Inspection on 07/11/05 for The Rookery Cottage

This inspection was carried out on 7th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Rookery Cottage 20/02/08

The Rookery Cottage 26/07/05

The Rookery Cottage 20/12/04

The Rookery Cottage 17/08/04

The Rookery Cottage 21/03/04

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Hillview Farm

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Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 The Rookery Cottage 249 Shinfield Road Reading Berkshire RG2 8HE Lead Inspector Lucy Martin Unannounced Inspection 7th November 2005 14:20 The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Rookery Cottage Address 249 Shinfield Road Reading Berkshire RG2 8HE 0118 987 2278 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) Milbury Care Services Limited Mrs Helen Mary Petty Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th July 2005 Brief Description of the Service: Rookery Cottage is a large detached listed building with an extension added at a later date. It is a few miles from Reading town centre and is situated on a busy main road. The house is set back from the road and has a large garden. The home is close to public transport and offers easy access to all local amenities. A range of shops are within walking distance of the home. Rookery Cottage is a residential home for up to six adult service users with a learning disability, some of whom have additional mental health needs. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection which started at 2.20pm and finished at 5.20pm. The inspector saw and greeted all six service users currently living at the home and two were spoken with. The inspector also spoke to the Manager and several members of staff as they carried out their duties. A brief tour of the house was made and records, including service user’s files, were seen. What the service does well: What has improved since the last inspection? What they could do better: There is still a need to ensure that the unmet requirement to replace the lounge and communal carpet downstairs is met. An enforcement notice was issued following this inspection to ensure compliance. Any new service users moving into the home should have a full assessment undertaken prior to the move and there should be clear information on each service users file regarding the management of their finances. Each file should also include a photograph of the service user. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 6 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 Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 There was no evidence seen to indicate that the new service user’s needs had been assessed prior to admission. EVIDENCE: A new service user had been admitted to the home from another home owned by the same service provider, 12 days before this inspection. The inspector was informed that visits to meet the new service user had taken place and the new service user had visited his new home and met the service users. However, there was no records written of the introductory visits and there was no evidence on his file that an assessment had been undertaken prior to admission to assess suitability. The inspector was informed that a Care Management Assessment had been carried out but the information was not available in the home. All that was available were the two care files transferred by the previous home and the new home were starting to write up new care plans. This was a planned admission and it is essential for the welfare of the new service user, that some basic information is recorded on routines, likes and dislikes, communication etc. and staff are not expected to trawl through files to obtain this information. It is a requirement that new service users are admitted only on the basis of a full assessment. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 Service users are able to make decisions about their lives. More information should be recorded regarding service users and the management of their finances. EVIDENCE: A sample of service users files were seen and it was positive to note that the work to improve and update the content of service users files has continued. A number of care plans and risk assessments on file had recently been reviewed or updated. It was noted that not all of the service users files contain a photograph and it is required that they do so. Service users are able to make decisions about their day-to-day lives and are encouraged by staff to make choices. For example, one service user had refused to go out to day services that morning and although encouraged to go out, his choice was respected. Other examples recorded include where service users refuse a meal or to go out socially. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 10 One service user has been involved in a local advocacy group and an invitation was seen on display inviting service users to attend a meeting of an independent advocacy group in Reading. Two of the service users have some control over their finances but there was not found to be clear information recorded in their files regarding the management of their finances. It is a requirement that these details are added to the service user’s files. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Daily routines promote independence and service users are offered a healthy diet. EVIDENCE: The house and grounds are large and service users are free to spend time where they wish. On the afternoon of this inspection, some service users were choosing to spend time in their bedroom whereas others were in the communal lounge. The weekly food menu was seen which is drawn up on a Sunday for the following week. Service users choose a evening meal for one day and on a Sunday, there is a roast. The ingredients for the evening meal were in the fridge and was being cooked when the inspection finished at 5.20pm. It was positive to hear from one service user that they prepare a special pudding on one day a week and shop to buy the ingredients. A few menus for puddings were seen which included photographs of this service user cooking. