Inspection on 05/05/05 for Gladstone House

This inspection was carried out on 5th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Gladstone House 03/10/06

Gladstone House 08/09/05

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 Johns Road 24/26 St Johns Road Redhill Surrey RH1 6HX Lead Inspector Cathy Clarke Unannounced 5 May 2005 13.45 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 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 Stationary 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 Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 24/26 St Johns Road Address 24/26 St Johns Road Redhill Surrey RH1 6HX 0207 388 1266 Telephone number Fax number Email 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 Care Home 6 Category(ies) of LD Learning Disability (6) registration, with number PD Physical Disability (6) of places SI Sensory Impairment (6) 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. The requirements made at the Fire Officers visit on 9th February 2004 will be actioned within the agreed timescale. 2. The recommendations required in the planning officers report will be actioned within the agreed timescale. 3. The requirements made after the pharmacy inspectors visit will be actioned within the agreed timescale. Date of last inspection 6 January 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 in a residential area of Redhill. All of the Service Users attend the RNIB College. Each service user has their own bedroom. There is a small garden to the rear of the property and local amenities and transport are close by. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over 4 hours and was the first inspection to be undertaken in the Commission for Social Care Inspection year April 2005 to March 2006. Cathy Clarke, Lead Inspector for the service, carried out this inspection Mr. Mark Eckersley and Mrs Heather Peters were present as the representatives for the establishment. A full tour of the premises took place and documents inspected included care plans, menu plans, staff records policies and procedures. Five service users were spoken to during the inspection. This was a positive inspection. The inspector would like to thank the staff and service users for their time, assistance and hospitality during this inspection. What the service does well: What has improved since the last inspection? A more proactive approach to developing the skills that service users require to promote their independence. Some of the service users have put together some bedding plants in pots and these are displayed in the rear garden. Radiator covers that were deemed as institutional in appearance have been replaced. In fact all of the radiators and covers have been changed throughout 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 6 the home bar one bedroom and the kitchen where replacement was not required. Blinds have been fitted to the bathrooms. The home previously had two boilers in place and this has now been replaced with a single boiler. Furniture for the lounge has been replaced and there is an ongoing maintenance and refurbishment plan in place. New curtains and nets have been purchased throughout the house. Work on the upstairs bathroom and moving the position of the bath has eradicated the cause of the damp patch to the downstairs bedroom ceiling. 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 Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 standard(s) 1,2,5 The homes statement of purpose and service user guide has been developed in appropriate formats providing prospective residents with details of the services the home provides enabling an informed decision prior to admission. EVIDENCE: The statement of purpose and service user guide was reviewed in October 2004. Details relating to the new manager are to be included. There have been no new service users since the last inspection. Each new resident would be assessed using the RNIB assessment tool. Goals are set for service users and the outcomes are recorded in the care plan. During inspection residents files were sampled and seen to contain signed copies of contracts outlining the terms and conditions of their stay. Please see requirements section of this report. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9,10 There is a proactive approach to promoting the independence and life skills of the service users through careful care planning and risk assessment. Confidential information is protected and stored appropriately. EVIDENCE: Individual plans of care are drawn up with the service user and the key worker. Two of the service users spoken to confirmed that they lead the meetings with their key workers and that the plans are reflective of their individual needs. One service user commented that since working with his key worker he has learnt how to make his own sandwiches and puts his washing in the machine. He also likes to go singing and take part in gigs, which he is pleased he gets paid for doing. Discussion was held with one of the service users who wants to take part in daily living tasks but finds the locking of the COSHH cupboard a nuisance. This was discussed with the service users and management and the problem has been resolved. A risk assessment has been undertaken and was seen on file. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 10 The service has a confidentiality policy in place and all information relating to service users is kept in locked cabinets within the office. The computers are password protected. Each service users file contains a confidentiality contract. The chairperson makes a statement relating to the confidentially of information shared within review meetings. Information given in confidence is not shared with families/friends unless permission has been specifically confirmed. