Inspection on 28/05/09 for Redroof House

This is the latest available inspection report for this service, carried out on 28th May 2009.

CQC found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Redroof House 04/12/08

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Extracts from inspection reports are licensed from CQC, this page was updated on 07/08/2009.

Key inspection report Care homes for older people Name: Address: Redroof House 40 Mill Road Epsom Surrey KT17 4AR     The quality rating for this care home is:   two star good 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: Lisa Johnson     Date: 2 8 0 5 2 0 0 9 This is a review of 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 2 1 0 stars - excellent stars - good star - adequate 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. that people have said are important to them: They reflect the things 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 Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People 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 Older People Page 3 of 25 Information about the care home Name of care home: Address: Redroof House 40 Mill Road Epsom Surrey KT17 4AR 01372748247 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mr Ranjith Hikkaduwa Liyanage,Mr Nethaji Jayawardana,Maithri Jayawardana care home 5 Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users to be accommodated is 5. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Date of last inspection Brief description of the care home Redroof is a converted House set in its own grounds. It is close to a shopping area and is approximately ten minuites from Epsom town centre by car. The service provides support to five adults with learning disabilities. Accomodation is situated over two floors . One bedroom is provided on the ground floor. There are two sitting rooms and a large kitchen. There is one communal toilet on the ground floor. Three bedrooms have en suite facilities and the other two bedrooms have access to a large bathroom which has a jacuzzi bath. Care Homes for Older People Page 4 of 25 Over 65 0 5 Brief description of the care home There is a small enclosed garden to the rear of the property and car parking spaces are available at the front of the house. The weekly fee is £1,000 Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This visit was part of a key inspection. The site visit was unannounced and took place over three hours and twenty minutes commencing at 9:20am and finishing at 12:40pm. Mrs. L Johnson regulation inspector carried out this visit. Mr. N Jayawardana registered manager represented the service . During this visit we spoke to one person who lives in the service and we had the opportunity to speak with this persons advocate. We spoke with the registered manager and we received surveys from two health and social professionals . These comments are reflected throughout this report. During this visit we conducted a tour of the premises, looked at a persons care plan , risk assessments, medication administration records, staff personnel and training records, quality assurance systems and policies and procedures. Care Homes for Older People Page 6 of 25 The last key inspection was conducted on 4th December 2008. the home was issued a statutory requirement notice in respect of staff recruitment practices. A Follow up random unannounced inspection took place on 26th January 2009 to assess compliance,which had been met. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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 Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 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 and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. 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 them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people are provided with accessible information that they need to know make an informed choice about the suitability of the home as a place to live. Peoples needs are assessed prior to admission. Evidence: The home has a statement of purpose, which is made accessible to people and is formulated in pictures. Information includes the homes aims and objectives, complaints procedure and the services that it is able to provide. Since our last inspection which was undertaken six months ago there have been no new people admitted to the home. There is currently one person residing in the home and information seen demonstrated that information was obtained from the care manager, health care professionals and previous placement. A pre admission assessment was carried out by the manager, which covered the Care Homes for Older People Page 10 of 25 Evidence: persons health, personal, emotional and social needs. The manager has recognised that they wish to make further improvements in assessing in more detail peoples cultural and diverse needs. Surveys received from a care manager and health care professional surveyed stated that the services assessment arrangements ensure that accurate information is gathered . Care Homes for Older People Page 11 of 25 Health and personal care 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 health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they 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. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them 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. People receive support from staff in the way they want and prefer and their physical and emotional needs are met. The home supports people with their medication in a safe way. Evidence: The service has implemented accessible, detailed and comprehensive care plans. Since our previous visit these have been further enhanced with a range of pictures. A care plan for one person living in the service was viewed, which was based on their health, personal, social, emotional, social, cultural and religious needs. A review has taken place since our previous visit and an action plan has been implemented. A health care professional surveyed said, The home provides an individual approach to caring for the service user that they are currently supporting. Two health and social care professionals stated that peoples health care needs are monitored, reviewed and met by the service and that the persons privacy and dignity is always respected. One health care professional said, The home will ask for support with issues that they are unsure about. Care Homes for Older People Page 12 of 25 Evidence: The care plan clearly records the persons likes, dislikes and preferred routines recorded as What