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Personal support is provided consistently to service users to maximise dignity and privacy. The medication records seen were in good order. EVIDENCE: All of the service users need some personal support and forms are used when personal care is carried out by a member of staff of the opposite gender. The staff team is relatively well balanced in terms of gender, but there are more female members of staff than male and 5 out of the 6 service users are male. Times for getting up and going to bed are flexible and there is good consistency in staffing. One service user has specific needs regarding their physical disability. It was positive to note that additional specialist support is currently being obtained including a new Occupational Therapists assessment, in order to be able to continue to support this service user in the best possible way. The home uses a Monitored Dosage System for medication and has recently changed supplier. On the afternoon of this inspection all the staff were being introduced to the system by a pharmacist who was explaining any differences in procedure. More training is being provided by this supplier in the New Year. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 13 The medication administration records were seen and were appropriately completed. There were guidelines seen on service users files regarding the administration of any PRN medication. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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): 23 Service users are protected from abuse and harm. EVIDENCE: The home has procedures and information in the office regarding the abuse of vulnerable adults. This includes a copy of the local interagency procedures. A sample of five staff files were seen in relation to the training that they had attended. All five members of staff had attended training on the protection of vulnerable adults in the last two years. This was confirmed by the Manager who said that all the staff team, except the very newest, had attended training in this area. As stated in this report under Standard 7, there is a need to ensure that clear information is recorded in service users files regarding the management of their finances. A number of the service users have behaviour which can be challenging. There was up to date information on their files regarding meetings with psychiatrists and psychologists and strategies on how to deal with such behaviour. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 and 30 Overall, the home is in a reasonable state of repair and is clean but there is still an urgent need to replace the lounge and communal downstairs carpet. EVIDENCE: On this inspection the communal areas downstairs were seen including the lounge/dining area, the kitchen and the laundry room. Two bedrooms situated on the ground floor were seen and the two bathroom on the upstairs floor. Overall, all areas seen were in a reasonable state of décor and the bedroom for the new service user appeared homely and it was nice to see a ‘welcome to your new home’ card from all at Rookery Cottage. It has been a requirement since March 2004 to provide the CSCI with a timescale indicating when the lounge and communal downstairs carpet will be replaced. The carpet is heavily worn and marked. This matter was followed up in separate correspondence after the last inspection in July 2005, as the requirement was still not met. A further timescale of 26/9/05 was given. The Associate Regional Director of Milbury responded saying that this timescale would be met. On arrival at the home, it was evident that the requirement had not been met. It is acknowledged that there have been some difficulties in getting maintenance tasks undertaken as the home is owned by a different organisation and now Parkside Housing has taken over the landlords. However, The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 16 this matter is urgent and must receive attention. Following this inspection, an enforcement notice was issued stating that the carpet in the lounge/dining room, hall and downstairs corridor must be replaced by 21 December 2005 with suitable carpeting or flooring. The home was clean and since the last inspection a new industrial washing machine with a sluice facility has been purchased for the laundry room. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 17 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 Service users are supported by a core group of experienced and competent staff. EVIDENCE: There is a core group of experienced staff who know 5 of the 6 service users extremely well. It was a recommendation made at the last inspection that there is a front sheet in each member of staff’s file recording the name of the training course attended with the date. This had been done and shows that staff have attended a range of training. NVQ training was not looked at on this inspection. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 and 39 Feedback is sought from service users regarding the service and it is well managed. EVIDENCE: The Manager is now successfully registered with the CSCI. She is aware of areas in need of further development at the home but all too often the day-to day running and wellbeing of the service users takes priority over everything else. This is as it should be but means that most work is reactive, rather than proactive. The monthly Regulation 26 reports are carried out on a regular basis by the Service Manager and are routinely sent to the CSCI. A more detailed audit of the service is carried out annually which records the views of service users, their family and the staff team. This forms the basis for ongoing work. The Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 1 x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 2 x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x x x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 The Rookery Cottage Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x x x x DS0000011353.V264541.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA24 Regulation 23(2)(b) Requirement To replace the carpet in the lounge/dining room, hall and downstairs corridor with suitable carpeting or flooring. (Previous timescale of 26/9/05 has not been met) New service users are admitted only on the basis of a full assessment, involving the prospective service user, using an appropriate communication method. Details regarding the management of service users finances are documented on file. A photograph of each service user is included in their records. Timescale for action 21/12/05 2 YA2 14(1) 07/01/06 3 4 YA7 YA6 13(6) 17(1)(a) 07/01/06 07/01/06 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 Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Berkshire Office 2nd Floor 1015 Arlington Business Park Theale, Berks RG7 4SA 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 Rookery Cottage DS0000011353.V264541.R01.S.doc Version 5.0 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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