Care Home: Keeper`s Cottage

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What the care home does well Information was available to help people make an informed choice about using the service and people living in the home had visited it and been involved in decisions about moving in to ensure it was right for them. The changing health and personal care needs of people living in the home were appropriately supported in a way that enabled them to take sensible risks and they were being provided with a variety of opportunities and support to ensure their lifestyle needs were appropriately met. People living in the home were being safeguarded from abuse by staff that had received training about this and were competent to care for them and their concerns and complaints were being taken seriously. The home was very comfortable, clean and well-maintained people living in the home had an environment that safely met their needs. Appropriate management systems were in place to ensure that the health, safety and welfare of people living in the home was promoted and protected. What has improved since the last inspection? The registered providers have continued to support people living in the home to be as independent as possible and care plans were available to describe the support they needed. The manager had tried to do a further management award as was previously recommended although had been told this was impossible, due to the size of the home. What the care home could do better: Care plans belonging to people living in the home should be further developed to include their individual strengths and abilities and reflect a more holistic picture of their needs. Risk assessments of people living in the home should be further developed to reflect the capacity of the individuals to take responsibility for their actions and the support needed to help them be as independent as possible. The staff should continue to develop their skills and the systems for checking the how well the home is running should be developed to enable further plans for improvement. CARE HOME ADULTS 18-65 Keeper`s Cottage Rear Of 7 Gibraltar Lane Laceby Grimsby North East Lincs DN37 7AU Lead Inspector Rob Padwick Key Unannounced Inspection 27th February 2008 11:45 Keeper`s Cottage DS0000002924.V360282.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 Keeper`s Cottage DS0000002924.V360282.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. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Keeper`s Cottage Address Rear Of 7 Gibraltar Lane Laceby Grimsby North East Lincs DN37 7AU 01472 871017 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) thecliftons@keeperscottage.org.uk Mr Donald Ashley Clifton Mrs Andrea Gillian Clifton Mrs Andrea Gillian Clifton Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th March 2007 Brief Description of the Service: Keepers Cottage is a care home providing personal care and accommodation within a family type setting for two adults with learning disabilities. The home is owned by Mr and Mrs Clifton and Mrs Clifton is the registered manager. The accommodation is provided in a large bungalow sited in a residential area in the village of Laceby. It is close to shops and local amenities with public transport links to the nearby town of Grimsby. People living in the home have their own bedrooms and share a lounge, kitchen/dining room, conservatory and bathroom facilities. There is a large, very well maintained garden and ample parking provided. The home does not intend to admit any more people to the home in the future. A copy of previous inspection reports are available to service users and visitors to the home. The current fee for care provided in the home is £335 per week. The levels of care to be provided for this fee are detailed in the home’s statement of purpose and service user guide. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection report is based on information received by the Commission for Social Care Inspection (CSCI) since the last key inspection of the home that took place on 20th March 2007, together with other information obtained during a site visit to the home. A questionnaire asking for information about the service was sent to the home manager before the inspection visit and information from this was included as part of the inspection process. Other information used, included direct feedback from people living in the home, together with responses from questionnaires sent to their relatives and professional staff who know them well and official notifications received by the Commission for Social Care Inspection about the home. The inspection visit for this service lasted for 3.75 hours and during this period, time was spent talking with people living in the home and observing their daily lives. Other time involved inspecting the building and looking at care plans and other records and talking to staff. What the service does well: What has improved since the last inspection? Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 6 The registered providers have continued to support people living in the home to be as independent as possible and care plans were available to describe the support they needed. The manager had tried to do a further management award as was previously recommended although had been told this was impossible, due to the size of the home. 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. Keeper`s Cottage DS0000002924.V360282.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 Keeper`s Cottage DS0000002924.V360282.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 and 4 People who use this service experience good outcomes in this area. Information was available to help people make an informed choice about using the service and people living in the home had visited the service and been involved in decisions about moving in to ensure it was right for them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We spoke to people living in the home who told us they had visited the service before moving in to make sure it was right for them. The two people living in the home have lived their for a number of years and evidence was seen in their case files, of recently reviewed assessments for them, which had been carried out by Social Services to ensure the service was able to meet their needs satisfactorily. Written information was available to help people make an informed choice about the home, although the manager indicated she had decided that in the future, no further people will be admitted to the home. Keeper`s Cottage DS0000002924.V360282.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 People who use this service experience good outcomes in this area. The changing needs of people living in the home were being appropriately supported in a manner that enabled sensible risk taking that was consistent with their everyday lives. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed they were able to make decisions about their lives and feedback received from relatives was very positive about the home. One stated they “do a very good job…the boys seem very happy all of the time …I don’t think it can improve”. Informal consultation in the home was observed to be positive throughout the inspection visit and people living at Keeper’s Cottage indicated they were supported with making choices where this was needed. Daily notes documented information about what people living in the home had done and care plans documented the type of support needed and some of the goals identified for them to achieve. Whilst adequate for their purpose, it is recommended the care plans are further developed to acknowledge the strengths and abilities of people living in the home and reflect a more holistic picture of their needs, together with the support required for Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 10 promoting and achieving their wellbeing. People living in the home indicated that since moving in to Keeper’s Cottage they had been supported to be as independent as possible and take sensible risks and case files inspected indicated an approach that was consistent with their everyday lives. The risk assessments however were somewhat basic in detail and it is recommended these are further developed, to reflect the capacity of the individuals to take responsibility for the consequences of their actions and the support needed to maximise their independence in relation to these matters. Keeper`s Cottage DS0000002924.V360282.