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14,16 The ethos of the service is to provide opportunities for service users to achieve their development goals, making them more independent and offering a range of educational and social activities. EVIDENCE: All service users attend the RNIB College and take part in a number of activities at the college, which assist with maintaining and improving their independence. One of the service users was at college during the inspection rehearsing for the summer show. Two service users work in local charity shops. Service users confirmed that they like to attend the pub club on a Friday. One of the service users was looking forward to going home at the weekend because it will be his birthday and he is going to celebrate with his family. Service users enjoyed the trip to a local theme park and have photos displayed in their rooms. This weekend two of the service users will be remaining in the house and staff are going to access the homes transport and they are going to go out. One of the service users said he would like staff to take him to the 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 12 cinema or bowling. An excursion to the ice rink was very popular and one of the service users explained that he had skated for the first time and managed not to fall over. During the inspection three of the service users were playing on a play station game based on general knowledge a lot of fun and interaction from both staff and service users was gained. One of the service users is moving to Italy to live with family in June and has said that she will donate some of her books to a woman that she knows in the local community and others to the home and other service users. The service user was concerned that she would not be permitted to give gifts to the staff when she leaves and it was suggested that maybe she should speak to the senior managers at the RNIB to ascertain whether this is allowed under the present policies and procedures. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 standard(s) 19,20 Staff support and assistance with personal care is given ensuring the independence of the resident is paramount. EVIDENCE: Three service users require assistance with personal care tasks and this is provided in private. All other service users are prompted to get ready for college or the day ahead. An aroma therapist visits the service users weekly and chiropody treatments are on offer as required. All service users are registered with a local GP. Medication administration records (MAR) were checked for all service users and were correctly completed signed and dated. One of the service users takes medication with him to college and he signs a medication handover book. An audit check of the MAR charts was conducted to verify the correct codes were allocated for medications given when service users are away from the home, and these were found to be correct. Medication is stored appropriately and staff signatures are identified in the medication records file. During the inspection it was noted that Pharmaceutical advice had been given and recorded on file. Boots the Chemist provides all staff training. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 14 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 standard(s) 22,23 Policies and procedures are in place for dealing with complaints and the protection of service users from abuse, neglect or self-harm. EVIDENCE: There have been no complaints since the last inspection and service users spoken to during the inspection confirmed that they know who to take any issues or complaints to. There is a vulnerable adults policy and procedure in place. Most staff have attended training provided by Surrey County Council and follow the Surrey Multi Agency Approach to the prevention of abuse. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 15 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 standard(s) 24,26,27,28,30 The standard of the environment within this home provides service users with an attractive and homely place to live. There are plans in progress to improve the décor and furnishings within the home. EVIDENCE: The home has a maintenance plan in place and much work has been completed since the last inspection. All of the radiators within the home have new radiator covers and radiators with thermostatic valves have been replaced in all rooms bar one of the bedrooms and the kitchen. The two-boiler system has been replaced by a single boiler system and the bath in the upstairs bathroom has been moved to eradicate a problem with the plumbing. Service users have said that they like the new furniture in the lounge. There are plans to provide new dining room furniture. Pipes on the rear wall near the door to the garden in the kitchen must be boxed in. Service users were interviewed in their rooms and said that they are pleased with the furnishings and way that they are decorated. The premises are clean and tidy and free from any mal odour. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 16 One of the service users showed me a patch on her ceiling where water has previously come through from the bathroom above. We discussed the fact that although this was a requirement from a previous inspection the service had been working to correct the problem in the bathroom upstairs and would now be in a position to complete the outstanding maintenance to her ceiling. The service user will be moving out shortly and we discussed whether it might be better if the work were completed after she had vacated the room. Blinds have been fitted to all bathrooms and net curtains and drapes have been changed throughout the house. A staged approach to redecoration of the home is to be undertaken. The colour scheme is to be changed to give a more peaceful image. Staff explained that the dining room is to be changed into an activities room; the service is taking advice on colour schemes from the rehabilitation department of the RNIB College. One of the service users spoken to during the inspection commented that she would not feel confident out in the garden without assistance because of the uneven surfaces. The manager would like a planned approach to the garden refurbishment with the involvement of service users who enjoy gardening. Three of the service users have put bedding plants into tubs and these were on display in the rear garden. Please see requirements section of this report. