Care Home: 14 Cook Close

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What the care home does well Service users are supported by a small team of staff, who support them to maximise their independence, within the confines of their individual needs and disabilities. Service users spoke of being generally happy with the environment, stating that they felt the home was homely and generally inviting. What has improved since the last inspection? The home has in place a procedure to be followed for the admission of new service users to the home. Service users spoke of their needs in respect of their privacy and dignity being addressed much better. The maintenance issues identified in the last inspection report have now been addressed, and the issues referred to were no longer evident. What the care home could do better: The home`s recruitment process needs improving, particularly in relation to ensuring that Criminal Records Bureau checks are obtained for all staff prior to their commencement in employment. This is to ensure that the process adequately protects service users from risk of harm and/or abuse. CARE HOME ADULTS 18-65 14 Cook Close Dovercourt Harwich Essex CO12 3UE Lead Inspector Neal Cranmer Key Unannounced Inspection 31st October 2007 09:00 14 Cook Close DS0000017722.V353984.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 14 Cook Close DS0000017722.V353984.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. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 14 Cook Close Address Dovercourt Harwich Essex CO12 3UE 01255 240095 01255 240095 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) The Brain Injury Rehabilitation Trust Mrs Suzette Anne Doherty Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) 7th November 2006 Date of last inspection Brief Description of the Service: Cook Close is a detached bungalow situated in a residential area of Dovercourt. The home has three single bedrooms. The home caters for the needs of three people who have cognitive, behavioural and functional deficits resulting from acquired brain injuries. The registered provider is The Brain Injury Rehabilitation Trust; a charitable organisation, which operates, registered homes nationally. The sister home to Cook Close is Myland House in Colchester, which is approximately 20 miles away. Fees’ for residing in the home are between £ 828.80 per week and £ 1080.87, an additional charge is made to service users who require one to one care of 162.20 per week. Further additional charges are made for the following items: Hairdressing, individual swimming lessons, toiletries and holiday’s. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is the result of an unannounced key inspection to the home, which took place over one day in October 2007, lasting approximately 5.00 hours. The inspection included discussion with all three of the service users in residence, the home manager and staff. A tour of the premises was undertaken, which included viewing of service users’ rooms, communal areas and gardens. This tour indicated that the premises were generally well equipped to meet the needs of the service users in residence. During the course of the inspection process a range of documentary records were sampled, including the home’s Annual Quality Self Assessment Audit (AQAA). The information included in the annual quality assurance form (AQAA) which had been submitted to the Commission for Social Care Inspection, was also used in compiling the inspection report. This form gives homes the opportunity of recording what they do well, what they could do better, and what has improved in the previous twelve months as well as future plans for improving the service. What the service does well: What has improved since the last inspection? The home has in place a procedure to be followed for the admission of new service users to the home. Service users spoke of their needs in respect of their privacy and dignity being addressed much better. The maintenance issues identified in the last inspection report have now been addressed, and the issues referred to were no longer evident. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 6 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. 14 Cook Close DS0000017722.V353984.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 14 Cook Close DS0000017722.V353984.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 good. This judgement has been made using available evidence including a visit to this service. Prospective service users could be confident that the policy and procedures in place would ensure they have an appropriate assessment to identify their needs. EVIDENCE: The home has not had any new admissions for a number of years. However the home does have a pre-admissions screening tool in place which was seen to cover the following areas of need: social history, medical history, physical health, mobility, and communication. As part of the assessment a full functional needs assessment is carried out. This assessment is then used as the basis for formulating the service users initial plan of care. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that their assessed and changing needs will be reflected in their individual plans of care. Service users can expect to be supported to make decisions about their everyday lives with assistance as required, and to take risks as part of developing an independent lifestyle. EVIDENCE: All three-service users’ files were sampled. They all contained a good level of detailed information relating to their personal care needs and how they should be supported. The identified care objectives were clear and unambiguous, as were the guidelines to staff. All of the care plans seen had review date set. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 10 Throughout the course of the visit staff were seen and heard interacting positively with the service users. The level of banter was two-way, and was clearly acceptable to the service users, indeed in most cases it was observed they initiated it. The service users, although being wheelchair users, are quite independent and staff work hard with them to support them to maintain their independence. Service users were seen making drinks, washing up and going about their everyday business within the home independently or where necessary with assistance. Risk assessments are carried out at the point that service users are admitted to the home. All three files sampled contained risk assessments which identified the nature of the risk, and the actions to be taken to minimise the risk. The risk assessments were designed to keep service users as safe as possible, without impeding their independence. From looking at a sample of risk assessments there was evidence that service users had signed and agreed their individual assessments. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that they will be supported to take part in activities that are of their choosing, and that they will be supported to maintain links with people that are important to them. Service users can be assured that they will be provided with a varied and nutritious diet. EVIDENCE: None of the service users residing at the home have any paid or voluntary employment, or take part in any Adult Education programmes, this being the choice of the service users. However discussion with the service users evidenced that they are supported to continue to take part in activities that they had enjoyed prior to sustaining their injuries for example sailing, swimming and going to the gym. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 12 Service users are supported to access the community, and spoke of attending various clubs for people who have physical disabilities, going to the local library, banger racing, and meals out. One service user spoke of being supported to maintain links with ex -work colleagues through their attendance at meetings related to their specific area of interest. Discussion with service users indicated that they are supported and involved in the planning of their annual holiday breaks. The home has an open door policy on the receiving of visitors, and service users spoke of staff supporting them to maintain links with their families and friends through the sending of cards and letters. One service user spoke of the home supporting them to make visits home on a fairly regular basis. Meals provided by the home were varied and nutritious, and were provided three times daily, at least one of which was a hot meal. Meals are provided flexibly to meet the requirements of the service users. Service users spoke of being consulted with about the planning of the menus, and the menus sampled indicated this by the signature of the service users on the bottom of them. Food stocks sampled on the day of the inspection were adequate, and evidence of fresh fruit being available was seen 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported in a way that ensures that their physical and emotional needs are met in a way that is appropriate to their needs. Service users can further expect to be protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Discussion with service users indicated that they felt their needs were being met in a way that respected their privacy and dignity. Comments had been made by service users at the previous inspection about staff not always knocking on doors before entering rooms. However at this inspection service users reported that this was no longer an issue. Service users stated that times for getting up and retiring to bed were generally flexible within limits. Service users spoke of being free to choose what choice of clothing they wished. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 14 All service users continue to be registered with a general practitioner, and records relating to service users healthcare needs were maintained clearly and concisely. Service users access healthcare support from generic healthcare services, this included Dentist, Opticians as well as their General Practitioner. In addition to these services, service users have access to Consultant Psychiatrists, Psychologists and Neurologists who are employed by the Brain Injuries Trust. The home’s medication practice was sampled and found to be in order. The home does not maintain any medicines of a controlled nature, and administration records inspected were found to be in order, with no evidence of any errors or omissions. All staff who administer medicines have received training to do so. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that the home has in place robust policies and procedures for ensuring that they are protected from harm and or abuse. EVIDENCE: The home has a complaints procedure which is corporately developed, and which contained the contact details for the local office of the Commission for Social Care Inspection. The home has not received any complaints since the previous inspection visit. Discussion with all of the service users indicated that they were well aware and able to raise any complaints or concerns that they had, and knew whom they should address these to. As with the complaints procedure the adult protection procedure is also corporately developed, although in the event of an allegation being made the home would follow the Essex County Councils Guidelines for reporting allegations of abuse. Discussion with the home manager indicated that all staff have received training in adult protection, this statement was verified through the viewing of staff training records. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in an environment that is generally homely, comfortable and safe, and which is kept free from any unpleasant odours. EVIDENCE: The home is fit for its stated purpose, being homely, comfortable, safe and generally well maintained. The home is in keeping with the local community, being situated in a small private cul-de sac. The premises are equipped to met the needs of the residents in residence, with all doorways being wide enough to accommodate service users who require the use of a wheelchair to access the home. The home has an ongoing refurbishment programme. Since the last inspection the home has been redecorated throughout and service users spoke of having been consulted with over the colours. Further refurbishment is scheduled, with 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 17 new flooring due to be laid in the lounge and hallway, along with the fitting of a new emergency lighting system. The furniture and fittings in the home was domestic in nature, and were of a good quality. On the day of the inspection the home was bright and cheery, and was free from any unpleasant odours. The home’s laundry facility is situated just off the kitchen, separated by a door, with a further doorway leading directly out to the rear of the property. The laundry was equipped with domestic style washing machines and dryers, which were adequate to meet the needs of the number of service users in residence. Hand washing facilities were available. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Service users can be assured of being supported by a team of staff who are competent, well trained and well managed. However they cannot always expect to be adequately protected by the home’s recruitment policies and practice. EVIDENCE: Discussion with service users indicated that staff were accessible and approachable, and were interested and motivated, and had a good understanding of their needs. The home’s recruitment practice was sampled through the viewing of three staff records, two of the three had all of the documentary evidence required under Regulation 19, Schedule 2 of the Care Home’s Regulations. The third file sampled did not contain any evidence of a Criminal Records Bureau or POVA first (Protection of Vulnerable Adults Check) having been undertaken. These checks must be undertaken to ensure the protection of service users. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 19 Staff training files sampled indicated a good level of training, the files sampled showed that staff had received training in, adult protection, induction, manual handling, appointed persons first aid, food hygiene and infection control. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported through the ethos of a home that is well run and managed. Service users can also expect that their views will be sought, as part of the home’s quality review process. EVIDENCE: The home’s registered manager has significant previous experience of managing and working in the care sector, and holds an N.V.Q (National Vocational Qualification) level 4 in management and care. They have overall responsibility for the running of both Cook Close and its sister home in 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 21 Colchester. To support them in this work, they have two deputy managers, one in each of the two homes. The home’s quality assurance process is managed corporately, and visits are carried out annually, by representatives of the Brain Injuries Trust. Discussion with service users indicated that during these visits their views about the home are sought. In addition to these visits, monthly visits are undertaken by representatives of the Trust, in line with Regulation 26 of the Care Homes Regulations, copies of the reports from these visits are sent to the home. The home’s safe working practice was sampled through the viewing of the following safety certificates, all of which were current: Boiler safety certificate, fire certificate of inspection, hoist service report, electrical installation certificate, portable appliance test record, and gas safety certificate. 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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 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 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 3 33 X 34 2 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 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 23 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. 1. Standard YA34 Regulation 19, Schedule 2. Requirement The registered person must ensure that in respect of persons working in the home all of the documentary evidence listed under Schedule 2 of the Care Homes Regulations is maintained. This is to ensure that service users are adequately protected. Timescale for action 31/12/07 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 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 14 Cook Close DS0000017722.V353984.R01.S.doc Version 5.2 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. 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