Care Home: Stone Cottage

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What the care home does well People get the chance to visit the home before they decide to move in. The home makes sure it is the right place for them before they move in.There are good plans so that staff know what people need and how to support them. People can make choices about what they want to do each day.There is good support for people to join in activities in the local community. They also have the chance to try new things and improved on what they know.The home helps people to stay healthy.People`s complaints would be taken seriously. Staff know how to keep people safe and protect them.Staff are properly recruited, trained and supported to do their work. They know what help each person needs.The managers make sure the home is run for the benefit of people who live there.. What has improved since the last inspection? There was nothing the home had to get right from our last inspection. We made no requirements orrecommendations. What the care home could do better: We made no requirements or recommendations. Key inspection report Care homes for adults (18-65 years) Name: Address: Stone Cottage Meeth Okehampton Devon EX20 3EP The quality rating for this care home is: three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Anita Sutcliffe Date: 0 9 1 2 2 0 0 9 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should:  Be safe  Have the right outcomes, including clinical outcomes  Be a good experience for the people that use it  Help prevent illness, and promote healthy, independent living  Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home:  3 stars – excellent  2 stars – good  1 star – adequate  0 star – poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Care Homes for Adults (18-65 years) Page 2 of 31 Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by:  Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice  Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983  Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services.  Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 31 Information about the care home Name of care home: Address: Stone Cottage Meeth Okehampton Devon EX20 3EP 01805804683 01805804693 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Atlas Project Team Ltd care home 3 Number of places (if applicable): Under 65 Over 65 3 0 learning disability Additional conditions: The maximum number of service users who can be accommodated is 3. The registered person may provide the following category of service only: Care home only - Code PC to service users of either gender whose primary care needs on admission to the home are within the following category: Learning disability (Code LD) Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 31 A bit about the care home Stone Cottage is a care home for up to three people, aged 18 to 65, with learning disabilities. They have behaviours which may be a challenge to them and others. The home is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. It is situated in a rural setting on the edge of the village of Meeth, with views across Dartmoor. Care Homes for Adults (18-65 years) Page 5 of 31 Nobody shares a bedroom but no people at the home have their own bathroom. There are separate lounge and dining rooms, at the home as well as a conservatory. It is reasonably close to shops, pubs, and other amenities in local villages and towns, but transport is required. The home has a large garden, mainly grassed and with parking facilities at the front of the house. All areas are accessible to people who use the service. Current fees are: £1,817 to £3,054 People have to pay extra Care Homes for Adults (18-65 years) Page 6 of 31 for some personal items. Care Homes for Adults (18-65 years) Page 7 of 31 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and health care support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 8 of 31 How we did our inspection: This is what the inspector did when they were at the care home. We looked at our records about Stone Cottage before we visited. We checked if there had been any complaints and information the home had sent us called notifications. While we were there we looked around to check if the home was a safe and comfortable for people. One persons care plan told us what people needed. We spoke with staff and looked at what Care Homes for Adults (18-65 years) Page 9 of 31 was going on to check if people were getting the right support. We spoke with managers and we looked at records to check whether the home was run for peoples benefit. What the care home does well People get the chance to visit the home before they decide to move in. The home makes sure it is the right place for them before they move in. Care Homes for Adults (18-65 years) Page 10 of 31 There are good plans so that staff know what people need and how to support them. People can make choices about what they want to do each day. There is good support for people to join in activities in the local community. They also have the chance to try new things and improved on what they know. The home helps people to stay healthy. Care Homes for Adults (18-65 years) Page 11 of 31 Peoples complaints would be taken seriously. Staff know how to keep people safe and protect them. Staff are properly recruited, trained and supported to do their work. They know what help each person needs. The managers make sure the home is run for the benefit of people who live there.. What has got better from the last inspection There was nothing the home had to get right from our last inspection. We made no requirements or Care Homes for Adults (18-65 years) Page 12 of 31 recommendations. What the care home could do better If you