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 People who use this service experience good outcomes in this area. People living in the home were being provided with a variety of opportunities and support to ensure their lifestyle needs were appropriately met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home told us they were able to take part in range social activities and develop their life skills and evidence of this was seen in the records maintained in the home that we inspected. People said the manager had supported them to use public transport independently and confirmed they knew what to do if they needed help whilst out, in order to ensure they were safe. Case files contained evidence of support provided for people to attend colleges, social clubs and to try out opportunities for paid employment and discussion with the manager indicated following a review with Social Services, a referral had been made for help to obtain alternative forms of support to help with this. People living in the home confirmed they were able to make choices about their lives and contributed to suggestions about the home. People said they were able to go to bed when they liked and had helped decide on a recent Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 12 holiday they went on to Turkey. Evidence was seen that people living in the home were provided with a healthy diet and discussion with them confirmed they liked and enjoyed the food given to them. Feedback received from relatives was very good about the home and confirmed that the manager listened and responded positively to ideas about the service. Keeper`s Cottage DS0000002924.V360282.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 People who use this service experience good outcomes in this area. People living in the home were being appropriately supported in order to ensure that their health and personal care needs were met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home were largely independent of health and personal care and the case files inspected contained evidence of the support required to assist them with identified areas of need and encouragement to assist them to be independent. Daily notes and other records confirmed that the health needs of people living in the home were being monitored appropriately and discussion with them indicated the manager supported them to see health professionals when this needed. At the time of this site visit, neither of the people living in the home were taking prescribed medication and discussion with the manager indicated when this was required, support was provided to enable them to be as independent as possible and ensure they were safe. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 14 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 People who use this service experience good outcomes in this area. The concerns and complaints of people living in the home are taken seriously by staff who had received training to ensure they were safeguarded from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home confirmed they were both happy and knew what to do if they were not satisfied with the service they received. The home had an appropriate complaints policy to ensure the concerns of people living in the home were taken seriously and inspection of the complaints log confirmed that neither the Commission for Social Care inspection nor the home had received any complaints since the last site visit to the home. People told us they trusted the staff and felt safe living at Keeper’s Cottage and information provided by the manager indicated training about the Protection of Vulnerable Adults had been obtained to ensure people living in the home were safeguarded from harm. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 15 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 People who use this service experience good outcomes in this area. The home was very comfortable, clean and well maintained in order to provide people living in the home with an environment that safely meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was domestic in character, well maintained, and provided a comfortable, clean and homely environment. People said they were supported by staff to help keep their rooms tidy and enjoyed doing small jobs around the home and evidence for this was seen in the homes records. The bedrooms belonging to people living in the home were decorated to good standard and equipped with items of electrical equipment and their personal belongings. Evidence in the homes records indicated appropriate maintenance and servicing of equipment being carried out to ensure people living in the home were safeguarded from harm and kept safe. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 16 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 People who use this service experience good outcomes in this area. The needs of people living in the home were met by staff who were competent and appropriately trained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People living in the home indicated their needs were being met and their relatives who we contacted confirmed this was the case. The service does not employ any staff, but evidence in the homes records indicated the needs of people living in the home were being appropriately monitored and supported as needed. Although the service does not have a formalised training plan, evidence was seen that the registered providers maintained and updated their skills in a manner that was proportionate to the service, in order to ensure the needs of people living in the home are met. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 17 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 People who use this service experience good outcomes in this area. Appropriate management systems were in place to ensure the health; safety and welfare of people living in the home was promoted and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has a Certificate in Social Services, which is a formal social work qualification. The manager has over twenty years’ experience of both field and residential work, but does not possess the Registered Managers Award. Since the last inspection visit to this service evidence was seen she had endeavoured to undertake this award as previously recommended, but that this was not feasible owing to the small nature of the home. Both people living in the home and their relatives indicated the service was well run and the administrative records and procedures that were inspected were considered appropriate for the home. The management approach to the service was open Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 18 and positive and the people living in the home appeared comfortable in an atmosphere that was informal and relaxed. The registered providers do not currently operate a formal quality assurance system for measuring the performance of the service, although evidence of questionnaires previously circulated to families and other people who know the service well was seen. A recommendation is made about this. Maintenance and safety records for service that we inspected were up to date and being satisfactorily kept in order to ensure people living in the home are kept safe from harm. Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 19 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 3 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 4 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 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 Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. 1. Refer to Standard YA6YA6 Good Practice Recommendations The Registered Person should develop the care plans belonging to people living in the home to acknowledge their individual strengths and abilities and to reflect a more holistic picture of their needs, together with the support required for promoting and achieving their further wellbeing. The Registered Person should further develop risk assessments of people living in the home to reflect the capacity of the individuals to take responsibility for the consequences of their actions and the support needed to maximise their independence in relation to these matters. The Registered Providers should continue to maintain and update their skills to ensure the needs of people living in the home are met at all times. The Registered Person should re institute and develop the quality assurance systems for the home in order to formally evaluate the service and develop plans for further improvement. DS0000002924.V360282.R01.S.doc Version 5.2 Page 21 2. YA9YA9 3. 4. YA35YA35 YA39YA39 Keeper`s Cottage Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Keeper`s Cottage DS0000002924.V360282.R01.S.doc Version 5.2 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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