Care Home: Paddock Cottage

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What the care home does well Paddock Cottage provides sensitive and dignified support to resident`s who have complex needs by creating a stable and safe environment. A sample of comments made by relatives about the care their relatives receives included: "very good"; "I have every confidence in the home it is run most efficiently"; "absolutely first class" and "Happy at the moment the place is kept clean and he is well looked after" Resident`s lives are enriched by the promotion of independence, choice and being enabled to live their chosen lifestyle. A relative commented: "always seems to be doing something" Resident`s benefit by being supported to maintain relationships with their families and friends. Relatives commented: "Always made to feel welcome when I visit"; "Staff keep in regular contact with me and I can just phone up if I need to clarify anything" and "I have a wonderful working relationship with the staff"The meals are good offering both choice and variety and catering for special dietary needs. . Residents continue to live in a clean, homely environment, which has been decorated and furnished to a good standard with their bedrooms furnished and decorated according to their individual preferences. A relative commented: "environment is lovely nice gardens and close to some nice walks". Staff make a positive contribution in residents lives as residents benefit from a well trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. Comments about staff included: "Staff chop and change but this does not seem to effect him but it is quite steady at the moment" and "now more men so much better mixture of staff"; What has improved since the last inspection? There were no areas of shortfall noted at the last inspection that required improvement. The manager reported that since the previous inspection the home have obtained the services of an advocate. Further opportunities have been provided for residents to engage in meaningful activities and occupation. What the care home could do better: The homes literature needs to be reviewed to ensure that it reflects the services and facilities offered at Paddock cottage and is in a format accessible to the people for whom the home is intended. This is necessary so existing and prospective residents are aware of their rights and responsibilities while staying at the home. Care plans need to be regularly reviewed to ensure that they accurately reflect residents needs, preferences and provide the appropriate guidance for staff on how to provide consistent safe support. Bedroom and toilet doors must have appropriate locks fitted, which protects resident`s privacy and ensures their safety by being able to unlock the door from the inside and which enables residents to be able to exit independently. CARE HOME ADULTS 18-65 Paddock Cottage Rusper Road Ifield Crawley West Sussex RH11 0HL Lead Inspector Jane Jewell Unannounced Inspection 25 March 2008 11:00 th Paddock Cottage DS0000014657.V359401.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 Paddock Cottage DS0000014657.V359401.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. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Paddock Cottage Address Rusper Road Ifield Crawley West Sussex RH11 0HL 01293 611776 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) Alliance Home Care (Learning Disabilities) Ltd Ms Alison Hunter Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 persons in the registration category LD (learning disabilities) category aged 18-65, who may also have past or present mental disorder. Date of last inspection Brief Description of the Service: Paddock Cottage is a care home registered to provide accommodation and personal care for up to 6 residents between the ages of 18 and 65 years who have learning disabilities. Additional conditions of registration provide for any of those 6 residents who might also have past or present mental disorders. The home was obtained by its current owners in 2002. The home is situated on a main road in a residential area a few miles from the centre of Crawley town with local amenities and transport links nearby. The detached two-storey property provides accommodation on both floors in six single bedrooms. One bedroom has en-suite facilities. Communal rooms are on the ground floor and there is an activity room in a separate building in the grounds. The garden to the front of the home provides a driveway and parking area. There is a secure large rear garden, which is accessible to all residents. The homes literature states that it aims to ensure that at all times the rights of those using our service are placed at the forefront of our philosophy of care. The manager reported that the fees for residential care are currently £11450 to £1334 per week, depending on the services and facilities provided. Extra such as:, hairdressing, chiropody, some transport and leisure activities, toiletries are additional costs. Paddock Cottage DS0000014657.V359401.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 Two star. This means the people who use the service experience Good quality outcomes. The information contained in this report has been assembled from an unannounced inspection undertaken over five and half hours and information gathered about the home. This includes discussion with three relatives and the manager had completed an Annual Quality Assurance Assessment (AQAA) form prior to the inspection and the information contained in this document has been included in this report. The inspection was facilitated by Alison Hunter (Registered Manager) and in part by the deputy manager. The inspection involved a tour of the premises, observation, examination of records and discussion with residents and staff. There were six residents living at the home at the time of the inspection. The focus of the inspection was to look at the experiences of life at the home for people living there, this involved observing residents in their daily routines and their interactions with staff. Signs of residents well-being/ill-being (terminology used for observing behaviour for people who do not verbally communicate) were observed and are also included in this report. In order that a balanced and thorough view of the home is obtained, this inspection report should be read in conjunction with the previous inspection reports. The Inspector would like to thank the residents and staff