want to read the full report of our inspection please ask the person in charge of the care home. If you want to speak to the inspector please contact: Anita Sutcliffe Colston 33 33 Colston Avenue Bristol Avon BS1 4UA 01179307110 Care Homes for Adults (18-65 years) Page 13 of 31 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line - 0870 240 7535. Care Homes for Adults (18-65 years) Page 14 of 31 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and health care support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 15 of 31 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People thinking of moving into the home can be assured that their care needs will be assessed and can be met. Evidence: There has been one admission to the home since the previous key inspection. We discussed how the organisation ensures that peoples best interests are considered when moving to the home. The manager and organisation representatives make a full and detailed assessment of a person so they can be sure Stone Cottage can meet their needs. The person last admitted to Stone Cottage was able to visit the home and every effort was made to ensure the move was a positive one. Staff had a good knowledge of how to care for him and he appeared to be well settled and at home. Care Homes for Adults (18-65 years) Page 16 of 31 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are listened to, their needs understood, challenges well managed and they are supported to meet their potential. Evidence: Care plans should describe in detail how staff are to assist and support the person to lead the life they choose. The plan should include detail of any restrictions, assessment of risk and how risk should be managed in a way that restricts the person as little as possible. The people who live at Stone Cottage have behaviours that can be a challenge to themselves and others and are a safety risk. Each of the three people living at Stone Cottage were met. We were told that there is a meeting each morning to discuss what they will do that day. Staff throw ideas in which helps provide more opportunity, but people are fully involved. The day we visited each person spent time out of the home, one swimming, another went to Barnstaple. We spoke to the acting manager, her deputy and one support worker about peoples Care Homes for Adults (18-65 years) Page 17 of 31 Evidence: needs and they could describe those needs in detail. Where peoples needs are such that restrictions on choice or liberty are imposed this is very well documented and the person is aware of the reasons. Risk is very well considered and managed, and detailed records are kept. Advice is appropriately sought from experts outside the organisation, such as care managers and health care professionals, as necessary. Staff understand how to reduce behaviour that adversely affects a persons life, enhance positive behaviours that enrich their lives and teach new skills. Care Homes for Adults (18-65 years) Page 18 of 31 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have the opportunity to benefit from a quality lifestyle and fulfilled life within their capabilities and with regard to their well-being. Evidence: Although the home is rural there are frequent trips to local amenities. We were told by one about playing tennis and swimming. Where a person benefits from individually tailored activities this is arranged. Choices for the day are discussed each morning and where an interest is expressed this has been followed up. People help with the household chores if they are able. One person was washing the kitchen floor when we arrived. Special social events are shared with other Atlas homes. People also have a holiday each year. The home goes to great lengths to help maintain positive family connections for people. Care Homes for Adults (18-65 years) Page 19 of 31 Evidence: This can include staff taking them long distances to visit. People are able to influence the menu and we were told food is enjoyed. Planning, buying and preparing food is a shared activity at the home. There is unrestricted access to the kitchen although there are safety measures in place to reduce the risks, which could be substantial. We saw people enjoying chocolate biscuits mid morning. Care Homes for Adults (18-65 years) Page 20 of 31 Personal and health care support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and health care needs are understood and met. Medication is handled diligently, with strict controls in place to ensure peoples well being. Evidence: People at Stone Cottage rely completely on staff support to ensure their health care needs are met. They are supported to make choices. Emotional health needs are well managed through detailed care planning and support management. Each person is registered with a G.P. in Torrington. They have a yearly health check and regular hearing and eye checks. We saw that arrangements were being made to follow up some health concerns. Staff say that no person has the ability to safely handle their medicines, so this is done for them. Medicines are securely stored; records clearly kept. Staff work within the organisations very strict guidelines and practice when handling medicines and no as necessary medicine can be given without authority for a senior member of the organisation. Care Homes for Adults (18-65 years) Page 21 of 31 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that complaints would be taken seriously and dealt with properly. They are protected from abuse through strong leadership and the culture of the organisation. Evidence: People who use the service would be unlikely to use a formal complaints procedure but staff were observed to have the skills to communicate with them well. People