Inspection on 03/10/06 for Gladstone House

This inspection was carried out on 3rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Gladstone House 08/09/05

Gladstone House 05/05/05

Gladstone House 06/01/05

Gladstone House 29/11/04

Similar services:

Thorndene

Sutton Lodge Nursing Home

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 24/26 St John`s Road 24/26 St John`s Road Redhill Surrey RH1 6HX Lead Inspector Mary Williamson Key Unannounced Inspection 3rd October 2006 11:00 24/26 St John`s Road DS0000052048.V314052.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 24/26 St John`s Road DS0000052048.V314052.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. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 24/26 St John`s Road Address 24/26 St John`s Road Redhill Surrey RH1 6HX 020 73 881266 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) RNIB Mark Eckersley Care Home 6 Category(ies) of Learning disability (6), Physical disability (6), registration, with number Sensory impairment (6) of places 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th September 2005 Brief Description of the Service: 24/26 St Johns Road is a home for people with Sensory Impairment and Learning Disabilities owned by the Royal National Institute for the Blind. The home is in a residential area of Redhill. All of the Service Users attend the RNIB College. Each service user has an individual bedroom. The property is close to all local amenities and transport. There is a small garden to the rear of the premises. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was undertaken by Mary Williamson the Lead Inspector for the service. The home manager Mark Eckersley was present throughout the inspection. The inspector originally called at 11.00 hrs and all the service users and staff were out shopping, or attending college, so the inspection commenced at 13.00 hrs. S, one of the service users answered the door and welcomed the inspector into their home. It was possible to spend a considerable amount of time talking to S and B in the kitchen and gaining a very good insight of what it is like to live at St Johns Road. They had both been shopping earlier for shelving and a book case which they were keen to show the inspector. It was also possible to meet other service users during the course of the inspection. A tour of the premises was undertaken and records relating to the care of service users and the management of the home were examined. There was the opportunity to meet staff and observe various routines of the home. There were no relatives, or other professionals visiting the home during the inspection. General discussion took place regarding the future of The RNIB College and prospects for the service users living in community homes who access The College facilities. The inspector would like to thank the service users and the staff for their help and positive approach to the inspection process. What the service does well: The home provides support to service users in a sensitive and caring manner to promote independence. Risk assessments are not restricting and service users are encouraged to take an active part in all aspects of daily living. Strengths and needs are outlined in well- maintained care plans as agreed with individual service users. The service provides a comfortable well- decorated and safe environment for service users to live in taking into account need choice and age. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 6 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. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4, and 5. Quality in this outcome area is good. Judgement has been made using available information including a visit to the service. The statement of purpose and service user guide provides service users with the appropriate information regarding the choice of home. Needs assessments and contracts of occupancy are also in place. EVIDENCE: Service users have access to a statement of purpose and service users guide. B stated that he has this on a CD and S stated that he has a paper copy, this can also be provided in Braille format if required. Pre admission needs assessments are in place. These are undertaken by the manager with input from the multidisciplinary team on all service users in order to establish the suitability of the placement. Assessments were seen for S, B, and R. These were informative and formed the basis of individual care plans. S informed the inspector that trial visits are undertaken prior to admission to the home. Individual contracts of occupancy are in place outlining the accommodation and support offered and the method of funding. These are signed by the service user or their designated representative and retained on file. 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9, and 10. Quality in this outcome area is good. Judgement has been made using available information including a visit to the service. Needs and strengths are reflected in good care plans, which include risk assessments and are handled in confidence. Evidence indicated that service users are included in all aspects of life in the home. EVIDENCE: Individual care plans are in place for all the service users. These are based on the per- admission needs assessment, input from the service users and information from families. Care plans were seen for B, S, and R, which were informative, well maintained, reviewed on a regular basis and individually signed. Service users are encouraged to take risks and make decisions as part of an independent lifestyle. Assessments are in place for all identified risks and do not restrict movement or choice. The emphasis of the home is to support the service users to undertake activities, which will maximise their ability and promote independence. One service user can walk to the local shop while another can use a taxi with confidence. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 10 Information and records relating to service users are stored in a secure place when not in use. 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, and 17. Quality in this outcome area is good. Judgement has been made using available information including a visit to the service. Appropriate activities meet individual and collective needs. Family and friendship groups are maintained and a varied diet is offered. EVIDENCE: Each service user has an activities plan, which includes opportunities for personal development at the nearby RNIB College. B and S stated that they go shopping for food at the local Sainsbury’s. They also like the “pub club”, going to football to support Southampton, visits to the cinema and theatre, trips out, music, videos and television. The service users also stated that they enjoyed a holiday last month in Somerset where they visited a cider farm. They have another holiday planned in December. Family links are maintained and relatives are encouraged to take an active part in the care planning process and attend reviews of care. Some service users go home for weekends and more have holidays during half term or college holidays. Friendship groups are also encouraged and S stated he likes to meet his friends in the pub. