Inspection on 12/08/08 for Richmond Lodge

This inspection was carried out on 12th August 2008.

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 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

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 13/03/2009.

CARE HOME ADULTS 18-65 Top Coxmoor Farm Richmond Road Kirkby in Ashfield Nottinghamshire NG17 7PR Lead Inspector Mary O`Loughlin Unannounced Inspection 12th August 2008 09:30 Top Coxmoor Farm DS0000071232.V370092.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 Top Coxmoor Farm DS0000071232.V370092.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. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Top Coxmoor Farm Address Richmond Road Kirkby in Ashfield Nottinghamshire NG17 7PR 01623 750620 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) Blue Sky Care Ltd Mrs Sharon Margaret Jarvis Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered persons may provide the following category of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission are within the following category: Learning disability - Code LD. The maximum number of service users who can be accommodated is 5. 2. Date of last inspection N/A Brief Description of the Service: Top Coxmoor Farm is registered to provide care for up to 5 people with a Learning Disability. The home is a detached, adapted and extended farmhouse. It has 5 bedrooms that offer at least 12 sq m of useable space and the main communal areas are in excess of the National Minimum Standards. The home has level access and there is a ground floor wet room with rails and a raised toilet seat for people with a disability. There are brochures and information about the facilities and services the home offers available at the reception point in the home. The weekly costs are, £1,160.00 and any additional staff support that may be required following assessment are charged at £11.00 per hour. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people and their views on the service provided. This process considers the provider’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. A review of all the information we have received about the home was considered in planning this visit including the Annual Quality Assurance Assessment (AQAA), and this helped decide what areas were looked at. The main method of inspection used was called ‘case tracking’ which involved selecting the care plans of 2 people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Members of staff, people who use the service and their relatives were spoken with as part of this visit. A partial tour was undertaken, which included looking at people’s bedrooms and communal areas of the home. The quality rating for this service is 2 star this means that people who use the service experience good quality outcomes. What the service does well: The information provided to people who enquire about coming to the home is very detailed and set out in easy read forms so people can understand what the services of the home are and who the staff team are. Considerable time and effort is taken ensuring that people are properly assessed and referrals made to ensure the best outcomes for them when they come to stay. People told us “ every effort was made to make the admission stress free and welcoming, every need is catered for and in a very caring manner” The staff team have a thorough induction into their role and have continued training to update their skills ensuring that people are in safe hands at all times. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 6 The environment is safe and staff ensure that people are assessed for their safety in everyday living, enabling people to achieve their potential. People are informed about how they are being protected from any abuse and staff are trained in responding to any suspicion of abuse or harm. 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. Top Coxmoor Farm DS0000071232.V370092.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 Top Coxmoor Farm DS0000071232.V370092.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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People are admitted only on the basis of a full assessment and involving them, their relatives and advocates. EVIDENCE: We looked at the information available about the home and its services and found that there was a lot of information that was supplied in both easy read, and brochure format to make it easy for people to understand and make a choice about whether they came to stay. From speaking to people at the home and their relatives, we found that the staff had made a lot of effort ensuring that admissions were only arranged after they had spent considerable time making assessments about the person and allowing them opportunities to visit the home and be introduced to the care staff. The staff had taken time to talk with and obtain all the required information from other professionals that were involved with people before they came to Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 9 stay, ensuring that they had all the information they needed about the person to develop a care plan that they agreed with and were consulted about. Records show that each person’s needs with regard to their culture, gender and religion are recorded and people can choose who they wish to provide care for them. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 10 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. People are consulted on every aspect of their lives and how they wish to be supported and staff ensure that they are protected from harm by thoroughly assessing any risks to their safety. EVIDENCE: People at the home have their own personal care planning book that describes what they need to support them. It informs people of the person’s communication needs, likes and dislikes, people that are important to them and their hopes and dreams for the future. Staff ensure that each person’s care plan is centred on promoting their independence, giving them choice and making sure that any risk to their health and welfare is taken into account. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 11 The care records show that people’s mobility has improved as staff take time to focus on developing independence. Each person has a file that contains comprehensive assessments of the risks in their daily activities and describes in detail how staff are to support each area of need in keeping with all expressed wishes. People told us “staff recognise and care for a person’s individual needs, and feel the staff cater for every need in a very caring manner. “ Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 12 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 are involved in meaningful daytime activities of their own choice and according to their individual interests, diverse needs and capabilities. They have been fully involved in the planning of their lifestyle and quality of life. EVIDENCE: This is a new service and the literature available in the home shows that staff have taken time to learn about the local amenities available for them to access, including day centres, surgeries and support groups. Information we received from community agencies show that the service is committed to the principles of inclusion and promotes and fosters good relationships with neighbours and other members of the community. Staff are receiving training from accredited sources to ensure they can fully support people with any communication difficulties. They learn about sign Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 13 language, visual aids and methods of communicating with people who have problems in this area. We saw how staff had worked with people, increasing their mobility, monitoring their wellbeing and enabling people to take part in their chosen activities both at the home and local community. People can choose who provides care for them from a diverse staff group in terms of age, gender, sexual orientation and background. Relatives told me that staff had gone to great lengths to ensure that they listened to and talked to people about their interests. People receiving the service said that they “can always do what they want both during the week and at the weekend.” “ I always make decisions about what I do each day” “Relatives told us that staff monitor people’s diet if this is necessary and ensure they are offered suitably healthy food of their own choice.” Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence including a visit to this service. The health and personal care support that people receive meets their personal choice, individual needs and safety. EVIDENCE: The staff rota shows that consideration is taken regarding the provision of care staff of either gender being available at all times ensuring that people can have the support they want. People’s care plans reflected how they wished to be supported with personal care and showed the involvement of speech therapists and physiotherapist’s in the support of their health and wellbeing. We saw that people are able to wear what they like and their appearance reflected their wishes. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 15 The care records show that people have access to external health professionals ensuring they are monitored and any potential problems are dealt with at an early stage. Relatives told us “they were kept informed of any changes in a person’s health and that they could not fault the way everything is done with regard to care” Staff told us about their knowledge of how people wish to be supported and knew the importance of providing personal care in private. Staff record any changes in mood, behaviour and general wellbeing and ensure people are free to make their own decisions about how to spend the day within a suitable risk management framework. The medicines are safely managed through an efficient medicine policy that reflects current recognised guidance. Medicines are stored safely, recorded into the home and on administration, which provides a suitable audit trail ensuring no mishandling takes place. Staff are trained to administer medicines safely. The care records included guidance on all the medicines people are prescribed to ensure staff recognise and report any side effects people may experience. The manager told us that a suitable cabinet for keeping controlled medicines in safely and legally was on order and that no controlled medicines were in use at this time. Staff who monitor blood sugar did not have appropriate records of training to ensure they were competent to undertake this health related task. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 16 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 excellent. This judgement has been made using available evidence including a visit to this service. People are listened to and taken seriously by a staff team who are trained in how to protect vulnerable people from abuse. EVIDENCE: The Commission has received one concern since the service registered with regard to an allegation that there was litter on the main public driveway. We discussed this matter with local public authorities who told us they did not uphold this concern. This inspection found the external grounds and driveway to be free of litter. There have been no allegations of abuse and the service has not received any complaints or referred any alerts regarding safeguarding people from abuse. We found that people who use the service are supplied with a complaints procedure that they can understand and they have regular access to external advocacy groups. People are also given information on what they should do if they feel that anyone is behaving inappropriately towards them or others. Staff receive training on protecting people from abuse and they have recognised accredited training in how to manage aggression through a nonabusive psychological and physical intervention programme. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 17 People told us that staff always treated them well and acted on what they say. “ I can talk to all staff, they are nice.” Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 18 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): 24-27-28-29-30 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is clean, safe and comfortable, well maintained and reflects the individuality of the people using the service. EVIDENCE: The home is accessible via a ramped access directly into a small hallway. There are security systems in place that activate an alarm. There is no passenger lift however the home can accommodate people who have a primary need of Physical Disability, there is a ground floor wet room with rails and a raised toilet seat for people with a disability. The home has 5 bedrooms that offer at least 12 sq m of useable space. The rooms are furnished to a high standard. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 19 Four bedrooms have en-suites that consist of mains fed showers, toilets and wash hand basins. One has been fitted with a bath. There are views from all windows overlooking the grounds. The bedrooms have TV points and adequate electric sockets and smoke detectors that are linked to the fire system. There is a lounge, a dining room and a conservatory. The floor space exceeds national minimum standards (NMS). Certificates were in place to evidence all the required safety checks including evidence that the home had been registered with and inspected by the local Environmental Health Department. The environment was clean and warm and well maintained. The external buildings are in the process of consideration for residents use when the home is more occupied, the manager said she would get the opinions of the residents about the use of the buildings. There is an infection control policy and they work closely with external specialists, such as NHS infection control staff, to ensure that infections are minimised. Staff have received training in infection control. People told us “ My room is always clean and I like it because it’s downstairs, I like the big toilet and shower room best” Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 20 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): 32-34-35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The service has plentiful staff available at all times to support people’s needs, activities and aspirations, in an individualised and person centred way. EVIDENCE: Relatives told us ”the service provided by the home supports people to live the life they choose and that staff have catered for all needs.” The staff rota shows that there are suitable numbers of people on duty and over 70 of the care staff team are trained to a standard that exceeds the National Minimum Standards. We examined the staff files and saw that staff are recruited safely, they have appropriate Criminal records checks to ensure that they are suitable to work with vulnerable people. They are selected to ensure that they have the individual skills required to meet the diversity of the people accommodated. They are from diverse backgrounds in terms of age, gender and ethnic origin. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 21 We identified that the staff receive a comprehensive induction for 7 days at the start of their employment and continued training is part of their individual training and development assessment profile. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 22 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 good. This judgement has been made using available evidence including a visit to this service. People live in a well run home that ensures their health safety and welfare. EVIDENCE: The manager has the required qualifications and experience to run the home. The inspection found that the manager promotes equal opportunities, has good people skills and understands the importance of person centred care and effective outcomes for people who use the service. The AQAA contains excellent information that is fully supported by appropriate evidence. It includes a high level of understanding about the importance of equality and diversity. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 23 The home has appropriate, effective and regular support through a named line manager and, as required, access to professional accountancy and business advice from its own financial director. The systems in place for record keeping are very well organised and staff are fully involved in all aspects of the home. Relatives said they were confident in the skills of the manager. Record keeping is of a high standard. Records are kept securely and staff are aware of the requirements of the Data Protection Act. People can gain access to their records, have their own records in their room and contribute to them. Staff are trained in Health and Safety, the records of fire safety were seen; these show that external fire specialists conducted fire risk assessments. Each week staff test the fire alarm system and they have all received training in Fire prevention. Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 24 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 4 3 X 4 X 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 3 25 X 26 X 27 3 28 4 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 3 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 3 X Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? N/A 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 YA20 Good Practice Recommendations Suppliers of Controlled Drug cabinets can confirm that a cupboard meets the legal requirements. We recommend that care homes request formal confirmation when purchasing a CD cabinet. Ensure that any health related task is undertaken only after consultation with the District Nurse and that signed training records are held for anyone undertaking blood sugar monitoring. 2. YA19 Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 Top Coxmoor Farm DS0000071232.V370092.R01.S.doc Version 5.2 Page 27 - 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. 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