appeared relaxed at the home and staff engaged with them easily. There is regular opportunity for discussion, one to one or within a house meeting when concerns could be raised. The home report no complaints made within the last year and the Commission have received no complaints about the home. Staff are aware of how to safeguard people from abuse and the homes whistle blowing procedure also provides that information. There has been one safeguarding alert within the last twelve months associated with the home. This alert was made by the home itself. The organisation took robust steps to ensure the well-being of people who live there. There is strong management within the organisation with a passion for the peoples protection. Care Homes for Adults (18-65 years) Page 22 of 31 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service live in a home, which is clean, well furnished, warm, safe, comfortable and meets their individual needs. Evidence: We looked around the home, including each persons bedroom. It was warm, clean and fresh throughout. The furnishings and decoration are modern and in a good state of repair. Each person is able to choose the colour scheme and furnishing for their room. One person told us his bed was very cosy. Furniture is purchased which suits the particular lifestyle of the person, in one case this being a sofa so they can relax as they prefer when listening to music. The laundry facility is adequate to meet the needs of the people currently living at Stone Cottage and the kitchen contains modern equipment. No person has washing facilities in their room but the home contains an attractive bathroom and also a shower room. There is no disability equipment necessary within the home. The outside of the home provides space, is tidy and well kept. The home is well Care Homes for Adults (18-65 years) Page 23 of 31 Evidence: maintained and in a good state of repair. Since a visit by a fire safety officer the home have changed the layout of rooms to improve safety. The risk which had been identified was mostly to staff. Care Homes for Adults (18-65 years) Page 24 of 31 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service benefit from staff that are skilled, experienced and well supervised. They are protected through robust recruitment practice. Evidence: We had discussion with the acting manager, the deputy and a new member of staff, at the home for only three weeks. Staff told they are never asked to care for people outside their area of expertise and confirmed that support and advice is always available to them. They receive formal supervision of their work six times a year and appraisal weekly, then monthly, then six and twelve monthly when new to the home. We were told that there is always one staff to one person at the home, with the exception of two staff to one sometimes for outside visits and one awake and one asleep at nights. A staff member described his recent recruitment and discussed his induction to the organisation, home and work. He was not yet working unsupervised and we saw this in practice, senior staff stepping in to change something when they had recognised this was necessary. The registered provider ensures staff are in no doubt as to what is expected of them. Care Homes for Adults (18-65 years) Page 25 of 31 Evidence: Staff training provides them with the knowledge necessary to deliver a high standard of care also ensuring people and staff are safe. It includes fire safety, food hygiene and behaviour management. Staff consider the training to be of good quality. Care Homes for Adults (18-65 years) Page 26 of 31 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, run in peoples best interest and their health and safety are properly attended to. Providing quality care is the focus of the organisation. Evidence: There is an effective management structure within the organisation. The registered manager of Stone Cottage is Mr. Michael Brummitt. He was not available for the inspection, but the person who holds the legal responsibility for the home on behalf of the organisation was. We also spoke with the staff who manages the home on a day to day basis and the deputy manager. The deputy manager is currently undertaking the organisations own trainee managers course. Neither acceptance on the course, or a post in management following the course, are guaranteed, but based only on performance and achievement. Peoples welfare is the prime concern and there is very strong leadership and support for staff. Staff are clear what is expected of them and feel very well supported in their work. Where staff performance is not acceptable immediate steps are taken. Care Homes for Adults (18-65 years) Page 27 of 31 Evidence: We discussed the Mental Capacity Act and deprivation of liberty safeguards with the Responsible Individual, Mr. Paul Hewitt. The organisations own policies and procedures regarding liberty are clear, detailed and ensure any restriction in liberty is for a good reason and for a very limited period of time. However, it was agreed that application would be made to test that the home is compliant with this new legislation, in place to protect people. The health, safety and welfare of people who use the service are met through effective care planning and support, competent staff, good management and administration and investment in the building. Care Homes for Adults (18-65 years) Page 28 of 31 Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 29 of 31 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 30 of 31 Helpline: Telephone: 03000 616161 or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 31 of 31 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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