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,36 All interactions observed between staff and service users evidenced a high degree of respect and skill in working with the individual service users at the home. Staffing is currently under review and the number of staff employed must meet the needs of service users. EVIDENCE: During the inspection there was only one member of RNIB staff and one agency worker on duty. The member of full time staff had been on her own for the morning until the agency member of staff arrived at 11am. This meant that the member of staff was responsible for assisting all service users to get ready for college. Five of the service users were in the home at the time of inspection because activities at the college had been cancelled due to staff sickness at the college. This meant that service users were prevented from going out because there were insufficient staff on duty to escort them. The manager explained that staffing is being analysed and that the RNIB are looking into resolving some of the issues. Staff files sampled evidenced job descriptions, current photographs, copies of identification and two employee references. Criminal record bureau checks are held centrally at the RNIB College Campus. The file for the latest recruit was requested but not available for inspection. This member of staff was transferred internally and his recruitment records are held in his previous placement. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 18 Staff undertake induction and foundation training and workbooks seen during the inspection were of a good standard. Each section being signed off on completion. Workbooks are compliant with Skills for Care standards. All staff bar two are NVQ trained. The manager and deputy manager are undertaking NVQ Level 4 Registered Managers Award. The service is supplied with a snapshot of each agency worker before commencing duty. The snapshot for the agency worker on duty on the day of inspection was not supplied. It is recommended that snapshots specifically identify what training agency staff have undertaken. Supervision is conducted at least six weekly. Annual appraisals are to be carried out shortly the manager has not received appraisal training for some time and would benefit from an update programme. Regular staff and service user meetings are held. The agenda for which is posted on the notice board. Service users are supported to put items on the agenda for discussion. Please see requirements section of this report. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38,39,42 The management approach at the home provides an open, positive and inclusive atmosphere. EVIDENCE: The homes ethos is to promote the independence of individuals living there. The manager is to seek approval to become the registered manager with the Commission for Social Care Inspection. Service users attend regular meetings and contribute to setting the agenda items for the meetings. Key workers monitor the progress that service users have made towards independence. Service users are encouraged to give their views on how the home should be adapted to meet their needs. Health and safety checks have been carried out throughout the home and fire evacuations are carried out each month. Fire notices are in a written format and the suitability of this was questioned with the manager. Service users are 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 20 informed when there is going to be a fire alarm check. Self-closures are fitted to the bottom of doors. The dining rooms self-closure mechanism was not working on the day of inspection. Fire extinguishers were serviced on the 1st May 2005. There is a talking microwave in the kitchen and level indicators for liquid drinks. Risk assessments are in place for all service users. Please see requirements section of this report. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 3 2 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 2 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 24/26 St Johns Road Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 3 x x 2 x H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 22 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4 (1) (c) schedule 1 5 (1) (a)) 23 (2) (b) 23 (2) (d) Requirement New manager details to be included in Statement of Purpose and Service User Guide. pipes on the rear wall of the kitchen must be boxed in. The registered person shall having regard to the number and needs of the service users ensure that all parts of the care home are kept clean and reasonably decorated. This was a previous requirement timescale for completion 18.3.05 . This timescale has been extended. The garden to the rear of the property must be maintained to give access to service users with a visual impairment The registered person shall having regard to the size of the care home, the statement of purpose, and the number and needs of service users ensure that at all times suitably qualified, competent, and experienced persons are working at the care home in such numbers as are appropriate for the health and welfare of the service users. This was a Timescale for action 31/07/05 2. 3. 24 26 31/07/05 31/08/05 4. 28 23 (2) (b) 31/08/05 5. 33 18 (1) (a) 30/06/05 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 23 6. 34 17 (2) previous requirement timescale for completion 18/03/05. This timescale has been extended. Recruitment records of staff transferred internally must be made available for inspection and held within the home. 30/06/05 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 33 Good Practice Recommendations It is recommended that snapshots of agency workers forwarded to the home contain specific details of training undertaken by individual agency staff. 24/26 St Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 Johns Road H58-H09 s52048 24-26 St Johns Road v224761 050505 Stage 4.doc Version 1.30 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!