Inspection on 15/01/06 for Wisteria Cottage

This inspection was carried out on 15th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Wisteria Cottage 17/04/07

Wisteria Cottage 07/01/05

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 Wisteria Cottage 18 Lower Odcombe Odcombe Yeovil Somerset BA22 8TX Lead Inspector Lesley Jones Unannounced Inspection 15th January 2006 10:00 Wisteria Cottage DS0000061054.V278797.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 Wisteria Cottage DS0000061054.V278797.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. Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Wisteria Cottage Address 18 Lower Odcombe Odcombe Yeovil Somerset BA22 8TX 01935 863973 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 Amanda Jane Webb Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th March 2005 Brief Description of the Service: Mrs Webb is the Proprietor and manager of Wisteria Cottage, a three-bed home situated In the pretty village of Odcombe on the outskirts of Yeovil. It provides a service to people with a learning disability, some of whom have been assessed as having behaviour which can be challenging to manage, and would benefit from small living environment. Church View has twenty-four hour staffing, and Mrs Webb and her husband and family live nearby. Service users have individual daily programmes and are supported to attend a wide range of work, educational and leisure activities Mrs Webb also owns two other cottages in the village called Poppy Cottage, and Church View. Poppy Cottage provides a home for more independent service users who do not need twenty-four hour support, and although a part of the service as a whole does not require registration or inspection by this department. Church View is a home for five people with a learning disability. Church View also has twenty-four hour staffing and is subject to full inspection. Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Sunday 15th January at 10.00am. All three service users were at home. The last unannounced inspection took place on Sunday 27th February 2005. There were no requirements or recommendations following the last inspection. During this visit I spoke to the mother of one resident who was visiting her daughter, residents at home, and a member of staff. I also inspected a selection of records, and observed the interaction between staff and residents during some in house activity. Wisteria Cottage is part of the small company known as Village Homes, which has established itself as a competent and professional service. Mrs Webb is an experienced manager and has a good knowledge of working with people with a wide range of learning disabilities. Her knowledge, experience and commitment are evident in the high quality service provided. As this was an unannounced inspection, where it is often not possible to get feedback from families, I was very pleased to have the opportunity to speak to the mother of one resident. Her feedback was very positive, adding that she thought that the home went ‘the extra mile’ in providing care and that the care was ‘good medically, emotionally, physically and psychologically’. What the service does well: Service users are consulted about all aspects of their lives and activities and programmes are balanced to take into account individual’s wishes and risk management. Service users look well cared for, are appropriately dressed, and enthusiastic about the home, their rooms, Mrs Webb and the staff group and the things they do each day. Interaction between staff and residents is respectful yet jolly and light hearted, however residents are clear about expectations and boundaries. It is evident that staff are patient, kind and very fond of the people they care for. There is a happy atmosphere in the home. Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 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. Wisteria Cottage DS0000061054.V278797.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 Wisteria Cottage DS0000061054.V278797.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 This standard is met. A through assessment procedure is in place. EVIDENCE: Since the last inspection, a new extension has been added to the home and one new resident admitted. The records demonstrate that there is a thorough assessment process in place. In addition to information received from placing authorities and previous placements, Mrs Webb assesses prospective service users and her team in their own environment, and then during visits to the home. They may be invited to join activities or for an overnight stay. Each assessment process is guided by individual need. The initial assessment forms the basis if initial care plans, which are then reviewed. All new resident came to the home on a trial basis. Wisteria Cottage DS0000061054.V278797.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): 6,7,9, It is clear to see from conversation with residents alone, that all of these key standards are met or exceeded. EVIDENCE: All service users are consulted about their care plans and activity programmes. Care plans are very detailed, and include, risk assessments, and weekly activity plans. All are subject to ongoing and formal review. Care plans demonstrate that the services of specialists have been sought. Daytime activity is structured, with evenings and weekends more relaxed. Service users are involved in the development of their care plans with risk management identifying restrictions. Individuals need assistance to manage their personal finances and appropriate records are kept of staff involvement. Care managers are involved in checking finances at formal reviews. Following consultation, service users sign their care plans. All service users have risk assessments, which contain detailed and clear information. These assessments are discussed with service users to reinforce the identified risk and look at ways of developing individual’s skills. Areas that Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 10 are risk assessed include: the use of house keys, management of personal finance, going out alone and assistance required when bathing. Residents talked about what they do socially, and activities that help develop other life skills, such as learning to travel independently. They also talked about how activities have been changed to meet an expressed need, for example to improve reading or numeracy skills. Wisteria Cottage DS0000061054.V278797.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): 12,13,15,17 These standards are met or exceeded. EVIDENCE: This standard can be evidenced in individual’s activity programmes and by talking to staff and residents. Service users go to Yeovil College. Some access a variety of activities at Lufton Manor (a specialist college nearby). Mrs. Webb moves people into work placements as their abilities develop, providing the necessary staff support. One resident talked of the work she did in a local charity shop and how much she enjoyed it. There is regular use of a variety of services and facilities in the local community. These include shopping trips to Yeovil, and use of community facilities such as the church, swimming pool, cinema and cafes. All service users have a house key and key to their own room. All have locking cabinets in their rooms. Staff knock on bedroom doors before entering and service users are taught to respect each other’s privacy in this way as well. Mrs Webb aims to get the right balance between respecting individuals wishes Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 12 to have quite time alone with encouraging activity and having fun. A flexible approach to staffing means that individuals who chose not to go out, can be supported. Service users are supported and encouraged to maintain good contact with their families and maintain and develop friendships. Service users have access to e-mail, a pay phone and cordless phone (to promote privacy) and are encouraged to purchase mobile phones. Families are welcomes, to call into the home unannounced. Other service users have weekend visits to their parents. Service users plan menus each Sunday and go shopping during the week. There is some flexibility around meals and mealtimes to fit in with activities, however a record of meals eaten is maintained. Service users are encouraged to try new foods and due regard is given to promoting a healthy diet. The home is able to provide special diets, where needed and individual needs are catered for, for example caffeine free and low sugar. Service users assist with shopping, meal preparation and cleaning up after meals. Mrs Webb’s mother supports the home by providing home made cakes and puddings. Wisteria Cottage DS0000061054.V278797.