Care Home: Rose Cottage

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What the care home does well People living in the home benefit from having an established staff team in place, some of these have known them for several years. Comprehensive support plans ensure the individual and joint needs of people living in the home can be met. The range of activities offered meets the educational, social and leisure needs of people living in the home and they are included in the daily running of the home. What has improved since the last inspection? Since the last inspection a new company has taken over the service and introduced new systems based on Person Centred Planning that will individualise the support requirements of people living in the home. What the care home could do better: The office area is open plan and compromises confidential telephone conversations and stored documents of a confidential nature as people walk through the home to other areas. It is strongly recommended that this area is reviewed and secured. CARE HOME ADULTS 18-65 Rose Cottage Church Road Mersham Ashford Kent TN25 6NT Lead Inspector Paul Stibbons Unannounced Inspection 30th November 2007 11:15 Rose Cottage DS0000023535.V352746.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 Rose Cottage DS0000023535.V352746.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. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Rose Cottage Address Church Road Mersham Ashford Kent TN25 6NT 01233 502223 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) rosecottage@counticare.co.uk Counticare Ltd Post Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th June 2006 Brief Description of the Service: Rose Cottage provides accommodation for a maximum of four people with a learning disability aged between 18 and 65. The premises consist of a spacious cottage situated in the rural village of Mersham. The local pubs and village shop are a short walk from the home. There is a public bus service to the larger towns of Ashford, Hythe and Folkestone. The home has a large secluded garden and access to country walks. The scale of charges as at 27/06/06 range between £1202.05 and £1436.95 per week, there are additional charges for Horse riding, rock climbing, trampoline sessions, ten-pin bowling and hairdressing. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Key inspection was conducted over a period of four hours and the manager of the home was present. The AQAA (Annual Quality Assurance Assessment) had been completed and returned to the Commission prior to the inspection and informs some of the findings. A tour of the building was carried out and a variety of documents and records were examined Discussion took place with two residents and four staff during the visit and two care managers and a relative were contacted following the visit. What the service does well: 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 be made available in other formats on request. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 6 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 Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 7 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): 1,2,4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People considering moving into the home have sufficient information on which to make an informed choice. People considering moving into the home know their needs will be assessed to ensure the home will meet their expectations. EVIDENCE: Service user guides viewed were available in widget format for people who would benefit from pictorial information. There have been no new admissions for over 5 years but the AQAA states that people are only admitted once a full and comprehensive assessment has been conducted and the opportunity to visit the home and stay over for a trial period. Three care plans viewed confirmed the needs of individuals had been assessed. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 8 The home’s Statement of Purpose and most recent inspection report were available for interested parties. Rose Cottage DS0000023535.V352746.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): 6,7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The assessed needs and personal goals of people living in the home are reflected in an individual plan of care. People living in the home are consulted on, and participate in, all aspects of life in the home. People living in the home are supported in developing daily living skills and to take risks as part of an independent lifestyle. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 10 EVIDENCE: The home is in the process of changing individual care plans into the new provider’s format. Three care plans viewed detailed the support requirements of individuals that included likes and dislikes, the preferred method of receiving support, risk assessments and life plans. There is evidence that care plans and risk assessments have been reviewed and updated where necessary. Records of residents’ meetings and staff meetings were seen and general feedback from residents and staff spoken with was that these meetings were beneficial in enabling discussion around activities, menus and general running of the home. The AQAA states that people living in the home are encouraged to participate in domestic chores and staff members spoken with confirmed that residents are supported in developing daily living skills. The office area is open plan and people are constantly passing through to other parts of the home, telephone conversations or discussions of a confidential nature can be heard by anyone passing through the area. This issue has been raised in previous reports by the Commission and it is recommended that the new providers review the facility. Rose Cottage DS0000023535.V352746.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): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home have access to a range of activities and are part of the local community. The rights of people living in the home are respected and responsibilities recognised in their daily lives. People living in the home enjoy a varied and balanced diet that is of their choice. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 12 EVIDENCE: The activity records of three people living in the home were viewed and daily diaries confirm that a range of activities that meet the social and leisure needs of individuals are participated in. Activities noted included the Martello day centre, special Olympics, Monday club, discos, life skills training, personal presentation, drama and numeracy and literacy. Daily records were seen showing the extent to which residents participated in any given activity and this information is evaluated to inform future activity and progress. The home’s manager states that residents are supported in accessing the local town and other community based facilities and that the staff team is flexible in work hours to accommodate activities. Care managers spoken with were in agreement that the home facilitated “loads of activities”. The residents of the home have enjoyed a holiday at Butlins holiday camp in Minehead this year. The AQAA states that all people living in the home are registered to vote in elections and would be supported in doing so if they wished. People living in the home are supported in maintaining family relationships and friendships and relatives spoken with confirm that the home has a “good staff team”, “very helpful”, always keep us informed”. The AQAA states that families are actively invited and encouraged to visit the home. Menus viewed indicated a varied and nutritiously balanced diet and residents spoken with said they enjoyed their food. Rose Cottage DS0000023535.V352746.