Inspection on 07/02/06 for Whitegates (The Cottage)

This inspection was carried out on 7th February 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

Whitegates (The Cottage) 13/03/07

Whitegates (The Cottage) 05/07/05

Whitegates (The Cottage) 11/01/05

Whitegates (The Cottage) 06/05/04

Similar services:

Hillview Farm

Dalewood Respite Care

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 Whitegates (The Cottage) The Coach House - Elizabeth Fitzroy Support Farnham Road Liss Hampshire GU33 67G Lead Inspector Drew Gurney Unannounced Inspection 7th February 2006 09:30 Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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 Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitegates (The Cottage) Address The Coach House - Elizabeth Fitzroy Support Farnham Road Liss Hampshire GU33 67G 01730 897503 01730 895607 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) Elizabeth Fitzroy Support Miss A Lashbrook Care Home 14 Category(ies) of Learning disability (14) registration, with number of places Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th July 2005 Brief Description of the Service: Whitegates (The Cottage) provides a service for fourteen adults with a learning disability, some of whom may have associated physical disabilities. Two separate establishments that are managed by one registered manager. Whitegates provides support for eight adults and The Cottage for six adults, each with their own separate support team. The home is situated in a rural part of Hampshire, within the village of Liss. Transport facilities are provided for service users to access local facilities and larger towns in the area. The home has well-established links with local General Practitioners and the Community Nursing Team. One of three registered services on this site, developed and managed by Elizabeth Fitzroy Support, Whitegates and The Cottage are well established in the local community. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place during a period of 4.5 hours and was unannounced. The registered manager was on duty at the home and assisted the inspector throughout the inspection. The home is registered for 14 service users and on the day of the inspection there was one vacancy in Whitegates. At the time of the inspection there were two and a half full time equivalent vacancies at Whitegates and one full time vacancy at The Cottage. Speaking with four service users, three members of staff and the registered manager provided evidence for this report. The inspector also had the opportunity to read and inspect records, tour the home and observe the interaction between staff and service users. Please refer to inspection report dated 7th June 2005 for key standards not inspected on this occasion. What the service does well: What has improved since the last inspection? Since the last inspection, routine maintenance and re-decoration has continued within the home. This includes decoration of the lounge in Whitegates, two bedrooms in The Cottage; the replacement of carpeting in the hallway of The Cottage has taken place; three radiators in Whitegates have been covered and risk assessments have been undertaken of all areas where radiators remain uncovered; staffing levels have increased, including care staff and a cleaner Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 6 and information was available that new sofas and chairs have been ordered for the lounge of Whitegates as required during the previous 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. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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 Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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 and 5 The home is able to demonstrate that they would be able to assess the needs of individual service users before being admission to the home. The registered persons are able to demonstrate that many service users have been provided with a contractual agreement but there is a need to pursue the remainder. EVIDENCE: Established procedures were available for viewing outlining the assessment procedures for the admission of new service users to the home. This protocol is also supported by an additional tool, which aids staff to develop risk assessment and streamlines the assessment procedure. In response to the previous inspection request, many service user files now contain contractual agreements made between service users, various funding social service authorities and Elizabeth Fitzroy Support. Six contracts were available for viewing. The manager and members of the administrative team are continuing in their approach to various authorities and hope to finalise this requirement shortly. This objective remains a requirement until all service users have the necessary agreements available on file. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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): 7 Work is in progress to ensure that service users are involved in reaching decisions regarding their needs both current and future; every endeavour is made to support service users in reaching personal decisions and choices. EVIDENCE: Various forms of information within files viewed indicated that wherever possible, appropriate written or symbol formats are used to identify with service users their personal choices. Work is currently taking place in conjunction with the East Hampshire Advocacy group with regard to seeking the views of service users concerning their choices and decisions regarding standards in supported living. This tool is also proving helpful to staff to identify service user current choice. The Inspector viewed the minutes and agendas of service user meetings that are held every two months. This information was documented and recorded in picture symbol format and topics included chosen activities and decisions reached for the forthcoming two months and other issues relevant for discussion. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 10 The manager also provided recorded information of group meetings held fortnightly at On Track Day Services, which are attended by the majority of service users at Whitegates. The meetings are held to identify service user feelings in making personal choices, using various measures such as colours to identify emotions. This procedure is conducted with service users and in conjunction jointly with staff at both the home and day services. Outcomes such as holiday decisions are reached using this approach. The inspector viewed procedures for financial recording practices within the home and individual financial sheets headed ‘My Financial Plan’ for a few service users. These plans identified how money and benefits are sourced and paid into bank accounts, named relevant signatories for accounts and how finances are managed due to inability and identified subject to risk assessments. Decisions are reached with the support of family members. The inspector checked ready money held in individual tins against recorded information for two service users and the totals were accurate in both instances. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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 Service user’ rights are respected by staff with regard to choice, dignity and access. EVIDENCE: Keys are available for all rooms and bathrooms are lockable, with master key access. However, staff support with bathroom use is provided according to assessed need. Lockable cupboards are available in all bedrooms. Service users open their own mail where able to do so. If this is not appropriate, a member of staff who sits beside individuals, assists service users. Information about this procedure is recorded on individual files. Mail is sorted in the quiet room and when service users are out of the building; mail is placed in individual pigeonholes awaiting their return. Information was available indicating that staff are currently working with service users and individual local authority care managers towards investigating service user aspirations for the year ahead. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 12 Recorded information was also viewed indicating the communication choice of service users with regard to when they choose to make telephone contact with families. Staff support service users to pass information directly from and to family by telephone and projected voice systems. The quiet room, as well as bedrooms are available when it is a service user’s wish to be alone. Most service users were absent from the home and attending day service facilities. Those remaining at home were observed watching a personally chosen DVD or enjoying snacks or lunch. Staff were seen to respond to individual choices for drinks and snacks. Cupboards in both kitchen had pictures of their contents enabling service users to make a personal choice about what snacks were to their taste All areas have unrestricted access within the home. