, agreed periods of time some of the service users may be at home without staff support. Service users are happy regarding this arrangement. The volunteers both have a National Vocational Qualification in care (at level 2). The registered manager said she had just completed her Registered Manager’s Award (NVQ 4) and was awaiting the certificate. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 17 Although some health and safety training has been completed, there are some gaps in training provided. By regulation staff must have training in first aid, manual handling, infection control, food handling and fire instruction. All staff need to receive training in infection control, fire and manual handling. The infection control nurse can provide infection control training. No service user currently needs lifting, or physical assistance with movement. However, staff need some basic manual handling awareness and such training is available, for example, at the adult college. If staff handle food (e.g. from making a sandwich) they must receive suitable external training e.g. a food hygiene certificate. The local college will be able to provide this training. There must always be at least an ‘approved first aider’ on the premises. St John’s Ambulance can provide this training. Evidence of training, e.g. a valid certificate must be maintained on file. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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): 37, 39, 42 Quality in this area is adequate. The judgement has been made using available evidence including a visit to the service. The registered persons appear to be suitably experienced and qualified to manage the home. The registered persons have a suitable approach to the management of quality assurance, although it is recommended they develop a brief policy to outline this. The management of health and safety issues is satisfactory; although the registered persons must make some improvements so service users can be assured they live in a safe environment. EVIDENCE: The registered persons have suitable experience, skills and knowledge to carry out their roles. The registered manager said she has completed her Registered Manager’s Award but is awaiting the certificate. A quality assurance survey was completed with service users and their relatives in April 2006, and this seems satisfactory. A high level of satisfaction was reported. Monthly residents meetings take place and these are The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 19 documented. Service users all said they were very happy living at the home, and said they found the registered persons supportive and helpful. A lot of ‘quality monitoring’ takes place on an informal basis as the registered persons and service users live together. There is considerable interaction between everyone, and any problems or dissatisfaction is resolved as issues arise. The building is well maintained, and any maintenance or improvements are carried out as necessary. It is recommended the registered persons develop a brief quality assurance policy outlining, e.g. via bullet points, the approaches they take to managing quality and improvement issues. There is generally a suitable approach to health and safety. Service users all said they felt safe living in the home. The Environmental Health Officer visited the home in February 2003 and found food handling arrangements satisfactory. A portable electrical appliance test was completed in April 2006. There however is no record that a hardwire test has been completed on the electrical circuit. This must be completed every five years. The registered persons said the central heating system had just been installed (previously there was storage heaters only), and are aware they need to obtain a gas safety certificate / evidence heating is serviced annually. Arrangements to test the fire system are satisfactory, and suitable records are kept. A copy of the insurance certificate was observed. An accident book was observed, but no accidents were recorded, as the registered persons said there had not been any. Health and safety risk assessments need to be completed including one which outlines the risk of legionella, and what preventative measures are taken. The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 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 2 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 X 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.V300771.R01.S.doc Version 5.2 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA35 Regulation 18 Requirement The registered persons must provide staff with suitable training to do their jobs and meet regulatory requirements. Suitable evidence of training must be maintained. Training must include fire training, food handling (if food is handled), infection control, first aid (i.e. there must always be a member of staff qualified to appointed person level on duty), and manual handling. The registered persons must ensure the following health and safety measures are implemented: • A hardwire test on the electrical circuit must be completed at least every five years. • A gas safety certificate must be obtained annually. • Health and safety risk assessments must be completed. These must outline what control measures are in place to minimise any risks DS0000009079.V300771.R01.S.doc Timescale for action 01/12/06 2 YA42 13, 23 01/10/06 The Peacocks Version 5.2 Page 22 • highlighted. A risk assessment regarding legionella must be completed. 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 YA7 YA9 Good Practice Recommendations It was recommended: • The registered provider individually risk assesses service users regarding the proposal for them to spend assessed periods of time without staff support. This should be completed in consultation with individual service users and their representatives (e.g. family, social worker) • Liaises with CSCI regarding how the goal of enabling individual service users to spend time without staff support is implemented. • Keeps the approach under review in liaison with relevant parties. Provide soap and a clean hand towel in the bathroom at all times. Write a quality assurance policy outlining what measures the registered persons take to managing quality. 2 3 YA27 YA30 YA39 The Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Peacocks DS0000009079.V300771.R01.S.doc Version 5.2 Page 24 - 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!