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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical and emotional needs of people living in the home are met and they are protected by the home’s policies and procedures for dealing with medication. EVIDENCE: Three individual care plans were viewed and they were detailed in the support requirements and preferences of the individual. There is evidence that people living in the home are registered with GPs, Opticians and dentists and that they are supported in attending regular appointments. The AQAA states that people living in the home have access to other health care professionals where necessary and there is evidence of referrals within the viewed care plans, for example, Psychiatrist and Hospitals. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 14 There are no people living in the home that are able to manage their own medication and staff members take responsibility for this procedure. Medication is securely stored in a drugs cabinet and administering records viewed were legible and complete. Two training records viewed indicate that staff members responsible for dealing with medication have received training on the safe handling of medication and this is recorded in their files. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home know their views will be listened to and acted on and they are protected from abuse and neglect. EVIDENCE: The home has a clear complaints policy and procedures in place and staff spoken with were familiar with procedures for supporting people living in the home to raise any concerns. There have been no complaints received about the home by the Commission or received by the home. The AQAA states that all staff had appropriate checks carried out prior to employment and received training around safeguarding vulnerable adults. Staff members spoken with demonstrated a good understanding around adult protection issues and the home has recently raised a protection alert of possible financial irregularities by a family member. Residents spoken with appeared to be comfortable about approaching staff members with any concerns. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,28,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a safe, comfortable and homely environment with adequate personal and communal space to meet their needs. EVIDENCE: A tour of the home was conducted that indicated people live in a homely and comfortable environment. There were no obvious health and safety hazards identified during the inspection and the AQAA states that a monthly maintenance audit is carried out and any issues forwarded to the facilitations manager to address. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 17 There is a lounge area for people to relax in with television and an additional room with facilities to listen to music. It was noted that the bed used for staff sleep over is stored in the lounge and it is recommended that this be stored where it does not impinge on residents’ space. Bedrooms viewed were adequate in size to meet the individual’s needs and some had personal possessions displayed that reflected their interests and lifestyles. One bedroom that was sparsely furnished was justified through risk assessments for the individual in consultation with their family and care manager. People living in the home have access to a large kitchen area where they are supported in the preparation of meals and drinks. Relevant records were viewed in relation to food hygiene and infection control. There is a very large garden area that people living in the home can enjoy when the weather permits. The home was clean and tidy on the day of the visit but would benefit from redecoration after consultation with people living there to smarten the appearance of the home. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35,36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living in the home benefit from a stable, competent and qualified staff team who are well supported and supervised. People living in the home are protected by the home’s robust recruitment policy and practices. EVIDENCE: People living in the home benefit from having a stable staff team that have been in place for some time and have a good understanding of their individual and joint needs. The company provides comprehensive training and the training matrix viewed indicates that all induction and mandatory training has been carried out. The manager states that refresher courses are being made available to maintain Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 19 the knowledge and skills of staff. There are two members of staff with an NVQ qualification and one other due to complete the award. Staff members spoken with confirm that training attended enables them to effectively fulfil their roles. All staff members attend monthly supervision meetings and records viewed confirm the last supervisions recorded were for November 2007. Robust recruitment practices are in place for the protection of vulnerable adults evidenced by records of reference checks and CRB/POVA checks. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People benefit from living in a well run home with a competent and experienced manager in charge of day-to-day operations. The views of people living in the home, underpins all self-monitoring, review and development of the home. The health, safety and welfare of people living in the home is promoted and protected. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 21 EVIDENCE: The home manager has many years of experience of working within the care field and is currently completing an application for registration with the Commission. Members of staff spoken with, state that the manager is approachable and they can openly discuss any issues that arise in the course of their duties. Care managers spoken with after the visit state that the home manages behaviours very well and that they are kept informed of issues affecting their residents. The home uses resident meetings, care reviews, staff meetings and feedback from families and other health care professionals to ensure that the views of people living in the home underpin all self-monitoring of the service. The care director conducts monthly visits to measure the success in meeting the quality standards set for the service. Written copies of these visits were available to view in the home. The area where daily operations records and service user information is stored, is an open area. This compromises privacy of discussions and information, it is strongly recommended that this area is secured. The health, safety and welfare of people living in the home is promoted and protected as evidenced by various records and charts mentioned previously throughout the report and no obvious health and safety hazards identified during a tour of the premises. Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 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 2 3 X Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA41 Good Practice Recommendations Review the privacy and security of the office area Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local 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 Rose Cottage DS0000023535.V352746.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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