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): 18,19,20 These standards are met, and good systems are in place to ensure that medication is safely managed and administered. Residents are encouraged wherever possible to become involved with the management of their medication. EVIDENCE: Personal support is provided in private. There is good information and guidelines about personal care routines. Included in information for staff is a policy about individuals expressing sexuality, and how this is appropriately supported. The staff group are all experienced and have been inducted to the standard set by Mrs Webb. Service users access the primary health care team, NHS help line, psychiatrist, psychologist, and specialist support for eyes and feet. There are regular visits to the dentist. Staff are experienced in working with people with behaviour that can be challenging. Mrs Webb and all of the staff have training in the care of medicines by the local pharmacist and there are six monthly in house assessments to ensure competence. Medication is appropriately stored and managed and a monitored dosage system in use. The home has a homely remedies policy, and consults Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 14 with the GP about the use of non-prescribed medication. The pharmacist visits the home regularly and leaves excellent reports about practice in the home. Service users are encouraged and supported to manage their own medication wherever possible. Wisteria Cottage DS0000061054.V278797.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): 22,23 These standards are met or exceeded. EVIDENCE: There is a complaints policy and procedure in the policy manual for staff. Service users have a copy of the complaints procedure in a format they understand, and stamped addressed post cards to the CSCI with which they can summon help if they have a serious complaint. Making a complaint is discussed at house meetings. Service users confirmed that they would go to staff if they had a problem. The home has a whistle blowing and an abuse policy, both of which are discussed as part of the induction process. Staff sign to say that they have read and understood policies. Financial records regarding the management of personal finances were not inspected on this occasion, but checks carried out on previous visits have shown them to be well maintained. Service users and staff sign the records when any personal transaction takes place. Mrs Webb also carries out spot checks Wisteria Cottage DS0000061054.V278797.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): 24,30 Wisteria Cottage provides a really homely, comfortable and safe environment. It is decorated and maintained to a high standard. The house is well situated in a small village near to local fields and Ham Hill (a local beauty spot). The facilities in the house are in keeping with the homes philosophy of promoting independence and supporting people to develop daily living skills in ordinary domestic accommodation. EVIDENCE: All bedrooms are well personalised and attractively decorated. Service users do not have sinks in their rooms, but have good access to the communal facilities. In some instances, sinks in bedrooms would create problems with behaviour management. Residents and their clothes certainly looked clean and well cared for. There is a separate toilet and bathroom on the first floor and an en suite shower and toilet in the new extension (built since the last inspection). Service users share facilities in the main part of the house and currently this works well. The shower is thermostatically controlled and other hot water outlets regulated at the boiler. All service users need assistance or prompting with washing and bathing. Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 17 Shared space consists of a kitchen/diner and a lounge. Staff have a separate sleeping in room. There is no smoking in the house and the designated smoking area is in an area outside the house. Furnishing is safe, comfortable, of good quality and very attractive. The home is very clean and hygienic. Food hygiene training has been provided for staff. Hazardous substances are safely locked away and COSHH sheets are in use for all relevant substances. Mrs Webb follows the advice of the Environmental Health Officer in relation to the hygienic use of a kitchen-based laundry. All staff receive training in infection control. Wisteria Cottage DS0000061054.V278797.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): 32,34,35 These standards are met, staff are experienced, well trained and appropriately supported. EVIDENCE: Until the recent recruitment drive, eighty per cent of the staff group were qualified to at least NVQ Level 2. (The recommendation being at least fifty percent) Mrs Webb is in the process of supporting a number of staff with NVQ training. The records show that overall training for staff is good, that the staff group is experienced, and that few staff have left to work elsewhere. At least two references are taken on staff. All have a statement of terms and conditions and a staff handbook. Service users are involved in the interview process, and show prospective staff around Wisteria and Church View. During this process, interaction between the prospective staff member and the service user is observed. All staff have CRB and POVA (police) checks, and recruitment procedures follow requirements. Wisteria Cottage DS0000061054.V278797.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): 37,39,42. These standards are met and the home is well run. EVIDENCE: Mrs Webb has over twenty years experience as a carer and manager. She has worked with people with a learning dissability for fourteen years. . She has a Higher National Diploma in Care Management, is currently pursuing an NVQ level 4 in care management, and trained as a state registered nurse. Mrs Webb was part of the senior management team at Lufton Manor College for three years. Ongoing feedback is sought from service users as a way of assessing quality. Feedback is also sought from families, placing authorities and outside specialist agencies. At previous inspections evidence of feedback has been available in the form of letters from families,and service user comment cards. At this inspection, there was was feedback from the service users themselves, staff and the parent of one resident. Service user questionaires are given to service users at Christmas, so that they can have the opportunity of completing them when they are visiting their families. Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 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 4 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 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 4 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 4 x 4 x x 4 x Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 21 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Wisteria Cottage DS0000061054.V278797.R01.S.doc Version 5.1 Page 22 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. 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