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 12 Service users with support of their key worker plan the menus weekly. These are displayed in the kitchen with easy access. Service users are supported to plan and shop individually for the meals they prepare on a one to one basis. S is a vegetarian and is very competent in his choice of food. Some service users take a packed lunch to college, which they prepare with support. The food offered is wholesome and nutritious. The kitchen is well maintained clean and tidy. Some of the equipment has been adapted to promote independence and includes a whistling kettle, talking microwave, and non- slip chopping boards. 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, and 20. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. Staff support service users with personal care ensuring their independence and privacy is observed. Arrangements are in place meet the basic medical needs of service users. EVIDENCE: Five service users are registered with a local GP and one is registered with a GP in Oxford Road. The manager stated that he is currently in discussion with the PCT, as five service users are not offered a yearly medical check up, however they can see a doctor when necessary. B stated that he is very happy with his doctor. Dental care is now in place for all service users. The manager also stated that he had to find them an alternative dentist due to the lack of NHS funded surgeries. Optician services are accessed and specialist services are available at East Surrey Hospital when required. Personal support is offered in a sensitive and professional manner as outlined in individual care plans. S stated that he likes help with buttons. The home has a policy in place for the administration of medication. All staff who administers medication are familiar with this policy. Currently one service user is undergoing a programme of self- medication. There is a risk assessment for this. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 14 The medication recording charts were seen and are well maintained. Townsend Pharmacy undertakes regular medication audits. They also provide the medication for the home. All staff took part in three hours refresher medication training the previous week. 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. The complaints and abuse awareness policies in place protect the service users. EVIDENCE: B and S stated that they have a copy of the complaints procedure in their bedroom. One is in print format the other no a CD. This is also available in Braille on request. There have been no formal complaints since the last inspection. A record of minor “niggles” are kept and discussed at service user meetings. There is also an abuse awareness policy available in the above formats. The home has a copy of Surreys Multi Agency Safeguarding Vulnerable Adults Policies and Procedures in place and both the manager and deputy manager have attending training in these procedures. This has been cascaded throughout the staff team. 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 28, and 30. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. Service users live in a homely, comfortable, and safe environment. EVIDENCE: The home is clean comfortable and well maintained. The lounge has been recently decorated providing a pleasant and comfortable room to watch television, videos, play music, and games on the play station. Bedrooms are single and are personalised to reflect individual hobbies and interests. B and S had been shopping for shelves and a bookcase on the day of the inspection and staff were supporting them to assemble these. There is a small laundry room situated on the ground floor where service users are supported to do their laundry. There is also a control of infection policy in place. There is a garden to the rear of the property, which was identified at the last inspection for improvement. Plans are now in place for this to be landscaped and work is due to commence on 20/10/2006. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 17 24/26 St John`s Road DS0000052048.V314052.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, and 35. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. A competent, and trained team of staff supports Service users. Recruitment practices are safe. EVIDENCE: The number and skill mix of staff on duty was sufficient to meet the assessed needs of the service users. All staff undertake induction training including fire safety, manual handling, food hygiene, health and safety, abuse awareness, and first aid and this was evident on inspection of training files. Other training observed includes equality and diversity; activities risk assessment, visual awareness and sighted guide. The service users are protected by the home’s recruitment policy and practice. The manager stated that service users are involved in the recruitment of staff. Employment records were seen for two staff. These are well maintained and contain all the required employment documentation including a CRB (Criminal Records Bureau) reference number. S and B stated “ we are very lucky with the staff in this home” 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, and 42. Quality in this outcome area is good. Judgement has been made using available evidence including a visit to the service. The service users benefit from a well run home which, promotes the health safety and welfare of the service users. EVIDENCE: The home is well managed by a competent manager who has a good understanding of the needs of the service users in his care. He is well supported by a deputy manager and a competent team of staff. The manager is currently undertaking his Registered Managers Award, and the deputy manager is currently undertaking her NVQ level4. Quality assurance is monitored by service users meetings, regular reviews of care, monthly regulation 26 visits, and audits. It was recommended that quality assurance be formally monitored. The manager stated that the RNIB is working towards producing a service users feedback form for this purpose. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 20 There is a wide range of health and safety policies and procedures in place, which promote safety in the home. The staff were seen to observe COSHH procedures. The fire safety records were seen and are well maintained. Fire alarms are tested weekly and records kept. There is a contract in place for the maintenance of fire fighting equipment and emergency lighting. Regular fire evacuations are undertaken All accidents are recorded. The accident records book was seen and was well maintained. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 21 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 3 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 X 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 22 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 2 Refer to Standard YA24 YA39 Good Practice Recommendations It is recommended that the home manager informs the inspector in writing when the proposed work on the garden has been completed. It is recommended that the organisation implements a standard quality assurance monitoring questionnaire for all their registered home in order to be able to formally monitor quality. 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 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 24/26 St John`s Road DS0000052048.V314052.R01.S.doc Version 5.2 Page 24 - 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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