matters to me. Information seen in this persons care plan demonstrated that their health and personal care needs are recorded , which included guidelines for staff in supporting this person with a health matter that they have. A moving and handling assessment has been completed and their nutritional needs have been assessed. This person has been supported to access a range of health care professionals including General Practitioner, community team for people with learning disabilities, opticians and dentist. The outcomes of any health care consultations were recorded. The manager told us that a referral had been also made for the involvement of an independent mental capacity advocate (IMCA) to represent this person in respect of dental treatment. The homes medication administration practices were examined. Since our previous visit the home has acquired a locked medication cupboard, which now ensures that medication is stored more safely. Medication is dispensed using the monitored dose system (MDS). The home uses the services of a local chemist and arrangements are being made with them to visit the home to carry out audits and to conduct staff training. The chemist currently does not supply printed medication administration records, therefore these are recorded onto a Medication record implemented by the home. Arrangements are now in place to ensure that these are checked by two members of staff. The medication administration record was signed confirming that the persons medication had been administered. Systems are in place for the receipt and disposal of medication. Care Homes for Older People Page 13 of 25 Daily life and social activities 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 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. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. 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 are supported to participate in activities that meet their needs and preferences and access the local community. People maintain links with their family and friends and their choices are respected. People receive varied and well balanced meals. Evidence: During this visit we looked at the activities that the person living in the service takes part in. information was recorded in their personal plan in How i spend my week section. The care plan also contained comprehensive information about what the person enjoys. Records were maintained of all activities and social events that the person had participated in including attendance at a weekly social group, visits to places of interest, going shopping,foot and hand massages and visits to church, which meets their religious needs. This person has particular interest in music and has favourite singers. This persons preference has been supported by the home with the purchase of a music centre and a range of DVDs. Since our last inspection there have been no new people admitted to the home, however the last inspection informed us that people would be supported to maintain links with their families and friends and there is open visiting policy with no restrictions. A person currently living in the service had been supported by an Care Homes for Older People Page 14 of 25 Evidence: advocate. People are supported to make choices in their daily lives including, choosing their meals. A person living in the service is encouraged to choose their preferred breakfast cereals and during this visit was offered their preferred choice of beverage. During this visit good interaction was observed between the manager and the person living in the service who was observed to be relaxed and told us that he was happy living in the home . During this visit this person chose to spend time listening to their favourite music , which was respected. This persons advocate said that staff worked with their client in making choices in a gentle and supportive way. A health care professional surveyed said, The home promotes choice well The service has four weekly menus in place and the person living in the service is encouraged to choose their meals and pictures are provided to assist them. Records were maintained of meals provided. This person has dietary requirement which has been monitored by the General practitioner and a dietetic assessment has taken place. Care Homes for Older People Page 15 of 25 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. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. 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 are provided with a complaints procedure and know how to complain. The home safeguards people from abuse. Evidence: The home has an accessible complaints procedure, which is formulated in pictures. This information is provided to people in the service user guide . Since our previous visit the service has not received any complaints and none have been brought to the attention of the Commission. Since our previous visit the homes safeguarding vulnerable adults from abuse procedures have been reviewed, which now makes reference to the local authority procedures. The manager has obtained the updated version, which has been brought to the attention of staff, confirmed by a read and sign system that is in place.The registered manager informed us that they will be shortly attending the local authority safeguarding vulnerable adults from abuse training and they are planning to attend the vetting and barring work shops, which will provide information about this scheme,which will be coming into operation. Since our previous visit one safeguarding referral was made following the local authority policies in relation to recruitment practices in the the service. The service has now improved their recruitment practices ensuring that people using the service are safeguarded . (See standard 29) Care Homes for Older People Page 16 of 25 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, 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. 