for their assistance and hospitality during the visit. What the service does well: Paddock Cottage provides sensitive and dignified support to resident’s who have complex needs by creating a stable and safe environment. A sample of comments made by relatives about the care their relatives receives included: “very good”; “I have every confidence in the home it is run most efficiently”; “absolutely first class” and “Happy at the moment the place is kept clean and he is well looked after” Resident’s lives are enriched by the promotion of independence, choice and being enabled to live their chosen lifestyle. A relative commented: “always seems to be doing something” Resident’s benefit by being supported to maintain relationships with their families and friends. Relatives commented: “Always made to feel welcome when I visit”; “Staff keep in regular contact with me and I can just phone up if I need to clarify anything” and “I have a wonderful working relationship with the staff” Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 6 The meals are good offering both choice and variety and catering for special dietary needs. . Residents continue to live in a clean, homely environment, which has been decorated and furnished to a good standard with their bedrooms furnished and decorated according to their individual preferences. A relative commented: “environment is lovely nice gardens and close to some nice walks”. Staff make a positive contribution in residents lives as residents benefit from a well trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. Comments about staff included: “Staff chop and change but this does not seem to effect him but it is quite steady at the moment” and “now more men so much better mixture of staff”; 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. The summary of this inspection report can Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 8 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 Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 9 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): 1 2 3 and 4 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Prospective residents would be provided with information about the home although adjustments are needed to the homes information to make it more specific and accessible. The home is able to identify and meet the needs of the people currently living at the home. The way in which prospective residents would be assessed ensures that the home admits only those residents who’s needs can be met by living at the home. EVIDENCE: There is some information about the home and the services it provides which can be used to inform prospective residents and their representatives about the home. This includes a statement of purpose and service user guide, however this information needs to be made more relevant and specific to Paddock Cottage. This is to ensure that it accurately reflects the range of services and facilities the home offers. It is recommended that the service users guide also be developed in a format more suitable for the people for whom the home provides a service to. This is necessary to aid residents understanding of their rights and responsibility’s while residing at the home. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 10 There have not been any new admissions to the home since 2000, therefore, this standard was assessed in respect of the admission procedure for any future prospective residents. The manager was aware of the admission criteria for the home and knowledgeable about admissions practices that would ensure a comprehensive range of information is gathered about prospective residents. This would then inform their decision whether a prospective residents needs could be met at the home. There are also policies to ensure an effective preadmissions process and moving in arrangements. Residents at the home are assessed as having complex needs including some who have additional mental health and challenging behaviour needs. The age of residents ranges from 28 to 56 years. Through observation, looking at records and speaking to relatives, evidence was gathered that the home is meeting the needs of residents. All persons consulted regarding the home spoke positively about their experiences with the home. A sample of their comments include: “very good”; “very good at keeping in touch with me”; “I have every confidence in the home it is run most efficiently”; “absolutely first class” and “Happy at the moment the place is kept clean and he is well looked after” The manager stated that any prospective residents would be provided with the opportunity to visit the home in advance to assess the quality, facilities and suitability of the home with their family and representative. The length and type of any visit would depend on the individual’s needs and preferences. The first six weeks of residency is looked upon as a trial occupancy. Permanent residency is subject to a full review of care needs with the residents their representatives and care manager. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 11 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 8 9 and 10 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Care plans seen provided some framework for the delivery of care, however further work is needed to ensure that care plans are regularly being reviewed to ensure any changes in residents needs are promptly identified. The homes practices promote choice for residents. The home balances well the rights to residents to take reasonable risks as part of an independent lifestyle. EVIDENCE: Four individual plans of care were examined and these showed that staff had some guidance on the needs and preferences of residents. Good care practices were noted that the care plans focused on the strengths of an individual rather than what individuals could not do. All residents had a communication book with evidence seen of them being updated. Staff consulted with showed a good understanding of the personal preferences and routines of residents. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 12 There were some shortfalls noted in the care planning process, which related to the lack of a consistent reviewing process. This is necessary to ensure that any changes in residents needs are promptly identified and the appropriate guidance provided for staff. The main areas of shortfall were: • Behavioural management guidance did not reflect the practices being used. In order to ensure consistency in staffs approach it is necessary for these to be reviewed to ensure that they accurately reflect best care practices for individuals. • There was no evidence that residents individual goals and aims were being regularly reviewed or the targets leading to their attainment identified, this is necessary in order to promote residents personal development. Daily notes are recorded on each resident, which recorded the actions and events that have occurred. These were written in a respectful and none judgmental style. To promote good practices it was discussed that daily records should also be based on resident’s individual aims and objectives in order to be able to easily assess when gaols are being worked towards and achieved. The manager reported that the organisation was just in the process of implementing new care planning documentation, which they were hopeful, may address some of the areas of shortfall noted at this inspection. The home has a developed system in place for enabling residents to take responsible risks as part of an independent lifestyle. For example the main risks faced and posed by residents are assessed and any measures to reduce or manage the risk is recorded in order for staff to follow. Overall it was clear that the home respects and promotes resident’s rights to make decisions about their daily lives. Senior management were familiar with the principals of the mental capacity act, which helped to ensure that resident’s rights to make decisions about their lives was promoted. Staff were observed using a variety of communication tools to provide appropriate choices regarding food, drink, activities and personal care. A staff member said that they often have to make choices on behalf of residents based on their knowledge of residents’ likes and dislikes. An example was noted whereby restrictions place on a resident’s freedom of movement as part of a behavioural management strategy must be reviewed to ensure that it is in the best interest of the resident. Residents participate in the day to day running of the home in accordance with the range of their individual preferences and strengths. The home is proactive in involving residents in as much of planning their day as possible. One resident was observed helping to make their lunch. Other residents are involved in light domestic duties and making light snacks. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 13 Staff demonstrated an awareness of good practices about confidentiality, ensuring that sensitive information is kept secure and knowledgeable about the circumstances under which information must be shared with management and others. Staff are also aware that residents have the right to ask that some information not be shared with family or others. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 14 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 14 15 16 and 17 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s lives are enriched by the promotion of independence, choice and being enabled to live their chosen lifestyle. Resident’s benefit by being supported to maintain relationships with their families and friends. The meals are good offering both choice and variety and catering for special dietary needs. EVIDENCE: Each resident has a daily activities plan, which has been developed based on their individual preferences and needs. These plans showed that residents access a wide range of meaningful activities including college courses and leisure pursuits. A relative commented: “always seems to be doing something” Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 15 Records and discussions highlighted that residents attend local day centres collages, evening social clubs, horse riding, swimming, meals out, shopping, local walks, trampoline and cinema visits. A music and art group were particularly popular with residents. A staff member spoke about how they created opportunities for residents to try different activities based on their acquired knowledge of them, in order that they are able to experience different activities. Relatives commented upon how welcomed they are made to feel when they visit, this included being offered beverages or meals and staff being friendly and approachable. One relative said how helpful staff were in enabling their relative to continue to visit their home at the weekend. A sample of comments made by relatives include: “Always made to feel welcome when I visit”; “Staff keep in regular contact with me and I can just phone up if I need to clarify anything” and “I have a wonderful working relationship with the staff” On the day of the inspection, it was observed that the routines of the home were reflective of individual needs and their lifestyle. Residents were able to move around the communal space, choosing which rooms to be in and what level of company they wanted to enjoy. Staff spoke of the flexibility in daily routines regarding meal times, going to bed, rising and bathing, but acknowledged the importance for some residents of fixed routines. Much use is made of the local community including local shops, transport and pubs. The home also has its own transport, which enables them to access wider leisure facilities. The manager reported that all residents have had an individual holiday or days out, with a staff member saying that holidays are always good fun. Residents are able to help plan menus, shop for food and in some cases help prepare meals and snacks. Staff were observed eating along with residents promoting a social atmosphere. Menus showed that a varied and balanced diet is provided which includes fresh produce. Mealtimes and arrangements for eating are tailored to meet individual residents needs and what events and activities are occurring that day. Specialist diets are catered for, including weight reduction. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 16 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 the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from personal and health care support that is individual, respects their privacy and dignity. The medication systems are well managed promoting good health. EVIDENCE: Staff were observed providing sensitive care to residents which helped to maximise privacy and dignity. Staff were knowledgeable about the personal care needs of residents and were sensitive to how this should be provided to respect residents rights and dignity. Residents were very affectionate towards staff and clearly derived comfort from staff reciprocating their affection. The manager was aware that residents enjoyed being tactile with staff, in order to protect both residents and staff the manager agreed that written guidelines need to be development to ensure staff are clear on the individual boundaries for each resident. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 17 Staff support residents to follow their individual health plans, these also contained a record of any visits or contact with health care professionals. There was evidence of current involvement from General Practitioners, behaviour management team, Psychiatrist, dentists, opticians, and Language Therapist. It was clear that where there are concerns regarding the health or welfare of resident’s medical advice and intervention is sough promptly. The system for the administration of medication are good with clear and comprehensive arrangements being in place to ensure residents medication needs are safely met. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 18 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 the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. An effective complaints procedure and practices at the home protects the rights and interests of residents. EVIDENCE: There is a complaints procedure in place for residents, their representative and staff to follow should they be unhappy with any aspects of the service. Although it is recognised by staff that residents would require much support to make a complaint and were knowledgeable on how they would support a resident to do this. No complaints have been received or recorded by the home since the last inspection. All relatives consulted with said that they were aware of how to raise any concerns and felt comfortable to do so and that where they have raised minor concerns in the past these have been addressed promptly. The manager felt confident that residents also had opportunities to raise any concerns they had about the home to external parties, through day centres colleges and advocates that attend residents meetings. There are written policies covering adult protection, which identifies different types of abuse, possible indicators of abuse and how to report suspected abuse. However it did not accurately reflect who to report various types of suspected abuse to. The manager agreed to amend this document immediately. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 19 Staff have received formal training in safeguarding adults and prevention of abuse and the staff consulted with showed a good understanding of their roles and responsibilities under safeguarding adults guidelines. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 20 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 26 27 28 29 and 30 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents continue to live in a clean, homely environment, which has been decorated and furnished to a good standard with their bedrooms furnished and decorated according to their individual lifestyles. EVIDENCE: Paddock Cottage is a detached house situated in a residential area on the outskirts of Crawley. The manager stated that parts of the home are due to be redecorated soon with the hallway having recently been redecorated. Evidence was seen that any maintenance issues are promptly attended to, with all reasonable steps taken to maintain a safe home. Communal space consists of a kitchen / dining room, lounge and a summer house. Much effort is made to create a homely feel to the home whilst ensuring that furnishing and fittings are appropriate for the needs of the group of residents currently living at the home. A sample of comments made about the Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 21 environment included: “environment quite good”; “environment is lovely nice gardens and close to some nice walks” and “first class environment”. There is a large secure rear garden, which has equipment and areas of interest for residents to enjoy. Resident’s bedrooms are individualised reflecting their tastes and lifestyles. Some bedroom doors and a communal toilet door are fitted with barrels locks the type that is lockable from the outside only and cannot be opened from the inside once locked. The manager offered assurances that these have never been used inappropriately and agreed to ensure that suitable locks are fitted as soon as possible. The home has been required to ensure that doors have appropriate locks fitted, which protects resident’s privacy and ensures their safety by being able to unlock the door from the inside and leave independently. There are sufficient number of toilets and bathrooms located around the home including one bedroom providing en-suite facilities. The home is not designed to offer a service to people with physical disabilities and the stairs and other access arrangements would make it unsuitable for residents with significantly restricted mobility. Generally residents do not currently need any specialist equipment to help with mobility or independence around the home. All areas inspected were observed to be cleaned to a good standard, a relative commented “spotlessly clean” Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 22 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): 31 32 33 34 35 and 36 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff make a positive contribution in residents lives as residents benefit from a well trained and enthusiastic staff team that know them and who are safely recruited and employed in sufficient numbers as is necessary to meet their needs. EVIDENCE: Staff and relatives felt that there was always sufficient numbers of staff on duty for staff to undertake their roles in a timely manner and for residents to receive the support they needed, when they wanted it. Staff spoke positively about their experiences at the home and of their enjoyment describing their job as: “its good fun”. It was observed through the inspection that staff understood their roles and had a good rapport with residents and planning skills. The tasks of the day appeared well-organised and individual staff appeared confident in carrying them out. This helped ensure that residents knew who would be supporting them. Staff consulted with had a clear understanding of the aims of the home and how their individual role contributed towards achieving this. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 23 The manager reported that there has been little staff turnover helping to promote continuity in the support that residents receive. Staff on duty at the time of the inspection had known the residents for some years and demonstrated a good understanding of their needs and preferences. A sample of comments received about staff included: “Staff chop and change but this does not seem to effect him but it is quite steady at the moment” and “now more men so much better mixture of staff”; The home has been proactive in ensuring that the majority of staff receive a National Vocational Qualification (NVQ ) in Care or are in the process of working towards it. The personal files of newly appointed staff were inspected and these showed that a good recruitment process is followed which includes the use of an application form, interviews, Criminal Records Bureau (CRB) checks and written references prior to employment commencing. There is a commitment to improving staff skills through an ongoing training programme both in practical matters and the broader aspects of working with people who have learning disabilities. A staff member said: “we are all well trained here”. A training and development plan is available which identifies the training undertaken and planned for in order for the home to meets its aims and objectives and residents needs. Although there is a homes policy that staff receive regular formal supervision the manager acknowledged that currently this is inconsistent, instead staff have been receiving informal supervision through the manager working directly along side staff. The manager was aware of the need to re-instigate a formal programme of supervision in order to monitor that keyworkers are undertaking their roles and responsibilities. This is with particular reference to keyworkers reviewing care plans. All staff consulted said that they felt well supported by the manager to undertake their roles and felt able to approach them for advice and guidance. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 24 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 38 39 42 and 43 People who use the service experience good, quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from a well-motivated and knowledgably manager who promotes good care practices. The home regularly reviews aspects of its performance through a good program of self-review and feedback. A range of regular health and safety checks helps to promote the health and safety of residents and staff. EVIDENCE: The manager has worked at the home for a number of years and became the registered manager in 2000. They have many years experience in working and managing services for people who have a learning disability. They hold the Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 25 recommended management qualifications and have undertaken ongoing training to keep updated in best care practice issues and changes in legislation. Relatives and staff spoke positively about the manager with particular reference to her approachability and knowledge of residents. A sample of comments made about the manager included: “very efficient I can talk to her about anything”; “very approachable”; “knows how to run a home” and “ok”. The relationship between residents, staff and the manager was observed to be friendly and informal and the general atmosphere of the home was relaxed and open. The manager demonstrated a good understanding of the running of a care home and their roles and responsibilities. There are clear lines of accountability between the home and the provider. A representative of the provider visits at least monthly to undertake the required monthly-recorded visit to the home. There are several mechanisms in place for the manager to obtain feedback on the services of the home and whether it is achieving its aims and objectives. These include: annual placement reviews, Regular quality audits of the homes procedures, residents and staff meetings and written feedback from relatives. Examples were noted whereby improvements to working practices and the environment have been made based on this feedback. Written guidance is available on issues related to health and safety. Records submitted by the manager prior to the inspection stated that all of the necessary servicing and testing of health and safety equipment has been undertaken. Systems are in place to support fire safety, which include: regular fire alarms and emergency lighting checks, staff training and maintenance of fire equipment and fire drills were reported to have been undertaken. The manager reported that a fire risk assessment has been completed by a fire safety expert. This records significant findings and the actions taken to ensure adequate fire safety precautions in the home. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 26 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 2 2 3 3 3 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 3 25 x 26 2 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 3 Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 27 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 YA1 Regulation 4(1)(c) & Schedule 1 Requirement That the Statement of Purpose is reviewed to reflect the services and facilities available within the home and includes all areas listed in the National Minimum Standards. That each service user has a plan of care which accurately records their health, personal and social care needs and the actions needed to meet these needs, which is reviewed regularly to reflect any changes in needs and preferences. That bedroom doors have appropriate locks fitted which protects service users privacy and ensures their safety by being able to unlock the door from the inside and leave their bedrooms independently. Timescale for action 30/05/08 2 YA6 15(2)(b) 30/05/08 3 YA26 12(4)(a) & 13(4)(c) 30/04/08 Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 28 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 YA1 Good Practice Recommendations That the Service Users Guide be presented in a format suitable for the people for whom the home provides a service to, for them to be able to informed of the services and facilities at the home along with their roles and responsibilities while residing at the home. Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Paddock Cottage DS0000014657.V359401.R01.S.doc Version 5.2 Page 30 - 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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