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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 and 19 Service users are supported to make choice in various ways to positively enhance their lives. Records are available to demonstrate that staff ensure that service users’ healthcare is regularly monitored. EVIDENCE: Documentation viewed in service user’ records indicate that individual moving an handling risk assessments have taken place to establish how personal care and general mobility are conducted. The information headed ‘Supporting me with a bath/dressing’ contained relevant information concerning procedures as necessary for health and safety reasons, and was available on individual service user’ files. Much of the information is collated by staff who have provided long-standing support for service users and with service user involvement. On arrival at the home, the inspector was informed that one member of staff was supporting a service user to attend a health related appointment at Q.A. Hospital, necessary for the well being of the service user. Normally, dental treatment is obtained from Petersfield Hospital and information is recorded in support plans. Any service user with eyesight issues Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 14 are supported to attend for optical tests, where necessary. There are currently no hearing concerns for any service user in the home. The home is involved with three G.P. practices and information was available indicating that two female service users had been supported to change practice so that personal care could be provided by a female G.P. as preferred by them. Evidence supporting choice of times for getting up in the morning was substantiated by three service users still in bed on the inspector’s arrival at 9.30 a.m. The manager explained that if service users were not attending day service, time of rising and retiring to bed was suited to their needs, within reason. All new staff are initially ‘shadowed’ by a long-standing member of staff to ensure that service users are able to indicate that they are comfortable with staff providing personal care. Recorded service user information explains how staff must identify choice of clothing for the day by showing several items of clothing to service users. Current work is taking place with service users and families to develop which questions they would wish asked during recruitment procedures for prospective members of staff. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 15 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 and 23 The complaint procedure meets the required standard and is available in service user-friendly format. Adequate adult protection training has been undertaken and relevant information is available within the establishment. EVIDENCE: The complaint procedure has been updated and incorporates appropriate information for a complainant to express concerns and how these will be dealt with. The information includes picture symbol information for service users to express their concerns. The inspector viewed the complaint log procedure and identified that one complaint has been received since the previous inspection and remains to be finalised by the home. Information available, indicate that time scales are being adhered to. No direct complaint has been received by the Commission for Social Care Inspection (CSCI) since the previous inspection. The home has an adult protection policy procedure. Copies of the Hampshire adult protection documentation are available for staff reference. Staff induction information indicated that BILD (British Institute for Learning Disabilities) adult protection procedures are followed on a workbook basis. The manager initially undertakes an assessment of workbooks. The process then links with verification towards NVQ qualifications. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 16 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 The home is homely, comfortable and presents a cleaner and more hygienic environment for service users within the home. EVIDENCE: Maintenance and redecoration has been undertaken within the home, following concerns raised during the previous inspection. The Whitegates’ sitting room has been re-decorated satisfactorily. Information was available indicating that new seating is on order for this room. An offensive smell of stale urine was detected during the previous inspection. Until new sofas and chairs arrive, the additional material covers have been removed from the seating, leaving the wash/wipe surface in place. This has resulted in the unpleasant odour disappearing and a more pleasant atmosphere throughout for service users, visitors and staff in this room. Since the previous inspection, a cleaner has been appointed for the establishment and this appointment is reflected in the general uplift in the home’s appearance to the benefit of all service users and staff. The inspector conducted a tour of both Whitegates and The Cottage and all bedrooms were bright, cheerful and reflected individual hobbies and interests. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 17 Two bedrooms have been re-decorated in The Cottage and the hall carpet replaced. Carpets in both buildings were of reasonable quality and condition. One spare room on the top floor of Whitegates has now been allocated as a review room. The manager said that this decision had been favourably met by all concerned. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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): 34 Information on staff files did not demonstrate that all recruitment procedures are followed. EVIDENCE: A sample was undertaken of recent appointments. It was observed that full employment information as described in Schedule 4 of the standards was not available. Of three files viewed, all contained POVA clearance, completed application forms, photographs, health information and a record of interviews. In one instance however, only one reference was available. A requirement is placed that the home provides information to CSCI with regard to the missing reference. The management must also ensure that no appointments are made without all required satisfactory references being received. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 19 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 and 42 A quality assurance lifestyle audit is being carried out to include service user views. Adequate safety measures have been developed to promote highlighted aspects of service users’ safety. EVIDENCE: A quality assurance lifestyle audit has been developed and with the support of the advocacy team, relatives and the community health team, service users are being supported to complete the documentation involved. For each standard discussed in this documentation, a summary and action plan are available on file. An annual development plan is available for viewing and the manager informed the inspector that she is currently in the process of developing a business plan for the financial year ahead. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 20 The previous inspection required that risk assessments should be completed for all uncovered radiators in the building. The manager has responded to this request and following risk assessment procedures the need for three radiators to be covered was identified. All three covers were in place and risk assessments available for viewing. Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 2 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 X 33 X 34 2 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X x x x 3 x x 3 X Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 22 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 YA55 Regulation 5{c} Requirement A contract for the provision of services by the registered provider must be provided to all service users. This is a repeat requirement last made on 5.7.05 Staff files must include all items listed in Schedule 4. Timescale for action 07/05/06 2 YA3434 17{6} 21/02/06 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 Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Whitegates (The Cottage) DS0000011809.V281964.R01.S.doc Version 5.1 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. 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