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 living in the service have a comfortable, homely, safe, well maintained and clean home to live in. Evidence: The service provides a good standard of accommodation, which is well decorated and furnished to a modern style providing a comfortable and homely atmosphere. There is a large kitchen diner, and a large and smaller separate lounge.A communal toilet is available on the first floor and there is a large bathroom, which is provided with a jacuzzi style bath. There is a small enclosed garden to the rear of the property. Since our previous visit the home has now acquired a portable ramp to ensure that people using wheelchairs can access the home. A health care professional surveyed said, Redroof House has achieved a very pleasant, homely environment One bedroom on the ground floor is provided with en suite facilities and four other bedrooms are situated on the first floor which were comfortable and colour coordinated. One persons bedroom has en suite facilities and since our previous visit handrails have been installed to enable this person to maintain their independence. At the time of this visit the home was cleaned to a good standard and was hygienic. Infection control procedures are in place and we were informed that infection control is touched on during staff health and safety training. Since our previous visit the home Care Homes for Older People Page 17 of 25 Evidence: has received a visit from the environmental health office which was satisfactory. One health and safety matter was identified during our tour of the premesis .(see standard 38) Care Homes for Older People Page 18 of 25 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 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 to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by appropriate numbers of staff who are competent and in the main trained to meet their needs. People are protected by the homes recruitment policies and practices. Evidence: Currently there is only one person living in the service who is supported by one member of staff during the day. At night time they are supported by a waking member of staff. We were informed that two other members of staff are employed in the home with other cover being provided by the owners other home. The duty rota was viewed which was now accurate reflecting clearly who was on duty. A majority of care staff providing support have obtained National Vocational Qualifications (Level 2) and some staff are completing level 3. New staff receive induction, which was demonstrated by records viewed, which is based on Skills for Care core induction standards. The registered manager has implemented a training schedule, which details statutory training that staff have received including, safeguarding vulnerable adults from abuse, health and safety, fire awareness and moving and handling . One persons file contained a certificate in first aid. The Manager informed us that arrangements are being explored for staff to receive refresher training. The manager was advised to Care Homes for Older People Page 19 of 25 Evidence: maintain this record on the training schedule. The manager informed us that they have attended mental health capacity act training and is aware of the deprivation of liberty training. The manager was advised to provide staff training in equality and diversity and supporting older people ensuring that peoples needs are met in this specialism. Recruitment is based on equal opportunities. During this visit we sampled three members of staff recruitment files , which included the records for the most recent appointed member of staff who was not able to commence employment at the time of last inspection until required documentation had been obtained. Staff files now contained two written references, Protection of vulnerable adult first Checks (POVA) and enhanced criminal record bureau checks (CRB). Significant improvement has been made in improving staff recruitment practices ensuring that people using the service are safeguarded. However this must be sustained, therefore this is reflected in the rating in this outcome group Care Homes for Older People Page 20 of 25 Management and administration 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 led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate 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. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is run by an experienced manager in post. Peoples financial interests are safeguarded and the environment . The health, safety and welfare of people is in the main promoted and protected. Evidence: There is an experienced registered manager in post who is a qualified learning disability nurse and has obtained a management diploma. At the previous inspection the manager was also the registered manager of the providers other home but this has now ceased. There are also two other registered providers. The service holds team meetings. A health care professional surveyed said, There is an open door policy. At the previous inspection carried out six months ago we were informed that the home had implemented a dignity in care audit. As there is currently only one person residing in the service who has only lived there for six months feedback surveys have not been conducted yet, but we were provided with the format the home intend to use. The manager and providers are-in the process of preparing a format to use to complete Care Homes for Older People Page 21 of 25 Evidence: monthly monitoring visits and is aware that this is required. This is being planned to commence shortly. A person living in the home requires support to manage their finances. Records were available for viewing. Systems were in place to demonstrate that records and balances of expenditure were appropriately maintained. There are a range of systems in place to ensure peoples health and safety is protected. Regular environmental audits and risk assessments are conducted. Water temperature monitoring takes place and substances hazardous to health were appropriately stored.Since our previous visit the home has received a visit from the fire authority and appropriate assessments are in place and the home is currently implementing the requirements made as a result of their visit. During a tour of the home it was observed that radiator covers were provided in some of the communal areas , although these were not available in the kitchen and we were informed that these were not available in bedrooms. Therefore it was required that a risk assessment is carried out in consultation with the environmental health office about the suitability of the current arrangements. This is to ensure the safety and wellbeing of people living in the service. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 38 13 The registered person must carry out a risk assessment of the uncovered radiators radiators and take any neccessary action on the outcome. This is to ensure the safety and well being of people living in the service 01/07/2009 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 Older People Page 24 of 25 Helpline: Telephone: 03000 616161 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. 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