Care Home: Darley Cottage

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What the care home does well The expert by experience said, `I liked where the house was. There was a lot of traffic but it seemed to be near lots of shops where I thought it would be nice to look around. The lady in charge showed me a book they had made with coloured pictures of all the dinners they could choose from. I liked this and thought it was brilliant. I really liked this house and all the people in it`. MacIntyre Care, the organisation that runs the home, has developed an assessment procedure to be used with people who are interested in moving into the home. This is to make sure that the person`s needs are accurately identified so they and staff at the home can decide whether those needs can be met at the home. People who may wish to live in the home are able to visit and spend time getting to know the people who live there and the staff. This helps them to decide whether they want to live there. Each person who lives in the home has a person centred plan that sets out their care needs and how these are to be met. The people who live in the home are involved in drawing up their own person centred plans and are consulted on any changes that are made to the plans. They confirmed to us they knew about their care plans and who their key worker was so they knew they could be involved in drawing up their own care plans. People living in the home are supported to keep in regular contact with their family and friends. This can be by visits, phone or letters. Staff are aware of the importance of respecting the people who live in the home, maintaining their privacy and dignity. The care plans we saw during our visit showed that the way people wished to be cared for, with regard to personal and healthcare, was recorded and reviewed as required so people receive the care they need in the way they prefer. There are procedures in place for the people who live in the home and others to make complaints or raise concerns about the way the home is run; these procedures help to make sure that concerns raised are taken seriously and acted upon. The home is well maintained and decorated so it provides a safe and secure environment for the people who live there. The manager and staff are committed to ensuring the people living in the home are supported to be as independent as possible, to help them live as ordinary a life as possible. What has improved since the last inspection? Since our last visit to the home, a programme of decorating and other maintenance has been carried out. New windows have been installed, a driveway to the rear of the home has been re-surfaced and a number of bedrooms and communal areas have been re-decorated to make sure people continue to live in comfortable surroundings.Improvements to the way person centred plans are drawn up has meant more involvement and consultation with the people living in the home so they can say how they would prefer their support to be provided. People who live in the home are actively involved in staff recruitment, including interviewing prospective staff members, so they can have a say in who provides their care and support. All the people living in the home had full health checks in the last year to make sure all their health care needs were being met. What the care home could do better: People`s choice on what time they wish to go to bed should be included in their person centred plans so staff know when this should be and can help people in the way they prefer. The complaints procedure should be regularly discussed at the house meetings for the people who live there to make sure they know about what is being done with any concerns and complaints they may have. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Darley Cottage 6 Hoole Road Chester Cheshire CH2 3NH     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Val Flannery     Date: 0 5 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Darley Cottage 6 Hoole Road Chester Cheshire CH2 3NH 01244350128 Telephone number: Fax number: Email address: Provider web address: Sandra.earlam@macintyrecharity.org Name of registered provider(s): Name of registered manager (if applicable) Mrs Sandra Earlam Type of registration: Number of places registered: MacIntyre Care care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The registered person may provide the following category/ies of service only: Care home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 Date of last inspection Brief description of the care home Darley Cottage is a care home for six adults with a learning disability. Located in a residential area in Chester the home is close to shops, pubs and other local facilities. It is also on the bus route to the city centre. Access between the ground and first floors of the two-storey building is via the stairway. Five of the single bedrooms are in the main part of the home; a separate self-contained flat is located on the ground floor. One large lounge and a lounge/dining area are located on the ground floor. One communal bathroom/shower/toilet is provided, as is a separate toilet. Two of the bedrooms have en-suite facilities. Staff are on duty twenty-four hours a day to support the people living in the home. Care Homes for Adults (18-65 years) Page 4 of 28 6 Over 65 0 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The overall quality rating for this service is 2 stars. This means that the people who use the service experience good quality outcomes. This visit took place on the 5 November 2008 and took four hours. It was carried out by one inspector. An expert by experience also visited the home as part of the key inspection. An expert by experience is a person who, because of their shared experience of using services and/or ways of communicating, visits a service with the inspector to help get a picture of what it is like to live in or use the service. The expert by experience who came on this visit has been appointed by the Quality Company, under the direction of the Commission for Social Care Inspection, to take part in the inspection of services for people with a learning disability. Care Homes for Adults (18-65 years) Page 6 of 28 During the visit we spoke with the people living in the home, the manager and staff. We looked around the premises, joined people for a drink and the inspector looked at various records held by the home. The visit was just one part of the inspection. Before the visit the home manager was asked to complete a questionnaire to provide up to date information about the home. CSCI questionnaires were made available to people living in the home and staff so they could tell us what they think of the home. There were six people living in the home on the day of the inspection. The last inspection of this service was completed on the 17 November 2006. What the care home does well: What has improved since the last inspection? Since our last visit to the home, a programme of decorating and other maintenance has been carried out. New windows have been installed, a driveway to the rear of the home has been re-surfaced and a number of bedrooms and communal areas have been re-decorated to make sure people continue to live in comfortable surroundings. Care Homes for Adults (18-65 years) Page 8 of 28 Improvements to the way person centred plans are drawn up has meant more involvement and consultation with the people living in the home so they can say how they would prefer their support to be provided. People who live in the home are actively involved in staff recruitment, including interviewing prospective staff members, so they can have a say in who provides their care and support. All the people living in the home had full health checks in the last year to make sure all their health care needs were being met. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments of peoples needs are carried out before they move to the home and they can visit before moving in so they can decide whether the home would be suitable for them. Evidence: We looked at the records of the person who had most recently moved into the home, to see how this had been managed. We also spoke with the person during our visit. The records showed that the manager of the home had visited the person to assess their care needs. The persons family were involved in this process and in helping the person to visit the home to see what it was like before deciding if they wanted to move there. The information the manager had gathered covered personal and family details, health and personal care information, daily routines and weekly activity schedule, likes and dislikes. The records showed the person had visited the home on six times, including an overnight stay, between the date of the assessment and moving into the home. Care Homes for Adults (18-65 years) Page 11 of 28 Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in the home are fully involved in planning how they wish to be supported with their daily lives so they are enabled to make decisions and choices and be as independent as possible. Evidence: We saw a copy of a person centred plan for one person who lives at the home. Information contained in the plan showed how the person wished to live their life, the level of support he needed with daily living and how that support was to be offered. Risk assessments were seen to show how the specific care needs of the person were to be met so as to ensure their safety and well being. We also saw a record of a meeting held with the person and their family during which their care plans were reviewed. The expert by experience asked people who live in the home if they had been supported to make a personal care plan. They all said they had and knew what their plan was about. One person who lives at the home said, I can do most things I like because I tell (my worker) and we put it in so I can do it. Everybody the expert by experience Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: spoke with know who their key worker was. The expert by experience commented, I think they all liked their key worker. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live at the home receive the support they need for their chosen daily activities and their family and friends are able to visit the home so people who live at the home are able to maintain contact with those who are important to them. Evidence: We looked at the person centred plans of one person who lives at the home. These showed the person was consulted about their weekly activities and the level of support they need to maintain their chosen activities in the community such as attendance at day centres, work placement, using local shops and other community facilities. The daily routines for the people who live in the home are dependent on their planned activities - either in the community, in the home or if they have medical appointments. On the day of our visit, one person had helped in the home during the day with Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: housekeeping and shopping. Three people we spoke with said they are in regular contact with their families and friends. Their families visit them or they can go to visit their families. The care records we saw showed their family members are in regular contact, either by visiting or by telephone. People who live at the home told expert by experience of some of the things they liked doing, including going to a day centre, making crafts and card, playing games and work placements. The expert by experience said that they all seemed happy with the things they did and that they did a lot of nice things. One person told the expert by experience that they used to be able to eat in their bedrooms sometimes but that that has now been stopped. Another said We have to go to bed at ten. These issues were discussed with the manager who said that people can eat in their bedrooms if they prefer and that they do not have to go to bed at ten. She said she will arrange a meeting with the people who live in the home and make sure they are aware of this. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff are aware of the healthcare needs of the people who live in the home and how these are to be met so they are able to ensure advice and treatment is provided to keep people well and healthy. Evidence: The person centred plans we saw of one of the people who lives at the home included details on how the person wished to be supported with personal care by staff . The level of support needed with tasks such as dressing, using the bathroom and eating had been identified during the assessment that was done before the person moved into Darley Cottage. Also included were details on the persons healthcare needs and how these were to be met. The records showed this person had been supported to attend out patient and GP appointments. Because of the persons individual healthcare needs, staff had sought advice and guidance on how best to ensure the safety and well being of the person. Staff were seen helping two people as they prepared for a trip out to a firework and bonfire display. This help was offered in a sensitive and caring manner. Three people Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: who live in the home we spoke with during our visit told us they were able to do most things for themselves but that staff were always there if they needed them. One person said they go to hospital with staff. We saw staff talking with, and listening to, the people who live in the home and responding with sensitivity and good humour to requests for help or information. We checked medication records during our visit and found that these are kept satisfactorily to show that people who live in the home receive their medicines as prescribed. One person who lives at the home told us they look after their own medication, which they keep in a locked drawer in their bedroom. MacIntyre Care has policies and procedures on the administration of medication and a copy is kept in the home for staff to refer to so they have the guidance they need to make sure the medicines are managed safely. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Procedures are in place to ensure the safety and well being of the people who live in the home so staff know what to do to make sure people who live in the home are protected from abuse and their concerns are listened to. Evidence: The record of complaints we saw showed that any complaints or issues raised by the people who live in the home are recorded. According to the manager, the home has not received any complaints for some time. A copy of the complaints procedure is on display in the home, together with details on how to contact the Commission for Social Care Inspection. The expert by experience spoke with the people who live in the home about making complaints. Nobody wanted to make a complaint but two were not sure how to do this. The manager said they have not made any referrals under the safeguarding adults procedures although they have reported concerns to social services about one of the people who had lived in the home. The issues raised were as a result of the changing care needs of this person and action was taken by social service to address the persons needs. MacIntyre Care has policies and procedures on safeguarding vulnerable people, including No Secrets, a copy of which is kept in the home. Four of the six care staff Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: have received up to date training on safeguarding adults; the remaining two staff are due to receive up dated training by the end of November 2008. This helps to make sure that all staff know what to do to protect the people who live in the home from abuse. Care Homes for Adults (18-65 years) Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well maintained and people have chosen the decor in their own rooms so they live in comfortable surroundings that suit their needs and tastes. Evidence: The home is on a main road into Chester, close to shops, pubs and other community facilities. On the day of our visit, the home was clean, tidy, well-maintained and free from bad odours. The furnishings, fittings and other equipment are of good quality throughout the home. The expert by experience asked people who live at the home if they like their their bedrooms. They all said they did. The expert by experience was invited to see their bedrooms and looked at four. People told him they had helped to choose the decor for their bedrooms and they had all used things like posters, pictures and other possessions to make their rooms more personal and homely. They all have keys to their rooms so they can keep them private, and we saw people using their keys to open and lock their rooms during the time we were in the home. One person who receives support in the home has a self contained flat so they can live as independently as they choose. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are thorough checks done to make sure new staff are suitable to work with the people who live at the home and staff receive training and support so that they can provide good quality support for the people who live at Darley Cottage. Evidence: During our visit, we saw staff talking with and supporting the people who live in the home. The people who live there were comfortable in the company of staff and were seen asking staff for help with preparing drinks and talking about the days activities. The rotas showed that there is at least one member of staff on duty and usually two in the mornings and afternoon/evenings. One member of staff sleeps in the home during the night. The information the manager had sent us before our visit showed that all staff have an NVQ or equivalent in care. The information also confirmed that all staff have received mandatory training, that they are awarded certificates on completion and that training is up to date. People who live at the home told the expert by experience that staff help them to choose new things to do and they knew who their key worker was. MacIntyre Care has policies and procedures in place that ensure staff recruited to work Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: in the home have all the required checks before they start work there and that they have the qualities necessary to care for the people who live there. People who live at the home also take part in recruiting new staff members so they can have a say in who will be providing support for them. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run by an experienced and competent person so ensuring the health, safety and well being of the people who live there is maintained. Evidence: The manager for the home has worked for the MacIntrye Care for a number of years in a senior capacity. She has completed the Registered Managers Award, NVQ Level 3 and 4 and has attended training courses in order to update her knowledge on managing the home. During our visit, the people who live at the home and the staff were all positive about the management of the home and said the manager will listen to their worries and concerns and do something about them. Questionnaires on the quality of the service offered are given to the people who live in the home and their relatives. We saw a sample of the completed questionnaires during our visit and these showed an overall satisfaction with the service provided at Darley Cottage. Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: House meetings are also held where people can raise any worries or concerns they have about the way the home is running. The people who live in the home said they can always talk to the staff who will sort out any problems. The environmental health officer from the local council has recently given the home an excellent report following an inspection. This covered all aspects of health and safety in the home. MacIntyre Care has comprehensive policies and procedures on maintaining the health and safety of the people who live in the home, the staff team and other visitors to the home. A copy of these are kept in the home so staff can have easy access to guidance on health and safety matters to make sure that the people who live at the home are safe. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 16 People who live in the home should be made aware of whether they can eat meals in their bedrooms and the times for going to bed. The complaints procedure should be discussed with the people who live in the home at all house meetings so they are reminded about how to raise any concerns they may have. 2 22 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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