Inspection on 07/12/05 for Upton Cottage

This inspection was carried out on 7th December 2005.

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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Upton Cottage 19/12/06

Upton Cottage 26/01/05

Upton Cottage 26/08/04

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 Upton Cottage 18 Bay Road Clevedon North Somerset BS21 7BT Lead Inspector Nicola Hill Announced Inspection 7th December 2005 09:30 Upton Cottage DS0000008094.V264291.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 Upton Cottage DS0000008094.V264291.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. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Upton Cottage Address 18 Bay Road Clevedon North Somerset BS21 7BT 01275 878601 01275 878601 joanne.paterson@btconnect.com 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) Mrs Hazel Paterson Ms Joanne Paterson Care Home 16 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (16) of places Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd May 2005 Brief Description of the Service: Upton Cottage is a residential home for up to sixteen people with Learning Disabliity. It is family owned and run and is situated close to local amenities. The home has its own minibus for taking residents on outings and on holiday. The accommodation is located over three floors. There is no lift available but some rooms are located on the ground floor for those who are unable to manage the stairs. A large lounge overlooks the Bristol Channel at the front of the building. A second lounge has a large snooker table and the conservatory/dining room is at the rear. A terraced garden at the front has wooden steps leading down to the road. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection at Upton cottage took place with the manager of the home Joanne Patterson. The previous inspection at the home had highlighted several areas of development, and these were addressed as part of the inspection process. The residents at Upton Cottage were very welcoming, as always, and were happy to speak with the inspector and talk about their life at Upton Cottage. The inspector also had the opportunity to talk to members of staff at the home. The documentation reviewed as part of the inspection included: • • • • • • • • Care files. Fire safety documentation. Medication files. Staff files. Training records for staff. Staff Rota. Complaints record. Accident records. The manager has worked hard with the staff team and residents to ensure that the standards were met. What the service does well: The evidence for this was obtained from comments from the residents, staff and manager. The residents who spoke with the inspector were spontaneous, and appeared very relaxed and happy. The reasons for this range from being supported to access community facilities such as visits to the pub, and holidays, to the prevailing happy atmosphere at the home. Other comments related to the relationship between the residents at the home, which was generally stated to be very good, and the attitude and relationships they have developed with the staff and management of the home. None of residents expressed any concerns about the home, and majority of them had completed a comment card prior to the inspection. The atmosphere at the home is very relaxed and very much a home that belongs to the residents. The staff team at Upton Cottage is stable and provides a continuity of support to the residents. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 6 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. Upton Cottage DS0000008094.V264291.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 Upton Cottage DS0000008094.V264291.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): 1,2,3,4 There is information available for potential service users but not in an accessible format. EVIDENCE: The inspector reviewed the care files of the last three admissions to Upton cottage. It was noted that for the most recent admission to the home, a preadmission assessment had not been completed. However, the manager had obtained the full multidisciplinary assessment of the resident prior to the admission, and documented in the daily records the days on which the resident attended the home for short visits prior to admission. The manager was advised that it was necessary to carry out a preadmission assessment, which is dated and signed by her in order to demonstrate that she has fully read and understood the needs of the potential resident, and feels that Upton cottage can meet these needs. The preadmission assessment was available on the care files of the other residents, as was corroborative evidence of them visiting the home prior to being admitted. It would appear that for the last admission to the home the lack of a preadmission assessment was an oversight, and there was a plethora of information that identified the support needs of the potential service user. The service user guide, who was identified by the last inspection as being unavailable, was in fact available in the office. The inspector was able to read Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 9 the paper version of service user guide, and noted that contact details for the Commission need to be updated. The inspector and the manager also discussed having a more user-friendly format of the service user guide. The home still has e-mail/website information available for potential service users. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Care plan must reflect any changes in the residents’ support needs, and be signed and dated. EVIDENCE: The inspector reviewed the care files for the residents at Upton Cottage, these are held securely in the managers office. The care files have been divided up for easy access to information, and the inspector was able to cross reference recorded entries with the daily record, diary, and confer with residents that events had taken place. It was noted that going through the care plans, the individual assessment/support need sheets were not signed and dated, this would be a useful thing to do as it would indicate when the assessment had taken place, and who had actually written the care plan. The care plans also contain resident signature, and when reviewed, care plans are reviewed with resident. There was good evidence of health care reviews and identification of health issues. The care plans also included specific actions should be taken to ensure the health needs are met. The inspector was also able to read records of the Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 11 visits to the GP or to specialists. The care plans do not have a picture of the resident on, however the manager holds a further file that contained all the daily records and relevant risk assessment/behavioural agreements, which is available to care staff on every shift. In this file there is a laminated picture and a description of each resident, which can be used should there be an unforeseen absence. The daily records were informative, but the manager was reminded to ensure that staff record things objectively and not subjectively as these are documents which may be seen by resident or their representatives. The daily record may only have limited entries on as and when things happen. There is an expectation that there will be a minimum of one entry per week on this record. The inspector also looked at a residents’ person centred plan which was drawn up with the resident at the day centre, and which contains pictorial representations of things that are important to the resident such as pictures of friends and family. This file also contains information about the daily activity the resident follows, and particularly the interests and aspirations for the resident for their lifestyle. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 The residents at Upton Cottage are involved with a wide range of activity tailored for individual preferences. EVIDENCE: The individual resident all have weekly activity plans drawn up between themselves, the day centres, and the colleges. The residents at Upton Cottage all appear extremely happy and were very willing to discuss their life at the home. One resident was able to compare Upton Cottage with other places where she had lived, and stated that she felt Upton Cottage suited her need the best. The home supports residents to take part in community activities; there was evidence on the resident notice board of invitations to parties, different community events, and individual activities with relatives. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 13 The home has an activity board, which lists the different things that were happening through at the week so that residents and staff know what is going on. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 The homes supports the residents to achieve optimum health. EVIDENCE: The service users were able to confirm that they receive support in the way in which they prefer. For example, one resident was due to have a bath, and was able to state who supported her having the bath and which support worker would give it. The resident also stated that they had support from the person they preferred, and who knew what they needed to do. The home has a good relationship with the local GP practice, and liaises closely with the specialist support available from the community learning disabilities team. On the day of the inspection one resident was going to the dental Hospital for treatment, and a member of staff supported her. It was noted that one resident who has insulin-dependent diabetes, was currently going through a change in medication. Although this was fully documented within the medication record administration book, this had not been updated within the care plan. The manager had put in a lot of work to ensure that the resident, who now has the two different types of insulin, was safeguarded against mistakes and the two types of insulin were colour-coded. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 15 The insulin is administered through a pen, which has a preset dosage. In addition to this, the manager has ensured that the local diabetes specialist nurse has been to the home and talked to staff about the administration of the insulin and the reasons why it had been changed. The staff are also trained to monitor blood glucose levels, and this is recorded on the medication file. In order to support the resident, and the manager ensures that he had six monthly optician checks and is seen by the chiropodist on a regular basis. The manager has carried out a risk assessment for this resident in relation to his diabetes, and this gives information to support staff of how to recognise and what do you case of hypoglycaemia. Since the last inspection the manager has overhauled the medication system and the inspector was able to go through the medication system and track the medication given. The home uses the nomad system, and this was found to have been administered correctly and recorded correctly. The medication not within the nomad system has an individual stock control sheet as well as being recorded on the medication administration record sheet. This provided a very easy audit trial for the inspector to check these medications against. The medication system was found to be correct and up to date. None of the residents currently administer their own medication; only one resident keeps her inhaler. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 The procedures in place at Upton Cottage allow residents to raise concerns and complaints. EVIDENCE: The complaints procedure has been updated since last inspection, and copies of the procedure in their accessible format were seen around the home. They have been no complaints to the home since last inspection. The staff team have all had training through case K.S.C. L. Ltd in adult protection awareness; this took place in June 2005. The home has an adult protection policy and were reminded to include the new contact details for reporting abuse to North Somerset Council. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 17 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): Not inspected on this visit. EVIDENCE: The inspector did not tour the environment on this visit, however the manager informed the inspector of the proposed improvements to the structure of the building, for example, the windows at the rear of the building need attention, and it was noted in one bedroom that the sash had broken and there was a cracked pane of glass. The manager would also like to revamp the dining room area to provide different type of flooring and to provide additional cupboard space for staff and residents use for the storage of medication, and food. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 – 36 The procedures in place at Upton Cottage allow residents to raise concerns and complaints. EVIDENCE: The rotas provided by the manager indicate that there was sufficient staff on duty to meet the identified support needs of the residents. The inspector reviewed the staff files and noted that since last inspection that the recruitment procedures have improved. The files contain application forms with health declarations, copies of photographic identification, references, POVA first and CRB checks, and supervision records. It was discussed with the manager about recording induction, there were several pieces of information were seen by the inspector relating to induction, for example, the fire log contained the list of staff names who had been inducted into the home and shown around the fire safety systems. The manager has applied to Weston College for staff induction however the waiting list and availability of courses is such that in order for staff to receive induction within the timescale, then that her she must devise her own system. The manager has access to the TOPPS induction information from the Croner manual, which covered the areas for induction sufficiently, and it would be useful tool to demonstrate how staff are inducted at Upton Cottage. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 19 The manager is also supporting staff through the NVQ 2 in care award, currently two will be starting the award in February, and two other staff already has NVQ 2. Since the last inspection the staff team have undergone training to update their skills, the training has included: • • • • • • • • • Protection of vulnerable adults. Food hygiene certificate. Infection control. Health and safety awareness. Manual handling update. Fire safety. Risk assessment. First aid. Challenging behaviour. The manager is also arranging training as necessary in order to meet residents identified need i.e. medication administration. Supervision was discussed with the manager, who already has a good understanding of supervision and the processes involved. It was noted on some staff files that were records of supervision; one staff member commented that she found the process of supervision a very good forum in which to discuss the activity of the home in relation to her personal skills. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 20 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): 39,42 The manager must be able to demonstrate how the views of the residents are monitored. EVIDENCE: The manager and the inspector discussed the quality audit of the home and how of them satisfaction surveys should be completed. The surveys that were held on file were a couple of years old, and it was recommended to the manager that the satisfaction survey with the residents and their relatives should be carried on, and any issues arising from it can be addressed. The manager has access to the Croners model of quality audit, but has not yet carried out an audit. In light of the forthcoming changes to inspection practise, the manager was advised to carry out a quality audit, which will identify for her areas in the home that good be developed. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 21 The manager has reviewed many of the policies and procedures since the last inspection. She has also introduced new policies, which are pertinent to the service user group. In respect of health and safety at the home, there is one accident recorded since the last inspection, and this incident was notified to the Commission through the regulation 37 process. The inspector reviewed the fire safety at the home and found that the fire tests were recorded appropriately. The inspector was also able to see the certificate of insurance for the home on the wall at the office. As previously stated the staff have undertaken an update of the training in the health and safety and now all have current certificates for first aid, food hygiene, fire safety, and manual handling. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 22 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 3 3 3 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 2 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Upton Cottage Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000008094.V264291.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? NO No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard YA6 YA32 YA39 Regulation 15 18 24 Requirement Timescale for action 07/12/05 Ensure that care plans are changed as resident needs change. The induction of new staff 07/12/05 follows a planned programme and is recorded on their files. Quality audits and questionnaires 07/12/05 are implemented to assess customer satisfaction with the service. 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 YA2 Good Practice Recommendations Preadmission assessments must be recorded, dated and signed by the manager. Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Upton Cottage DS0000008094.V264291.R01.S.doc Version 5.0 Page 25 - 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. 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